Opening a portal to pleasure based sexual and reproductive health around the globe; a qualitative analysis and best practice development study

Figures & data

Table 1. Pleasure implementers and pleasure approach activities

Grantee organisation	Country	Audience	Pleasure approach activities
Encadrement des Femmes Indigènes et des Ménages vulnérables (EFIM)	Democratic Republic of the Congo	Women who have experienced gender-based violence (GBV)	Guided group discussions on pleasure with women who have experienced GBV.
Groupe de Volontaires pour la Promotion de la Maternité sans Risques (GVP-MASAR)	Democratic Republic of the Congo	Midwives and women attending prenatal consultations	Training of midwives to integrate a pleasure approach into their work with pregnant women and new mothers.
Haguruka	Rwanda	Young people and school staff in faith-based contexts	Guided group discussions on pleasure with young people and engagement of teachers and school staff in a pleasure approach
Sesotho Media and Development (SMD)	Lesotho	Young people	Guided group discussions on pleasure and film screenings with young people
South India AIDS Action Plan (SIAAP)	India	Sex workers	Guided group discussions on pleasure with sex workers
Transgender equality Uganda (TEU)	Uganda	Trans women and trans women who do sex work	Guided group discussions on pleasure with trans women and trans women who do sex work. Training of 20 health care workers (HCW) to provide pleasure based SRH to trans women.
Women’s Health and Equal Rights Association Rwanda (WHERAR)	Rwanda	Young women and girls not attending school	Engaged community-based organisations and youth clubs on a pleasure approach, implemented a radio talk show on pleasure and SRH
Young and Alive (YA)	Tanzania	Young people	Guided group discussions and leadership training on pleasure with young people

Figure 1. Map showing pleasure impact indicators for pleasure implementor

Table 2. Best practice table - “Let's Do It!”

