“Female Condoms Are_____”: Bringing local voices to decision-makers through a film contest

Female condoms are an important option for dual protection, yet awareness and availability remain too low in too many places, including areas with high rates of HIV infection and unmet need for modern contraception. Negative attitudes, perceived lack of demand, and tepid political will amongst international donors and policymakers are factors that continue to hamper widespread availability.¹ A variety of advocacy approaches are needed to help create an enabling environment to make female condoms a real choice for women and men.

PATH (http://www.path.org), an international nonprofit health organisation, has recently intensified its advocacy efforts to expand access to female condoms through its Protection Options for Women Product Development Partnership (POW PDP).^* The POW PDP focuses on market introduction and promotion of the Woman’s Condom (http://sites.path.org/rhtech/womans-condom), as well as advocacy to strengthen support for female condoms in general,^2,3 with the goal to increase international donor and government investment in female condom procurement and programming. To this end, the POW PDP implemented an innovative initiative to bring the voices of female condom supporters to international and national policymakers, as well as other female condom stakeholders, generate positive attitudes and political commitment, and amplify demand for the product. The idea of an international film contest resonated with the POW PDP because of its potential to share impassioned stories in an accessible format.

The “Female Condoms Are_______” Film Contest

In late 2012, PATH launched the “Female Condoms Are_______” Film Contest in partnership with the Universal Access to Female Condoms (UAFC) Joint Programme (http://condoms4all.org), the Center for Health and Gender Equity (CHANGE) (http://www.genderhealth.org), and the National Female Condom Coalition (NFCC) (http://www.nationalfccoalition.org). This global competition called for short films (1–5 minutes) that described how female condoms can enhance people’s lives and can be used in a sex-positive manner. The contest was open to individuals around the world who were at least 18 years of age or the age of majority in their countries. Filmmakers of all experience levels were encouraged to enter, and any film style or genre was welcomed. Filmmakers were required to thematically address at least one of the following prompts in their entry:

•	Why does the world need female condoms? Are male condoms enough or do we need something more?
•	What do female condoms mean to you and women and men in your community?
•	How would different types of female condoms affect your life or the lives of others?
•	How are female condoms different, special, or sexy in your experience or the experience of others?

Filmmakers titled their “Female Condoms Are_______” entry by filling in the blank with a word or phrase that captured the essence of their work. Films could be recorded in the filmmakers’ native language as long as they were subtitled or dubbed in English. Contest entrants retained ownership rights to their film but also granted PATH and the contest partners a licence to use their film for nonprofit awareness raising, advocacy, and education.

Outreach

We developed a dedicated website (www.femalecondomfilm.org) that included a flyer, official contest rules, and frequently asked questions. YouTube was selected as the platform to display the films. Prize money was offered for first (US$5,000), second (US$2,000), and third place (US$500) to encourage participation.

To reach filmmakers, we compiled a list of more than 300 film schools worldwide and emailed details to them. We also targeted film conferences, such as the 2012 Women in Film and Television International Summit, and liaised with individuals in the film industry to spread the word. To reach public health professionals, NGOs and advocates, we sent announcements to colleagues and posted them on sexual and reproductive health and rights, HIV/AIDS, maternal and child health listserves and social media, including Facebook, Twitter (#femalecondomsare), and LinkedIn.

Judging

Films were judged according to overall impact, creativity, originality, and strength of content and messaging. We created an online judging survey with quantitative and qualitative questions, which included:

•	An initial screen for eligibility by PATH staff.
•	A second round consisting of two staff from each partner organisation to narrow the pool of eligible entries to 12 finalists.
•	A third round with external judges to select prize winners — individuals with expertise in film, HIV/AIDS, and sexual and reproductive health. Guest judges were from the Seattle International Film Festival (Washington, USA), Lights.Camera.Help. (Texas, USA), MᐧAᐧC AIDS Fund (New York, USA), Norwegian Agency for Development Cooperation, and Uganda Ministry of Health.

Contest winners

The contest ran from November 2012 to March 2013. We received 27 films from 12 countries spanning five continents. The guest judges selected four winning films, including a tie for third place, which were announced in May 2013 at the Women Deliver conference in Kuala Lumpur, Malaysia.

