Shifts in Family Planning Interests in India during COVID-19

It’s no secret that COVID-19 has changed the way that we interact with healthcare worldwide. The pandemic and associated lockdowns have caused people, providers, and producers to shift the way that they interact with one another in order to maintain positive health-seeking and adoption behaviors. People have not been able to get information or access to services and products the way that they used to and it shows in how they interact on social media and on messaging services, like Nivi.

The COVID-19 lockdown in India began March 25 and content specific to COVID-19 was up and running by the end of the month (more on our response to COVID-19 here). Almost immediately there were changes; we saw nearly twice as many users engaging in the first quarter of the COVID-19 epidemic (April — June) compared to the first quarter of the year (January — March), with a 10% increase in users aged 15–24 years old. Initially, users wanted to know what to do about COVID-19 and how to maintain their sexual and reproductive health during the lockdown. But as time progressed, it became clear that despite being overwhelmed by a viral pandemic, users still had high interest in learning about fertility awareness, condoms, short-term acting methods (OCPs and IUCDs), and accessing family planning services and products.

Conversations on SRH and FP Methods

In terms of volume, Nivi users accessed family planning (FP) and sexual and reproductive health (SRH) conversations more than 300,000 times in the first six months of 2020. Among FP conversations, fertility awareness conversations were the most popular in all quarters, followed by conversations about short-acting methods. It is clear that during the initial shock of the pandemic, many users were very interested in conversations on condoms, ECPs, and OCPs. Growth in ECP conversations had the largest increase (95%) in user interest, albeit from a low level of access (only 3% of conversations accessed in Q1 were about ECPs). There were also high levels of growth for condoms (63%), OCP (61%), and implants (45%), indicating that many people wanted to maintain safe and healthy family planning methods despite all the chaos going on around them.

Building e-referrals during COVID
We started our COVID response aiming to deliver practical SRH information to users. We ran digital awareness campaigns to engage users on COVID topics of interest to them. After seeing the heightened interest in family planning methods as well as noting the barriers preventing users from accessing these products and services (no transportation access, fear of the virus, unsure if products will be in stock, unable to get a prescription), we started offering links to e-pharmacy and online consultations in India. Although the numbers are limited, we will continue to scale access via our partners, including Jhpiego, PSI, and Pathfinder, connecting Nivi users to provider networks including private pharmacies, nonprofit clinics, and government facilities.

While we may not be able to address all barriers, we can prioritize action on specific challenges and iterate (e.g. helping users get to a pharmacy, find a physician, or report stockout at a physical location). We tackle these issues by providing recommendations for e-pharmacies and online consultations with physicians. As Nivi continues to engage and refer users, we expect to see more interest in using online services to meet family planning needs. Working with our service delivery partners, we make recommendations and referrals to nearby clinics and practitioners who have the products and services that Nivi users want. We will continue to smooth users’ self-care health journeys, facilitating these conversations about family planning, and working with our pharmacy and physician partners.

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