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Building for Impact: FEM’s Year-End Report

Updated: 10 hours ago

TL;DR


In the second half of 2024, we made significant progress toward 24-month campaigns in 10 Nigerian states evaluated by a randomised controlled trial (RCT). We conducted stakeholder workshops receiving feedback on campaign content and visited 219 health facilities in preparation for installing our evaluation technology in control clusters. In expansion to new countries, we conducted a proof of concept (POC) in Niger. As in the DRC, we received warm stakeholder reception and high listener retention with this test campaign. We determined campaigning in the DRC is not cost-effective and are working toward launching a 24-month campaign in Niger in 2025.


Randomised Controlled Trial Preparations


Preparation for greater impact shaped the past year. We made major strides toward launching 24-month campaigns in Nigeria, which will be evaluated by a randomised controlled trial (RCT). We selected the ten states in which we expect to campaign, reaching an audience of ~ 20.8 million with 2,000 - 4,000 broadcasts per station per year. These states have previously received our content for no more than two weeks during proofs of concept.



RCT States: Abia, Enugu, Kaduna, Katsina, Kebbi, 

Nasarawa, Niger, Ogun, Ondo, Plateau


In the north, we will co-implement with our partner, the African Institute of Development Professionals (iDevPro Africa), in the states of Kebbi, Katsina, Kaduna, Niger, Nasarawa, and Plateau. In the south, we’ll co-implement with our partners, Parkers Mobile Clinic in Ogun and Ondo, and Rhealyz Global Empowerment Initiative in Abia and Enugu.


For these campaigns, we are developing content at a 5x larger scale than ever before. Content will be developed in four seasons, allowing us to refine and customise our messaging based on small rounds of qualitative research conducted between rounds of production. 


Halima Isah (left) and A’isha Ibrahim Dakasku record FEM content 

at production firm Elevators Business Empire in Kano.  


One component of our campaigns features testimonials where individuals share how family planning has improved their lives. In November, for example, we conducted 28 testimonial interviews—14 in Abia State and 14 in Enugu—balanced equally between rural and urban settings, with men and women aged 21-41. Participants related personal experiences that highlight campaign themes such as how family planning enables better care for children. They also addressed common concerns revealed in our audience research, including fears about contraceptive side effects like weight gain or increased bleeding.


Many shows are fictional and scripted. To solicit feedback and build support, we screened RCT scripts at stakeholder workshops in Abia, Abuja, Enugu, Katsina, Kebbi, Ondo, and Ogun. We involved participants from the Federal Ministry of Health (FMOH), state governments, civil society organisations, religious institutions, and community leaders. Additionally, we held separate discussions with FMOH and state government officials. 


These gatherings, which included about 175 stakeholders total, allowed us to share updates, outline our activities, and collaboratively review scripts for our fiction shows and ads. Stakeholder feedback was encouraging; many expressed appreciation for our collaborative approach.


We finalized production studio partnerships for all three regions, selecting firms based on their proven capacity to produce diverse and high-quality content.


Advancing Innovative Measurement Technology


To collect robust evidence to measure our impact, we developed a technology that can identify when our content is on air and replace it with unrelated content in a 1-8 km radius. This allows for the creation of control groups.

The technology: Antennas, often mounted on poles (left) are wired to devices (right)

which can recognise and replace FEM’s content so the region

around the transmitter is not exposed to our campaign. 


We previously detailed the five stages of technical assessment we complete in order to select suitable sites for our evaluation technology. We prefer to install at health facilities where the technology will be less noticeable; these locations must be operational, and safe enough for engineers and surveyors to access. Radio signals must be strong enough but not too strong.


Through the second half of 2024, we continued advancing through the fourth stage of assessment: cluster signal tests. By December’s end, FEM’s engineering team had visited a total of 219 health facilities across 10 states and installed 126 devices which each measure radio signal data over a one-week period. 


We anticipated it would take several weeks to install these devices in 165 clusters (the number needed to conduct our RCT). But we encountered more obstacles than expected. Security concerns, accessibility issues, and signal strength problems forced us to eliminate many facilities and identify replacements. 


Key progress includes the successful first live test of our on-air monitoring system, tracking ads from a station called Magic FM. This system, which we innovated with our partner UNITRONIC, listens to FM radio and transmits the signal strength and type to an online platform. This makes it possible to verify that our ads and shows played as agreed, so we can be certain the level of exposure in treatment regions. 


Meanwhile, our transmitter technology has cleared Nigerian customs and each unit arrived in regional storage, ready for installation when cluster selection is complete. 


Strategic Assessment in the DRC 


In 2024, we completed scoping projects with potential partners across five countries, ultimately selecting two regions for proofs of concept: Grand Kasaï (the DRC) and Zinder (Niger). In the DRC, we conducted a one-week campaign on Radio Katanda (Mbuji-Mayi), delivering family planning and birth spacing messages to approximately 172,800 listeners. (Read more in our Half-Year Report.) 

Mothers and their children pose together 

during FEM’s user conversation sessions in the DRC.  


The project enabled us to access DHIS-2 data, through the connections of our local partner, Les Ailes du Coeur. Access verified the prevalence of contraceptive stockouts in all regions. In Q3, we met with supply-side NGOs to understand if we could align our demand generation activity with their supply, or support the supply chain. 


