The HTSP Implementation Kit

Section 5: Position AMA and HP and Develop Key Messages


“Positioning” provides the overall emotional hook and direction for developing messages and determining persuasive and appealing communication approaches. Positioning provides direction for developing messages and helps determine the communication channels to be used. It also helps ensure that all program outputs and activities use a consistent voice, and reinforce each other for a cumulative effect. It is how communication professionals and marketers create a distinct impression of a product, service or behavior in the client’s mind. An intrauterine device (IUD), for example, could be positioned in terms of social status (including affluence or modernity), relationship satisfaction or health and well-being. Work with communication professionals or marketers to determine which will be most compelling to each audience.

Annex B provides illustrative positioning statements for FP SBCC programs focused on preventing the risks of AMA and HP pregnancies. Each emphasizes different motivators for FP use and highlights the primary benefits of FP as related to the positioning theme. Pretest and adapt these or other positioning statements to reflect local context.

Key Message Concepts

Outlined below are the types of key information about AMA and HP pregnancy to communicate to primary and influencing audiences. In developing key messages, add context-specific information and focus on locally relevant drivers and barriers to behavior change. Pretest messages with the intended audience and revise or refine messages according to audience feedback.

Depending on research findings, messages should include:

1. Risks of AMA and HP Pregnancy

  • In many Sub-Saharan African contexts, pregnancy itself is seen as a high-risk situation. Often, a woman’s age or number of previous births are thought to increase health risks to the mother or child. Therefore, informing women, their partners and families about AMA and HP pregnancy risks and associated warning signs is an important first step in preventing these high-risk pregnancies.
  • Messages can be developed for different audience segments: young women and their families who are anticipating their first pregnancy; women who have begun their family already and might be approaching AMA or HP status; and/or women who are already AMA and HP.
  • AMA and HP pregnancy risk information can be discussed with an emphasis on preventing AMA and HP pregnancy through modern FP method use, but should also include a component on managing and monitoring risks for women who find themselves in AMA or HP pregnancy situations.

2. Benefits of Modern FP Methods

  • FP can be viewed through several lenses. It can be seen as:
  • An opportunity to build economic stability of families.

  • An avenue to secure birth spacing or limiting for the health of women.

  • A development tool, since families will be able to time and space pregnancies and maintain their productive lives by avoiding undesired pregnancy.

  • With this framing in mind, messages can provide:
  • Information about modern FP methods such as advantages, disadvantages, side effects and how to manage them, where to get methods and method costs.
  • Information for partners and community leaders on advantages of using FP, focusing on FP health benefits for women at least 35 years old or approaching their fifth childbirth.
  • The difference between the effectiveness of traditional or natural FP methods, and modern FP methods. There may be pervasive misconceptions about the effectiveness of natural methods such as withdrawal.

3. Importance of Supporting Women and Couples to Avoid High-Risk (including AMA and HP) Pregnancies

  • While FP is seen as a woman’s issue, in many communities it is the man who makes final FP decisions. Couple communication increases FP method use and empowers men and women to share decisionmaking.
  • In much of Africa, community and religious leaders have an important role to play promoting health service use, couple communication and other behaviors. In addition to setting community norms, they can encourage more conservative community members to adapt healthier norms.
  • Satisfied users are convincing service promoters. Community leaders should get familiar with local services so they can help promote FP and MCH service use. Messages can include satisfied users’ stories to help create a supportive environment for women and couples to talk about and select FP methods that are right for them.
  • Clinic- and community-based FP and MCH healthcare service providers must be prepared to discuss AMA and HP pregnancy risks with clients in a non-threatening way, and to help clients prevent or manage high-risk pregnancies, including with AMA and HP women.


For step-by-step guidance on pretesting SBCC materials, please refer to HC3’s How to Conduct a Pretest How-to Guide.

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