Recently, at the International Family Planning Conference in Ethiopia, I learned lots of great lessons. One contribution I’d like to make is about an important and rarely discussed topic: What women want when it comes to Family Planning.
At Penda Health we’ve discovered a way to learn really quickly want women want. How? We sell our family planning services instead of giving them away for free (or highly subsidized prices).
I find that if you give someone free services, they will often take them whether they like them or not. And they definitely won’t feel the right to complain. After all, it’s free.
This changes fast when you ask women to pay. Suddenly they are transformed into entitled, demanding and shrewd customers that ask questions and speak up (often loudly), when something isn’t going right. And well, they should. It’s their families they’re planning! Once you ask someone to pay for the services you start getting lots of firm feedback. How firm? They don’t show up.
Penda Health is a for-profit for this very reason. We like being dependent on our patients for our funding. It FORCES us to listen to them and offer the services exactly how women like them. If not, we go out of business.
In our first 18 months, we have learned a lot. We almost went out of business. But by continuously listening to our customers and making fast changes based on their feedback, we’ve found a model that people LOVE. How do we know? Our first medical centre is now self-sustaining based on the fees paid by our patients. They have lots of options, but they choose to pay for our services.
For the sake of context, Penda Health builds and operates outpatient medical centres that offer nearly comprehensive primary healthcare to the whole family, with an emphasis on services like family planning, cancer screening, immunizations and pre-natal care. We currently have 2 medical centres based in Nairobi. In less than 2 years we’ve delivered family planning to over 1,000 women. Our medical quality is highly regarded by Safecare, Africa’s leading medical quality auditor.
Here’s a few highlights of the lessons we’ve learned by putting our women in charge. Women want their family planning:
#1 To be delivered in a physical medical centre
#2 To be delivered in a medical centre where they can bring their whole family
#3 To be delivered in a medical centre that treats them for all of their primary health care needs
#4 Women need caring, empathetic medical providers that spend time counseling and educating them about family planning
#5 Women need to feel confident in their providers. If you want them to return to your centre you better train your providers to communicate well
#6 Women are most ready to learn about family planning in small groups at schools, churches, chamas or workplaces
It may not be right for everyone, but I think that if more family planning implementers and funders tried to get their beneficiaries (you can start calling them customers if you like) to pay for Family Planning services, we might learn a lot about how to deliver it well.