Fertility Awareness for Community Transformation

In developing countries, a woman’s lifetime risk of dying due to pregnancy and childbirth is one in 75, nearly 100 times higher than the risk in developed countries. Studies also show that an estimated 220 million women are not using any family planning method, despite wanting to avoid pregnancy. Providing these women with information and the full range of family planning methods—including fertility awareness-based methods (FAM)—not only saves lives, but also improves other social, educational, environmental and economic indicators.

Work under the Fertility Awareness for Community Transformation (FACT) Project is fostering an environment where women and men can take actions to protect their reproductive health throughout the life-course by testing strategies to increase fertility awareness and expand access to FAM at the community level.

As a research, intervention, and technical assistance project, FACT is testing two primary hypotheses:

  1. Increased fertility awareness improves family planning use.
  2. Expanding access to FAM increases uptake of family planning and reduces unintended pregnancies.


The FACT team employs a systematic approach to testing these hypotheses through developing and investigating innovative solutions to improve fertility awareness and expand availability of FAM. The approach is guided by the Solution Development Cycle, an iterative process for the discovery, design, and development of solutions using formative research, participatory design, and intervention testing.

The aim of this process is to translate scientific data into simple, practical, and scalable solutions which can be integrated into existing platforms both within and beyond the health system such as community-based nutrition groups, agriculture co-ops, savings and loans clubs, and pregnant women’s groups. Key target populations for this project are youth (both married and unmarried), postpartum women, and couples who want to delay or space births in Sub-Saharan Africa and South Asia.


To test the first hypothesis, FACT is developing and testing solutions based on state-of-the-art social and behavior change communication (SBCC) theory and practice to assess their effect at the individual, couple, family, and community levels.

To test the second hypothesis, FACT is introducing and scaling up CycleTelTM, a proven mobile phone service to facilitate the use of the Standard Days Method (SDM), to assess the impact of a direct-to-consumer product on family planning method use. Other direct-to-consumer solutions, such as group teaching of SDM, TwoDay Method®, and Lactational Amenorrhea Method (LAM), will also be tested for their effect on access to and use of family planning.

Join Us

FACT has the capacity to provide technical assistance (TA) to USAID cooperating agencies, bilateral projects and NGOs. TA is available through the project to incorporate fertility awareness into a wide variety of programs focusing on key groups including youth, postpartum women, and young couples, as well as for the introduction of the Standard Days Method® (SDM), TwoDay Method®, and the Lactational Amenorrhea Method (LAM) through routine service delivery channels. The project can accept field support from partner countries for research and the provision of TA.

For more information, email irhinfo@georgetown.edu.