FRANCOPHONE WEST & CENTRAL AFRICA – Supporting young women with their reproductive health decisions: what can we learn from the Lydia Conseil Call Centre? 

by Camilo Antillon, Victoria Webbe, Saskia Husken  

Sexual and Reproductive Health Matters, 2022;30(1):4 April  (Open access) 

“High rates of unintended pregnancy, unsafe abortion and unmet need for contraception are persistent sexual and reproductive health (SRH) challenges in Francophone West and Central Africa (FWACA). These challenges are linked to existing barriers, particularly for young women, to access the SRH information and services they need…. This article shares the experience of the Lydia Conseil Call Centre initiated by DKT International* (DKT)…. 

“Between 2015 and 2019, the annual unintended pregnancy rate in [the region] was estimated to be 91 per 1000 women aged 15–44 years, [which] includes countries with some of the world’s highest teenage pregnancy rates…. Out of all unintended pregnancies, 42% in West Africa and 30% in Central Africa ended in an abortion. [The region] also has by far the highest abortion-related case fatality rate in the world, with approximately 450 deaths per 100,000 abortions…. The modern contraceptive prevalence rate is also very low…. The most-cited reasons for unmet need [for contraception] include lack of awareness of methods (over 5%), high costs (6%), lack of access (10%) and (among single women) not being married…. 

“With these challenges in mind, DKT launched the Lydia Conseil Call Centre in 2018. Based in Dakar and building on the notoriety of the DKT regional family planning brand “Lydia”, Lydia Conseil is one of the largest regional SRH call centres in FWACA. Via this service, users from anywhere in the FWACA region can anonymously connect via telephone or social media channels to a trained DKT Midwife Operator who answers questions and provides advice on contraceptives, pregnancy and other SRH related topics…. 

“Lydia Conseil combines the tailored medical counselling of a hotline with the geographic scale of a web platform. In cases where further medical intervention is needed, the Call Centre midwives are able to refer users to healthcare providers and products through DKT FWACA in-country networks. 

“Between February 2018 and April 2020, the Lydia Conseil Call Centre responded to almost 40,000 calls and messages specifically on contraception, unintended pregnancies and abortion. The Call Centre is currently able to respond to 4500 calls and online communications every month…. Users can connect via phone at the cost of a local call, or SMS, except in Senegal and Cote d’Ivoire where it is toll-free, or they can choose to reach the Call Centre via WhatsApp and social media messaging through Facebook or Instagram.  

“[F]amily planning represented the most common topic addressed by the Call Centre, followed by sexually transmitted infections (STIs) (13,755) and pregnancy (11,210). The age distribution of users was similar for all major topics, with the majority of queries coming from 19 to 25-year-olds, followed by 26–35-year-olds…. Due to the current legal restrictions on abortion in Senegal, the Call Centre operators do not offer counselling on abortion. Nevertheless, each month women reach out in need of information on managing unintended pregnancies and safe abortion services, and these inquiries have increased since the start of the Covid-19 crisis. The Call Centre midwives are determined to provide assistance and to protect and advance each caller’s right to the highest attainable standard of health in their respective countries, hence women seeking to terminate their unintended pregnancy are currently advised to see a quality gynaecologist for further assistance. 

“A 20-fold increase in calls coincided with the introduction of a Facebook Ads campaign promoting the Call Centre service across the region. The contribution of this campaign to the increased visibility and use of the Call Centre is confirmed by the fact that almost all users (97%) claimed to have heard about the Call Centre via Facebook.” 

And from the DKT West/Central Africa website re: Lydia Conseil 

In 2016, DKT International established a regional social marketing programme across French-speaking West and Central Africa to provide a full range of affordable family planning options, starting with “Préservatifs Kiss” (Kiss condoms) in Senegal and by 2020 a range of products in over a dozen countries, including emergency contraceptive pills – everything from the packaging and colours to the design and rollout of media campaigns was guided by young people.  

Access to safe abortion and post-abortion care remains limited in the region with high complication rates and little access to treatment. DKT is one of the only distributors of manual vacuum aspiration equipment in the region, supplying both private and public sectors. In mid-2018, DKT began launching medical abortion products in the region. In many of these countries, medical abortion products were completely new to the market, bestowing tremendous responsibility on DKT to educate providers on the safety and efficacy of using pills for abortion care.   

VISUAL: Lydia Conseil