The Lekie Project
The Lekie Project ("Lekie") is DKT Ethiopia's newest initiative to distribute family planning and other products to private sector outlets in rural Ethiopia.
Launched in 2012 and also known by the name Rural Social Marketing (RSM), Lekie is an innovative program that leverages the power of markets to assemble geographically diffuse populations at predictable intervals.
In Amharic, Lekie means "the family I want is the family I can afford", a name developed and pre-tested in collaboration with the Federal Ministry of Health that captures the family planning emphasis of the project.
The 2011 Ethiopian Demographic and Health Survey (EDHS) highlighted the ongoing fertility and contraceptive use gap between urban and rural populations. In 2011, the total fertility rate (TFR) was 2.6 in urban areas compared to 5.5 in rural areas. The contraceptive prevalence rate (CPR) was 53% in urban areas and 23% in rural areas during the same year.
The 2011 EDHS also showed that the regions of Afar and Somali continued to lag behind the rest of Ethiopia in contraceptive uptake. These are priority regions in Lekie
Rural Social Marketing (RSM) Team in SNNP
Given the above and the fact that 80% of Ethiopians live in rural areas, DKT Ethiopia is targeting high-value market towns in these areas with product delivery and promotion.
Lekie reaches rural women and men as they visit market towns. Markets are the primary meeting places for Ethiopia's geographically diffuse, primarily agrarian population. Lekie leverages the predictability of market days, which facilitates time-specific and efficient programming.
Prior to project launch, DKT Ethiopia interviewed 2,000 individuals in five (5) target regions. The research revealed that rural Ethiopians live in close proximity to an average of 2.1 market towns. The research further revealed that 95% of rural Ethiopians visit market towns at least once every two months and 67% go at least weekly.
In Lekie, DKT/E teams consisting of a Regional Coordinator, one (1) each male and female nurse and a driver deliver products to market towns on market days. They also conduct product demonstrations, mass events, and other awareness-raising activities as well as providing family planning counseling and referrals to local health facilities.
Teams travel on predictable routes that coincide with market days.
Lekie pays special attention to Afar and Somali given low family planning use in these areas.
From July 2014 - June 2015, DKT Ethiopia consolidated Lekie to 200 high-value market towns, down from a maximum of 835 towns at the initiative's peak. Despite this reduction, Lekie teams still managed to conduct 2,900 mass events as well as hosting over 15,000 small group discussions (SGDs). They also counseled and referred 42,651 and 26,383 individuals, respectively.
During the period, teams distributed:
- 1.44 million condoms
- 159,712 cycles of oral contraceptive pills (OCP)
- 257,336 injectable contraceptives
- 108,350 sachets of LemLem oral rehydration salts (ORS)
A total of 307 Lekie billboards had also been placed throughout the country by June 2015.
In October 2013, DKT/E began a 15-month pilot Lekie activity in 30 market towns in West Arsi, Guraghe, and Silte Zones of Oromiya and SNNP. The pilot, which was funded by the Bill and Melinda Gates Foundation (BMGF), experimented with three (3) implementation modalities testing the impact of increased frequency, stronger referrals, and the use of interim communicators - local partner organizations and individuals present while DKT Ethiopia teams are not present.
The pilot successfully concluded in June 2015, with the model deploying interim communicators showing considerable FP gains over the other two models. In the model using interim communicators, RSM teams distributed 2 – 4 times more CYP than teams in DKT Ethiopia’s mainstream RSM activity.
Overall, the pilot also concluded with implant contraceptives and IUCDs accounting for 46% of all CYP, compared to 14% in the 2011 Ethiopian Demographic and Health Survey (EDHS). The percentage of private facilities providing implant contraceptives and IUCDs also increased from 35% to 60%.
Contact Negussie GebreTsadik, DKT Ethiopia's National Operations Director, for more information on Lekie.