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Adapting to Change: FEM’s Half-Year Report (Jan-Jun 2025)

TL;DR


In the first half of 2025, FEM adapted to dramatic shifts in the family planning landscape when USAID suspended international family planning support. To ensure our work in demand generation aligns with sufficient supply, we restructured our upcoming 2-year campaigns in Nigeria. These campaigns will be evaluated by a randomised controlled trial. We reselected about half the states, and will launch in two waves, a year apart. We installed and tested our first evaluation transmitters in the field, and advanced creative content for the first season of campaigns. Internationally, we launched proof of concept (POC) projects with new partners in Benin and Togo, and conducted supply analysis and audience research prep in Niger, ahead of a two-year campaign. As we enter the second half of 2025, FEM is poised to launch our longest campaigns in Nigeria and Niger while expanding in West Africa with strong, new partnerships. 



Victory Nzewi (left) speaks to radio host Chisom Chiedu about family planning

while recording content for FEM. Victory founded Ifunanya Care Initiative (ICI), 

which promotes healthcare access and community empowerment.


Strategic Response to a Changing Landscape 


In the first week of January, the gutting of the US Agency for International Development (USAID) substantially disrupted reproductive healthcare across Sub-Saharan Africa. As a result, FEM had to rethink how and where our campaigns could have the greatest impact. The termination of USAID's $607.5 million annual family planning programme left 47.6 million women and couples without access to modern contraceptive care, according to the Guttmacher Institute. Guttmacher estimates that within 90 days of the funding freeze, 11.7 million women and girls lost access to essential contraceptive services.


FEM lost a 1.5 USD million Development Innovation Ventures (DIV) grant when USAID issued Stop Work Orders, part of a portfolio-wide suspension that terminated more than 5,300 awards. Thanks to our diverse funding base, this was not an existential threat for FEM. But our mass media campaigns cannot drive impact if contraceptive supply or services are unavailable. 


Supply landscape changes meant reassessing our planned 2-year campaigns in Nigeria. Through extensive stakeholder engagement — consulting 20+ experts from government, foundations, NGOs, and academia — we identified states where contraceptive supply is expected to remain stable. Data about newly pledged funding, and updated current supply availability, were important factors. 


We redesigned our strategy and plan to launch a staggered rollout, focusing initially on 5-6 states where our preparations are nearly complete and contraceptive availability is expected to remain sufficient. We aim to launch in a second set of newly onboarded states, one year later. Between the two cohorts, we aim to reach the 165 clusters necessary for a robust, randomised study of our work’s impact.  


Update about the Evidence


Recent surveys and service data offer different perspectives on FEM’s impact, underscoring the need for rigorous evaluation. In February 2024, the Performance Monitoring for Action (PMA) project completed its final family planning survey round in Kano, marking the conclusion of its multi-year study (2016–2024). An earlier survey by PMA found a 75% increase (among all women in Kano) between February 2021 and January 2022; during this time, FEM conducted a three-month pilot. PMA’s 2024 survey confirmed that the increase had been sustained during subsequent years, when FEM ran an additional 16 months of broadcasts across Kano. 


Not all sources of evidence align. A separate analysis of clinic service data suggests only small short-term increases in family planning clients and new acceptors at the start of FEM’s campaigns, with both outcomes flattening back to trend soon after. We are not able to share more details at this time due to academic researchers’ publishing timelines, but they will be forthcoming. 


Although clinic data may offer useful insights, they may not fully reflect changes in family planning use. The broader evidence base for the effectiveness of family planning radio campaigns remains comparatively strong. As shared in FEM’s first blog post: a review drawing on 130 studies of SBC interventions found that on average SBC increased use of modern contraceptives 30%-60%. J-PAL and DMI found a 2.5 year radio campaign in Burkina Faso increased contraceptive use by 20%. Family Planning High Impact Practice (HIP) named 18 additional studies linking mass media to increased contraceptive uptake.


Challenges with the quality of clinic health records in Nigeria have been expressed by varied sources (see here, here and Nigeria Health Watch). We remain committed to conducting a rigorous randomised controlled trial in Nigeria to generate rigorous evidence about our impact and contribute to the broader understanding of what drives sustained increases in contraceptive use among women who want to plan their families.


Randomised Controlled Trial Prep, Nigeria 


While adapting our geographic strategy, we maintained momentum on the creative and technical groundwork essential for launching two-year campaigns evaluated by a randomised controlled trial in Nigeria. We made steady progress on content development across the three regions of Nigeria where our campaigns will air. We developed distinctive opening themes for our campaigns in the South East ("Okwu Ndu," meaning truth and positivity) and South West ("Irin ajo wa, Itan wa," or "Our Journey, Our Story"); in the North, we’ll use our established signature tune.


Left: Beloved Hausa film actor, entrepreneur and father Aminu Shareef Momo 

records a Q&A show for FEM’s campaign. 

Right: Dr. Fatima Nasir, gynecologist for the Kano State Ministry of Health, records content.  