Best practice statement	Additional details	Quotation
Language and framing of pleasure
Don’t make assumptions about how closed or open people, groups and communities may be to pleasure.	Some groups are often viewed as out of reach for a pleasure approach. Assumptions around these groups are that pleasure is too stigmatised and that talking about pleasure would be uncomfortable and impossible. On the ground pleasure work has revealed that holding back these assumptions can allow for individuals and groups to decide their own response to a pleasure approach.	“A massive lesson learned was to not have preconceived notions about the communities’ openness to talking about pleasure. They went into this project assuming that the integration of pleasure into their conversations with Batwa women would be very complicated and that the Batwa women wouldn’t want to speak about taboo topics, however they have found this group to be extremely accessible and willing and enthusiastic to have a space to speak about pleasure” – Pleasure Implementer 6, Survey
Where use of local languages sounds offensive or sex negative when talking about pleasure, a mix of languages or inoffensive slang words can be used as alternatives.	Use of local languages can expand access to a pleasure approach but can include offensive or sex-negative words that refer to sex and pleasure. Some pleasure implementers chose to use a mix of Swahili and English to get around this challenge whilst others appropriated internet slang, verbalising emoji use to refer to genitals e.g. using the Swahili word for peach to refer to a vulva.	“Most of the young people, they were comfortable speaking in swa-nglish, it’s mixing English and the Swahili, in other words” – Pleasure Implementer 7, Survey
Pleasure can be introduced slowly into a conversation through discussion of topics that feel safe.	Understanding pleasure is fundamentally about understanding and respecting our own and others’ experiences, sensations, and desires. This way of understanding ourselves and others can be introduced via topics that feel safer, such as respecting and understanding experiences, sensations and needs when giving birth.	“We first start talking to them about respectful maternity care, where the woman must be respected while giving birth. It’s the same thing that needs to be respected before conceiving, that’s where we introduce the theme” – Pleasure Implementer 8, FGD
Pushback to introducing a pleasure approach to young people can potentially be addressed by amplifying young people’s voices.	A common push-back to introducing a pleasure approach to young people is that it will encourage them to have sex. However, many young people enjoy engaging with a pleasure approach and feel it equips them properly to navigate sexual experiences. Amplifying young people’s voices can be helpful in responding to this pushback.	“[Teachers have said] I’m concerned you are teaching adolescents about sex and reproductive health as this encourages them to have sex” – Pleasure Implementer 7, Survey “We had young people themselves responding to the comments that were saying, you know, it’s not promoting immorality, but actually promoting what we want to discuss and what we want to share” – Pleasure Implementer 1, FGD
Pleasure approach activities should seek to reveal gender norms and misogyny that may undermine, particularly women’s, experiences of pleasure.	Women’s pleasure is often overlooked and perceived as unimportant by both societies and individuals. Pleasure approach activities should aim to deconstruct and reveal why women’s experiences of pleasure may be undermined by this.	“On the scale of pleasure the male and female get to be assigned to roles and are bound to stick to their respective roles. A woman in most cases must make sure that her husband is satisfied and content, while on the flip side of the coin the same emphasis tends to be lost on men” – Pleasure Implementer 1, Survey
Facilitators and Training
Spend time training those who will facilitate the pleasure approach (youth educators, teachers), they may need time to overcome their own barriers to speaking about pleasure as for many this a new topic and skill.	Talking about pleasure can be new and scary. New facilitators of a pleasure approach will need training, time, and support to become comfortable talking about pleasure and sharing with others.	“It seemed to be like the first time for teachers to be introduced to the pleasure-based approach and SRHR contents … this slowed down the delivery of the content because teachers spent a longer time learning about the approach” – Pleasure Implementer 7, Survey
Provide your facilitators with ongoing support, learning to speak about pleasure is an iterative and ongoing learning process.	Learning to be comfortable and confident talking about pleasure is a long process with no end point. New ways of appreciating pleasure may reveal themselves at different times. Facilitators need ongoing support to reinforce their pleasure journey.	“There has been ongoing monitoring where the youth external facilitators have been supported in how to talk about sex and pleasure, for example, sharing thoughts with peers’ – Pleasure Implementer 2, Survey
It is essential that facilitators have the capacity to communicate positively and non-judgmentally about pleasure and sex.	People who are judgmental and share negative or stigmatising perspectives on sex or pleasure will not be able to facilitate a pleasure approach.	“Replace people who cannot communicate positively, authentically, and non-judgmentally” – Pleasure Implementer 4, Survey
If facilitators can be vulnerable and offer up their own stories, joys and struggles with experiencing pleasure, people are more likely to share their own experiences in a group setting, as the facilitator models the vulnerability and openness it takes to do this.	Being vulnerable and open about pleasure is difficult. Facilitators can model the ability to be vulnerable by sharing their own experiences of pleasure. Where facilitators expect people to be vulnerable without offering up their own vulnerability, this can stem from assumptions about for whom it is appropriate to talk about pleasure and sex e.g. sex workers.	“Oftentimes, people interacting with the sex workers are doing interventions there are power imbalances. All sex workers are expected to share their internal things like personal things. But they [intervention facilitators] won’t share their own personal experiences. It’s an intimate thing. So, when we break the cover, when we open about our own sexual practices and preferences, they’re happy to share about their preference” – Pleasure Implementer 4, FGD
