By Melissa Garcia and Elizabeth Westley
Melissa Garcia is senior technical officer and Elizabeth Westley is the director of the International Consortium for Emergency Contraception (ICEC), hosted by Management Sciences for Health.
“What happened when you went to the pharmacy and asked for emergency contraception?” Melissa surveyed a room full of television and radio writers attending a workshop in the Democratic Republic of the Congo (DRC). The participants looked around, waiting for someone to speak up first.
“The pharmacist gave me a look, so I had to show him my PMC badge to prove I was there for research, not for myself!” said a woman from Population Media Center, an organization that produces educational soap operas to improve the health and well-being of people around the world. Writers in Nigeria had similar stories to tell. An older man in flowing traditional robes confessed “I walked up and down the street three times before I summoned the courage to enter the store.” A young family planning (FP) advocate joined the media training in Senegal, and wearing her hijab, reported that the pharmacist demanded to know who the pill was meant for.
Over the past year, the International Consortium for Emergency Contraception (ICEC) has led workshops in the DRC, Senegal, and Nigeria with radio and television writers working on entertainment for education programming to create storylines that provide information on emergency contraception (EC)–sometimes called the “morning-after pill”–to their diverse audiences. EC can reduce the risk of pregnancy when taken after unprotected sex – the sooner the better. But most women don’t know that that there is an alternative to crossing fingers and hoping anxiously that menstruation will start on schedule. According to DHS data, over 80% of women in the DRC and Senegal do not know that this “post-coital” contraceptive method exists; in Nigeria, 70% of women are not aware of emergency contraception. Compounding the problem, EC is mainly accessed through private pharmacies. What’s more, EC is often left out of family planning counseling sessions and information materials, and it is not consistently offered to survivors of sexual assault. So just how can women learn about this second-chance method of birth control?
ICEC is working to move the needle on awareness and to address misperceptions and misinformation about EC by mainstreaming it in popular media. If family planning clinics won’t talk about it, how about soap operas? Given that EC implies a sexual encounter, it already makes for compelling storytelling. American television shows such as ER and Boston Legal, and more recently East Los High and Master of None, have helped to raise the profile of EC in the United States, but EC has not, to our knowledge, been integrated into entertainment in Africa. ICEC is now working with the Population Media Center in the DRC and Nigeria and ONG-RAES (Réseau Africain pour l’éducation à la santé) in Senegal to ensure that writers and producers understand the basics of EC and to brainstorm scenarios that could be included in their radio and television programming.
To familiarize them with the topic, we gave the writers homework to complete in advance: to go into a pharmacy and ask for the emergency contraceptive pill. While this was a simple task for the writers in all three countries, who are experienced in creating content for radio and television and are used to talking openly about rather complicated and personal topics, many of them reported unease in entering a pharmacy to ask for EC. For them, learning about EC and how it works – as contraception, to delay ovulation—is almost always a revelation. One of the male writers even phoned his wife after the training to explain that they might have been able to prevent their last – unplanned – pregnancy, had they only known that they could. Amidst the ensuing laughter and warm, honest exchanges, the exercise reveals the underlying assumptions and some judgment—whether self-imposed or not—that come with an interaction around the purchase of a very safe pill.
Using the information from the EC workshop, PMC-DRC writers integrated EC into the dramas Vivra Verra (French) and Elembo (Lingala), which aired in 2015 and 2016. A large team of writers from PMC-Nigeria are working on including EC into two new radio dramas, one in Hausa and one in Pidgen, while in Senegal, writers are working on a television soap opera, C’est la vie, which focuses on a village health centre.
When awareness of EC is low, entertainment can be a powerful tool. But misinformation can spread easily and quickly as well. We are working to make sure that the people who create entertainment have accurate information about emergency contraception. We hope that as more programs feature storylines that mention EC as a second-chance option, more people will take it upon themselves to buy EC—even if it is embarrassing to ask for it in a pharmacy.