We completed about half of the content for the first six months of programming. Idi Nasiru, a Hausa speaker with valuable experience from BBC Media Action and Johns Hopkins' Center for Communication Program, joined our team and strengthened content creation and production. 


We also continued at full pace with the technical work of cluster selection and evaluation technology installation. Prior to launching the campaign and study, we must complete the five-stage process of selecting clusters and installing our evaluation technology (transmitters which can identify when our content is on air and replace it with unrelated content in control groups). This process must be restarted in replacement states. We temporarily suspended onboarding new states to focus on launching in the first cohort.


We reached a significant milestone: completing cluster selection in the ten RCT states chosen in 2024, confirming a total of 127 viable clusters. Eighty of these clusters are in five states where we expect supply to remain stable and where we plan to launch the first wave of RCT campaigns. We also installed the first two transmitters in the field, at health facilities in Katsina. They will be tested with coded jingles aired by Vision FM Katsina. 


This transmitter antenna is one of our first installations, 

at a health facility in Katsina state. 


The quality of our RCT depends on participants in control areas not recognising that their content is different than usual. To reduce the risk of detection, we improved our content replacement technology. The original system used memory cards with a single ad for the radio station (e.g. “Listen to Freedom FM on 95.5”) for ad replacement and one fixed mix-tape of songs for show replacement. This could become noticeable to listeners over time. The team developed an upgrade that enables devices to randomly rotate through multiple ads (3-15 options) for 1-minute ad replacement, and up to 200 songs for 30-minute show replacement. This improvement significantly reduces the chance that listeners will detect content replacement patterns.


With these improvements and our phased approach in place, we are better positioned to launch the first wave of campaigns, generating evidence of the effectiveness of our intervention.


New Partnerships, New Countries


This year we reached a major milestone by launching proof of concept projects in two new countries, testing partnerships that could bring FEM's approach to millions of additional listeners. We hit an exciting growth milestone — launching proofs of concept (POCs) in Benin and Togo. These short projects include a stakeholder workshop to introduce our work, and a one-week campaign. They test our new co-implementation partnerships and are the first steps to bringing FEM’s model to millions of new listeners. 


In Benin, 518 women die for every 100,000 live births. Modern birth spacing is practiced by ~17% of women of reproductive age, while ~85% of health facilities stock at least five modern contraceptive methods, according to a 2022 UNFPA survey. Primary barriers include fear of side effects and social stigma, barriers that radio can address. 


We can reach ~3 million listeners in Benin in partnership with ONG Eclosion, a local NGO with four years of experience across health, agriculture, and innovation sectors. ONG Eclosion brings a data-driven approach and strong governmental relationships that will be crucial for our July proof of concept launch.


In Togo, reproductive health challenges are pressing, with a maternal mortality rate of 349 deaths per 100,000 live births. In the regions where we’ll work, just 14-19% of women of reproductive age use modern contraception and the rate of unmet need is one of the highest in the world. 


We can reach ~2.3 million listeners across three regions in Togo, in collaboration with ISCOME, an NGO with five years of experience in communication and community health projects. We aim to launch our proof of concept at the end of September.


This map shows the neighboring four countries

in which FEM is operating. 


Driving Impact in Niger 


Building on last year's successful proof of concept in Niger, we're now preparing for a two-year campaign that could reach ~2.8 million people and avert approximately 7,000 unintended pregnancies. 


As in Nigeria, contraceptive supply is crucial to the impact of our demand intervention. Data sources for contraceptive availability differ significantly between Nigeria and the other places we want to work, such as Niger. In Q2, we developed new methods to assess contraceptive availability and clinic access in expansion sites. Our methodology begins with analysis of physical access: how many people live in range of health facilities. We then use the best available data to estimate national rates of supply. Our approach also accounts for access limitations and potential harms from airing in areas without access. We map the supply chain at a high level and forecast funding. We incorporate stakeholder input throughout both analyses.


For Niger, DHIS2 analysis corroborates UNFPA surveys that indicate a high level of contraceptive availability in health facilities. Niger is exceptionally rural – 83% of Nigeriens live rurally – so travel times to facilities will be higher, which is taken into account when modelling our impact. We will interview audience members in our formative research to learn more about the conditions women face and what messaging will be impactful.


Moving Ahead Together


As donor funding contracts across the sector, supporting any intervention requires confidence it ranks among the highest-impact work in global health—we believe FEM does, and we're committed to proving it. As we step into the second half of 2025, our energy is focused on preparing for the RCT launch and formative audience research in Niger, and co-implementing POCs in two new countries. Each initiative positions us for impact ahead. 


We remain acutely aware of the increased challenges facing millions of women and families whose access to reproductive healthcare is under strain. These realities fuel our determination to keep learning, refining, and ensuring that our work delivers measurable health gains where they are needed most. Guided by the evidence-based, cost-effective approach that has defined FEM since the beginning, we are more committed than ever to driving change at scale.


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