In some cases, facilitators that are the same age and/or gender as the group, encourage more open discussion between those participating.	Pleasure implementers reported that women and girls can feel shy, intimidated and/or judged in mixed gender groups. Groups consisting of only women and girls can allow them to speak more freely about their experiences with pleasure. Although, other heterogeneity within groups should be considered. SIAAP told us that younger sex workers were shy to speak in the presence of older, well respected sex workers.	“So we put the women together and … we put the men together, and after we made a community debate between men and women to come to find a common ground and solutions in relation to the problems that they identified. Because if you put them all together at the same time, it’s difficult for them to come out with their thoughts” – Pleasure Implementer 6, FGD
Organisation and Funder Best Practice
Honour pleasure approach work that is already being done. It may not be named or recognised as a pleasure approach.	Where there is already pleasure work, in some form, occurring within a context. This should be recognised. Implementers should consider using this existing pleasure infrastructure.	“Way more organizations were already doing work very adjacent to pleasure based sexual health without ctually calling it pleasure based sexual health” – Pleasure Partner 1, FGD
Make time and resources available to have one-on-one sessions with pleasure implementers as they begin their pleasure approach work.	One-on-one sessions built pleasure implementers confidence in speaking about pleasure and about their project aims. It allowed them to refine their projects. It should be considered how this is delivered as funding pleasure work is scaled up.	“After we shortlisted the 8 organizations, we actually spoke to all of them and sort of helped them as well to refine what they had planned to do. There were lots of very ambitious projects … So I think especially from The Pleasure Project perspective, it really helped us understand who these organizations were and the type of work [they planned]” – Pleasure Partner 1, FGD
Connect pleasure implementers to a wider pleasure network.	Pleasure implementers should be connected to a wider network of others implementing pleasure, in both similar and unfamiliar contexts. This allows space for experiences and best practices to be shared between pleasure implementers and for them to feel less alone in their pleasure work.	“I think one of the main highlights for me from this project as well to allow the space, that additional space for grantee partners to come together” – Pleasure Partner 2, FGD
Formalise and legitimise doing pleasure work and including pleasure in grant applications.	Historically, AmplifyChange grantee partners did not explicitly include pleasure in their project themes, strategies or approaches. Less than 10 grants since 2015 have directly and openly worked on pleasure-based sexual health. In many of these projects, pleasure was a small aspect of the project that otherwise worked towards achieving other SRHR priorities. As part of AmplifyChange’s commitment to The Pleasure Principles (REF), pleasure-based sexual health is included in funding guidance to encourage organisations to apply for funding. In the first funding round where these guidelines were included, 27 applications out of 732 had a pleasure lens or focus. This shows growing confidence and drive from organisations across Africa and South Asia to work on pleasure in their advocacy activities.	“I think you were worried that we [Pleasure Project personnel] wanted to see it as a separate funding stream, like a pleasure funding stream. But I was then really pleased that it would be integrated across … as it became something that was more mainstream and people were less nervous to apply … if it [pleasure] is not clearly stated in the granting guidelines, they’re not going to feel confident because of the stigmatized nature of the subject”’ – Pleasure Partner 3, FGD
Document and evaluate pleasure work where possible.	Documenting and evaluating pleasure work is essential to add to our understanding of how to best implement a pleasure approach in a variety of settings and the impact a pleasure approach has on wellbeing and SRH.	“Now I think we have a really amazing group that can present to future grantees … but maybe in a more formal way than the way we did it [before]” – Pleasure Partner 3, FGD

Table

Organisation name
Grant type
Original Project Title
Total grant amount
Grant reference number
Implementation country(ies)
Name of AmplifyChange Grants Manager
Reporting period (From DD/MM/YY to DD/MM/YY)
Please provide a summary of the overall reflections of the pleasure-inclusive activities your implemented over the course of this project.
What worked well around the implementation of pleasure-based approaches in your work?
Please share up to three successes and three challenges you have identified related to the pleasure-inclusive approach in this project.
What outcomes or impact have you identified as a result of the pleasure-inclusive approach in your project? Did anything surprise you?
What lessons have you learnt through the use of a pleasure-inclusive approach?
Please share a specific example or story of change of how the pleasure-inclusive approach has worked in the project.
Has the pleasure work had any impact or contribution to other areas of your work and/or across your organisation?
Has this work enhanced your confidence in working on pleasure and sex-positivity in your work? How has it changed your approach to SRHR?
What pleasure-based approaches would you like to do more of going forward in your work, if anything?
What advice would you give to other organisations wanting to work on pleasure-based and sex-positive SRHR?
What technical support or assistance was the most useful or helpful?
Other
Are you happy sharing your experience and/or media (photos, videos, etc.) publicly?