First place

Female Condoms Are My Power, My Protection, My Pleasure!

http://www.youtube.com/watch?v=50VMPY5NCwk&feature=youtu.be

Submitted by: Pathfinder International: Linda Suttenfield, Estrella Alcalde, Nelson Fakir, Jaime Jacobsen, Felix Mambucho, Elizabeth Ortiz, Samboko, Nina Yengo, and Matchume Zango, Mozambique

This documentary follows two young female condom activists in Mozambique. Both are satisfied users and peer educators with Pathfinder International’s female condom project. Deolinda was first introduced to the female condom by her mother, a trained community activist, who discusses the importance of practising safer sex with Deolinda in the opening scene. Deolinda harnesses her knowledge and passion for female condoms to help empower other young women to pursue protected, pleasurable sex. Meanwhile, Benjamin takes on outreach to change the minds of skeptical men.

Second place

Female Condoms Are Preferable

http://www.youtube.com/watch?v=KIBTOterKys&feature=youtu.be

Submitted by: Doh Marceline Kahndi and the Community Human Rights and Advocacy Centre (CHRAC), Cameroon

This docudrama is based on a true story of a woman who reported to CHRAC that her husband raped her, and as a result, she had had five children at close range. The film opens with a middle-aged, married couple arguing in the street. The husband keeps asking for sex at the wrong times, and the wife is reluctant, because she already has so many children; however, she too wants satisfaction with her husband. A male friend acts as a mediator and suggests female condoms. The couple agrees to use them to both their satisfaction.

Third place

Female Condoms Are Pretty Nice

http://www.youtube.com/watch?v=WjagzoNZ6Dg

Submitted by: Alan Ting Judson, Tan Xin Tian, and Tang Ming Ting, Malaysia

In this film about life’s pleasures — including sex — a young Malaysian couple explore their options for protection and find that female condoms have a lot to offer. Rather than simply listing off benefits, the couple brings to life the benefits of the female condom through clever acting and cheeky sound effects.

Female Condoms Are a Woman’s Bargaining Power

http://www.youtube.com/watch?v=3Qb2DtI9NTg&feature=youtu.be

Submitted by: Karel Blondeel, Kenya

Shot at the Kisauni Drop-in Centre in Mombasa, Kenya, this film features testimonials from three young women who are the “number one” fans of the female condom. They partake in a lively product demonstration and proceed to discuss their personal experiences. They feel they “own the female condom” and that it “gives them the upper hand in sex” and contributes to zero new HIV infections.

Additional top films

Female Condoms Are About Self Love

http://www.youtube.com/watch?v=r9G-IzTmIcA&feature=youtu.be

Submitted by: Nawaal Deane and Sara Chitambo, South Africa

This film, without dialogue, depicts female condoms as a normal part of a woman’s routine — putting on lipstick for a date, relaxing with a glass of wine, and doing her hair.

Female Condoms Are Peerless

http://www.youtube.com/watch?v=_nYkPCz8Y3o&feature=youtu.be

Submitted by: Ikechukwu Erojikwe, Nigeria

This drama illustrates the difficulty many African women face when negotiating pregnancy prevention with their husbands.

Female Condoms Are Sexy

http://www.youtube.com/watch?v=hDVY8kgZ1zM&feature=youtu.be

Submitted by: Robin Brooks and Jason Wong, USA

In this spirited short, men’s misconceptions about the female condom are dispelled by an informed woman.

Female Condoms Are Freedom

http://www.youtube.com/watch?v=K6FZKlq47ws&feature=youtu.be

Submitted by: Denisse Arancibia Flores, Bolivia

In this monologue, a Bolivian woman touts the virtues of ugly men as she’s getting ready for a night out and is ready to leave only after inserting a female condom.

All 12 finalist films can be viewed at: http://www.youtube.com/playlist?list=PL-XBRNBKkU8di7SaKcG0FA0V4uXcum8Gk

Analysis of content

PATH sent an online survey to the 12 finalists to learn more about the making of their films. We asked about story and character development, main messages, distribution, and the filmmakers’ motivations and experiences. We received seven responses, including from the four winners.