There are at least two key barriers to contraceptive supply in the DRC. The first is last-mile delivery obstacles that prevent commodities from reaching women who want them: poor infrastructure, unclear routing, and security risks. The second is insufficient data for supply-chain management: the absence of a census since 1984, internet connectivity challenges, and frequent use of paper tools. 


Unfortunately, our analysis determined that campaigning in the DRC at this time will not meet our cost-effectiveness bar. While our test campaign showed promising engagement and listener retention, persistent supply challenges would significantly limit the impact of our work. We've documented our findings and established a valuable partnership in the region that could support future work should supply conditions improve. For now, we're directing our resources to regions where we can achieve greater impact, in Nigeria and Niger. 


Cost-Effective Campaign Prospects in Niger


We completed a proof of concept in Niger in partnership with ACS/LUCPAMIC Consortium, which has worked since 2014 to promote women’s rights, implement health programs including family planning and HIV/AIDS prevention, and improve living conditions for vulnerable populations through sustainable development initiatives. Together, we conducted and analysed eight user conversations about family planning, in which spousal communication and religion were repeatedly named as barriers. 


Potential listeners in Niger share quiet moments

with their children.


Stakeholder engagement is especially important during proofs of concept, when our work is introduced to new regions for the first time. Our partner engaged community and state leaders with dedication and resourcefulness. 


We developed new ad scripts to share with stakeholders and also presented three advertisements originally produced for northern Nigeria. This approach allowed us to evaluate whether content could be effectively reused across these neighboring regions. A warm reception for the Nigerian drafts indicated their potential for reuse in Niger, offering a highly cost-effective solution.


We produced two advertisements that aired for one week on three radio stations and conducted a post-airing assessment with 40 individuals. During the survey, we played the introduction music from each ad to test recall. The results were encouraging: 72% of respondents remembered hearing the first ad, while 57% recalled the second. One contraceptive non-user reported talking to their relatives about the ad.  


Challenges for our partner included flooding and internet outages due to the rainy season. Despite reduced communication due to these challenges, our partner operated with excellence and strong commitment.


Pending political stability, we plan to launch a full campaign in the Zinder, Maradi, and Tahoua regions in 2025.

These regions are key agricultural zones with high population density, 

collectively representing over 40% of Niger’s population.


Voices from the Field: Team Spotlight 


Since joining FEM in 2021, lifelong Kano resident and FEM’s first employee Kabiru Abdulkareem has played a critical role in our achievements. Known for his unflagging work ethic, Kabiru manages multiple critical responsibilities including survey oversight, monitoring and evaluation, and spearheading on-the-ground operations for our RCT.


“For me, FEM's work is incredibly important,” shares Kabiru. “I see it trying to solve one of the bedrocks of social problems, particularly here in Nigeria. I see a lot of children uncared for. I see a lot of women going through a lot, just because they don't have the right education to space births."


FEM Research and Process Manager Kabiru Abdulkareem 

introduces our work to key stakeholders at a workshop in Kano.  


Kabiru holds degrees in Mass Communication and Public Administration. He is excited about expanding his impact, both professionally and personally and is exploring agriculture, with plans to grow cocoa on his family’s rural property.

A devout Muslim whose core values are respect and positivity, Kabiru has been married to his wife, Amina Bashir, for 14 years; they share three children. 


“Children bring unexplainable joy,” says Kabiru. “For me, it’s been amazing. I love being a father." He enjoys taking his family to a nighttime amusement park and is training for a black belt in karate with the goal of teaching his daughters self-defense. 


Kabiru has observed FEM’s influence through everyday conversations. “At my children’s school, I overheard the bursary officer listening to a religious program from FEM. She didn't know I worked at FEM. I sparked up a conversation, and she said she never knew that the Muslim perspective permitted family planning before hearing FEM. A well known Islamic scholar was talking, which lent credence. We're not just targeting the drivers, we're also targeting the barriers – and in the north, religion is a major barrier.” 


Kabiru describes conducting quality control on FEM’s listener research, and breaking down in tears from stories of suffering. “You have to revive yourself and get back to work,” he says. “A lot of women are in dire situations that could have been prevented if they had adequate knowledge. This is one of the major drivers for my hard work.” 


“When I go out and experience how our program is changing lives, these are very special moments to me. It makes me feel that we’re doing things, we’re really changing people’s lives and affecting them. We’re making a big step toward changing what I feel is a very big problem in our society.”


Looking Ahead: Scaling Impact in 2025


Many women face barriers that prevent them from making informed decisions about their reproductive health and family size. Since 2020, FEM has worked to raise awareness and reduce misconceptions about family planning through radio. We envision a future where all women can make informed choices about their families and health. Over the next decade, we aim to expand to all regions where our efforts can cost-effectively improve lives.


The second half of 2024 has seen steady progress in our strategic direction, toward our longest-yet campaigns which will provide rigorous evidence of our impact while reaching over 20 million people. We've carefully evaluated expansion opportunities, making evidence-driven decisions about where our work can most impactfully avert maternal deaths and improve the lives of families. 


This post is complemented by our 2024 Annual Report.


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