In July 2021, KhairKhwah, an NGO based in Pakistan, collaborated with The Marie Stopes Society and Green Star Social Marketing to roll out their ‘Brown Bag Syndrome’ campaign.

KhairKhwah was established in May 2020 as a communications platform aimed at encouraging people to talk about “difficult” topics (mainly family planning) through various communication channels, although they also disseminate information about other health-related issues; for example, Covid-19 related communications.

The Brown Bag campaign was developed by M&C Saatchi World Services Pakistan, which has been KhairKhwah’s agency from the beginning.

“The objective is to change the way Pakistanis view family planning and address the stigma associated with it. The aim is to normalise such conversations, which is essential if we want to engineer long-lasting behavioural change,” says Muhammad Ahmad, Creative Director, M&C Saatchi World Services Pakistan. “KhairKhwah know it is not easy to introduce the idea of adopting family planning practices given that the target audience may not even be willing to even talk about the subject – hence the campaign slogan is: ‘Soch Ko Khaki Lifaafey Se Azaad Karo, Baat Karo.’ (‘Liberate the Way You Think From the Brown Bag; Talk to Each Other.’)

According to Ahmad, the agency has avoided “prescriptive and authoritative messaging” as people do not like being told what to do. The idea is to create awareness, disseminate information and leave it up to people to make their own decisions. “We do not want to dictate the number of children a couple should have; rather, we want to communicate the benefits of spacing out children, depending on their circumstances and how well they can support them.”

The campaign’s main target audience includes young, married couples who already have a child; a secondary target audience segment comprises parents and older siblings, who may be able to influence their children or siblings about the number of children they should have. “Parents need to talk to their children about family planning. This is something that is lacking in our society and we are trying to change this.”

The brief was to ‘normalise’ talking about family planning and writing the script was a challenge as the team was aware that no matter how subtle the messaging, they would probably end up offending someone. “We tried to minimise that risk and hoped for the best... It took us a year to develop the communication; it is quite a challenge to sell a product or service without being able to show it on screen.” Adding to the challenge was the fact that family planning is a very private topic and most people don’t want to hear about it and tend to change the channel when such communications air.

Another challenge was the brown bag. “We were invested in using the brown bag, but consumer insights revealed that many people saw it as a positive thing as it protected their privacy when they purchased ‘sensitive’ products,” says Ahmad. However, the agency went ahead with the idea and although there was some pushback from people pointing out that brown bags were actually a good thing, there was a silver lining. “The brown bag served its purpose because after several arguments over the brown bag on social media, family planning was being talked about and was suddenly not so taboo. The stigma around it had been broken to an extent as it was being discussed,” says Ahmad.

Apart from TV and digital, the campaign has an extensive in-person outreach programme centred on rural communities of Khyber Pakhtunkhwa, Punjab and Sindh. The programme has several components, including ‘branded’ vans driving around rural districts, and corner meetings (baithaks) where male health workers sit in open spaces and talk to men about family planning. “An insight from our research was that men in rural areas find it easier to talk to their male friends regarding family planning than to their spouses.”

Given that the campaign aims to bring about long-term societal behavioural change, gauging response is not really possible right now. However, according to Ahmad, the campaign’s effectiveness will be measured based on three main metrics. They are, ‘Knowledge and Information’ (how many people are aware of contraceptive methods and know where they can purchase them and how much they know about their possible side-effects); ‘Changing Social Norms’ (how comfortably people are talking about family planning and whether or not they are worried about being judged negatively if they do so); and ‘Intent and Uptake’ (how many people say that they are likely to use contraceptives and practise family planning after having seen the campaign). Another metric to gauge response is Poocho, the KhairKhwah helpline, which in Ahmad’s view could provide important insights to guide future campaigns.

KhairKhwah plan further family planning related communications in the future, although whether the brown bag will remain part of them will be decided depending on the results of the current campaign. According to Ahmad, “once we have broken the ice, the brown bag may not feature in our campaigns and we may move to more functional communication to encourage the use of contraceptives.” In his view, the next phase could focus on empowering and celebrating people who do practise family planning. This is not an easy thing to do in Pakistan’s context, and they need to be encouraged to start advocating family planning within their communities, as “it would be a service to their families, communities and to their country.”