The films were a mix of documentaries, dramas, and personal testimonials, with a few comedies and one musical. About a quarter of the entries had either minimal or no dialogue, which has translated well across international audiences. Many of the films were informational in nature and demonstrated female condoms to varying degrees of effectiveness. Films that employed humour or contained fun images and sound effects have resonated well with viewers by creating space to laugh and connect with what could be a potentially uncomfortable topic.

Female Condoms Are Pretty Nice

“We tried to use humour in our film because we believed that our friends would prefer to watch funny films instead of serious ones, so this was the only way we could catch their attention.” (Alan Ting Judson, Malaysia)

Sexual pleasure associated with female condom use was the most prominent theme and appeared in nearly all 27 entries. Young women and young couples were the main subjects of the majority of entries, and their storylines were closely linked with the theme of sexual pleasure. The focus on young people may have been a reflection of the entrants themselves, many of whom were young.

The functional benefits of female condoms for contraception and protection from sexually transmitted infections (STIs) and HIV were highlighted in a majority of film entries. “Dual protection” from pregnancy and STIs/HIV was rarely mentioned, which is interesting, because female condoms are the only option besides male condoms that offers such protection.

Many films focused on female condoms as a means of women’s empowerment. Several of these specifically showed women getting ready and planning ahead with the female condom. Several others were about the importance of engaging men as positive agents in female condom use and tended to depict male characters engaged in constructive conversation about the female condom. Finally, a few films contested the perception that female condoms are a niche product.

“There is a stereotype about the use of female condoms in Africa. Most of the adverts are aimed at rural or poor women and this means it does not cover the variety and diversity of women that need to be targeted… The idea of our film was to send a message to empowered young women.” (Nawaal Deane and Sara Chitambo, South Africa)

A handful of films from Africa focused on middle-aged, married couples and positioned female condoms primarily for pregnancy prevention and as a possible strategy for challenging traditional gender norms and roles. For example, Ikechukwu Erojikwe of Nigeria sought to “counter existing norms by depicting a woman rousing herself to take actions that will protect her no matter what the cultural environment should expect.”

Lastly, all entries focused on vaginal intercourse in heterosexual relationships. Only one film mentioned female condoms for anal sex (“Female Condoms Are a Woman’s Bargaining Power”), yet we know that men who have sex with men and heterosexual couples are using female condoms for protection during anal sex.

Leveraging the films for advocacy

Since the announcement of the winners in May 2013, contest organisers, filmmaker entrants, and advocates worldwide have used the films to raise awareness and build support for female condoms amongst policymakers, health professionals, the media, and potential users.

For those interested in showing the films locally, we created a film-screening toolkit available online (www.femalecondomfilm.org) and offline on a memory stick. It contains talking points, “how-to” tips for organising a film screening event, a film screening discussion guide, a fact sheet on female condoms, and descriptions of the 12 finalist films. We have received 83 unique visits to the web version of the toolkit, and 90 memory sticks have been distributed through our partner organisations.

Although the contest organisers do not have advocacy impact data from film screenings, we have tracked our own advocacy outcomes from online distribution, media outreach, and special events. In addition, we have collected distribution data from the filmmakers via an online survey and through follow-up email.

PATH created a playlist for the 12 finalist films on its YouTube channel, and the films have had more than 175,000 views on YouTube at this writing. In addition, all contest organisers have posted the films to their websites and have promoted them through Facebook, Twitter (#femalecondomsare), and Pinterest (www.pinterest.com/pathglobal/female-condoms-are_______/).

Contest entrants have also been promoting their films online. Pathfinder International’s film has played an important role in driving traffic to Pathfinder’s website and increasing visibility. The film landing page was the third most viewed page on their website since it was created and has attracted more than 13,000 unique views, 289 Facebook “likes” and 80 tweets.

Aided by the film-screening toolkit, contest organisers, filmmakers, and advocates have held numerous film-screening events and integrated the films into trainings. For instance, in recognition of the 2013 Global Female Condom Day (September 16), contest organisations and advocacy groups in Cameroon, China, Kenya, Netherlands, Nigeria, South Africa, and USA held film screenings that collectively reached thousands of individuals. In China, approximately 500 students at five universities attended campus screenings organised by the China Youth Network and PATH. The Global Female Condom Day film screenings ranged from a festive film event in Illinois (USA) sponsored by the Chicago Female Condom Campaign featuring a live DJ and a radio personality, to a cinema-style showing in Nigeria organised by UAFC’s partner, the Society for Family Health, with a discussion panel that included a doctor from local government, a community programmer, and the UN Population Fund.

Many events were designed specifically to reach and influence policymakers. Among these were the following:

•	Film screening at May 2013 Women Deliver conference in Malaysia.
•	June 2013 female condom workshop in South Africa with national policymakers and bilateral donors.
•	September 2013 World Contraception Day event in Belgium targeting European Union policymakers.
•	November 2013 International Conference on Family Planning in Ethiopia.

A screening for hairstylists and taxi drivers organised by Youthhood in Zimbabwe attracted the Mayor of Bulawayo, who “gave his support and promised to ensure council clinics are fully stocked with female condoms”. And at the female condom workshop in South Africa organised by Women in Sexual and Reproductive Rights and Health Associates, the films provided an “eye-opening” experience for policymakers and decision-makers who described never having encountered positive media on female condoms before. The films also helped create a comfortable space for the policymakers to discuss the product. At the end of the workshop, procurement representatives from the National Department of Health committed to improving their tendering procedures to help ensure a range of World Health Organization-prequalified female condoms were made available.

Finally, contest entrants have leveraged the films for their own trainings and campaigns. CHRAC distributed copies of its film to partners and held screenings in 37 communities in the Menchum Division of Cameroon. CHRAC is using its film as part of HIV/AIDS sensitisation for a peace-building project between farmers and grazers. Two other filmmakers have used the films as part of a global prevention campaign — the Flirt with the World^TM Million Condom Giveaway (www.flirttheworld.org) — with the goal of raising awareness about female condoms and organisations providing HIV services. As part of this giveaway, they planned to screen all the finalist films and distribute male and female condoms in countries across Africa in partnership with local NGOs and private sponsors.

Promotional efforts and special events have led to media coverage of the film contest and the winning films in more than a dozen news articles and blogs, including A&U Magazine, allAfrica.com , Mosaic, and Impatient Optimists (the Bill & Melinda Gates Foundation blog). Pathfinder International’s winning film was included in a BBC News Magazine spread about the return of the female condom, a piece that got more than 1.1 million page views and 3,000 “shares” on social media the day it ran. The film contest has caught the attention of journalists and helped to raise broader awareness of female condoms and the importance of improving access.

Conclusion

PATH, UAFC, CHANGE, and NFCC developed the “Female Condoms Are_______” Film Contest to document what female condoms mean to women and men worldwide and to use these stories as vehicles for advocacy with policymakers and other stakeholders. The quantity and quality of the submissions exceeded our expectations and demonstrate that female condoms are a topic of interest and inspiration in countries around the world. We have been deeply moved by how the films have resonated across communities and cultures and been incorporated into local advocacy and education initiatives. We continue to find opportunities to use the films in our advocacy and media outreach and to track how organisations and individuals around the world are utilising the films to advocate for universal access to female condoms.

Acknowledgements

PATH would like to thank the filmmakers whose survey input shaped this article: Alan Ting Judson, Ikechukwu Erojikwe, CHRAC, Pathfinder International, Karel Blondeel, Florence Adu, Marva Greer, and Nawaal Deane. We are grateful for the support of the film contest co-organisers — UAFC, NFCC, and CHANGE — and acknowledge the following PATH staff for their contributions to the contest and this article: Shannon Mills, Maggie Kilbourne-Brook, Lucy Zhang, Jeanette Lim, and Jean-Pierre LeGuillou. Funding from the Netherlands Ministry of Foreign Affairs made the film contest possible.

Notes

* Established in 2011, the POW PDP is a partnership among PATH, Shanghai Dahua Medical Apparatus Company (Woman’s Condom manufacturer), CONRAD, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA.