In 2006, the Ligne Verte phone hotline was created to provide individuals in Benin with free access to information about sexual and reproductive health topics at a time when unmet need for contraception was high and young women and adolescent girls were not being reached with reproductive health services.

Annual satisfaction surveys are conducted to improve the hotline to better address caller's needs and support call counselors.

The collaborative improvement process allowed the research team to develop a clearer understanding of the program's needs and weaknesses and thus make more realistic, affordable, actionable, and evidence-based recommendations for improvements.

To generate and maintain high client satisfaction, health program managers designing similar programs to Ligne Verte should prioritize end-user perspectives, support staff morale, and create continuous feedback loops for program improvement.

Since 2006, the Ligne Verte project—a toll-free national hotline that provides counseling and provider linkages to family planning, HIV, and sexually transmitted infection services—has been implemented by the Association Béninoise pour le Marketing Social et la Communication pour la Santé (ABMS) in Benin. Annual evaluations have been conducted to monitor client satisfaction, with feedback mechanisms to learn from callers and staff, aiming to continually improve the program. We document lessons learned from these evaluations, outline the adaptation process to improve the quality of the hotline, present results from Ligne Verte caller and counselor studies, and describe how the studies fed client-driven changes to the project.

Annual rounds of semistructured phone interviews with Ligne Verte callers and call center advisors were conducted. The sample of clients interviewed included consenting men and women aged 18 years and older who had used Ligne Verte services in the 3 months preceding the evaluation. All advisors working on the helpline were also eligible for inclusion in qualitative interviews.

From 2013 to 2020, most callers were satisfied with the Ligne Verte project. Users reported appreciating the accurate, timely, and confidential support they received from the helpline but noted the need to expand the service to other local languages and improve call quality. Call center advisors requested mental health support. In employing a systematic approach to program improvement, ABMS was able to add extended language services, upgrade their telecommunication hardware, and provide a psychologist for call center advisors. These program adaptations have increased caller satisfaction by 20 percentage points, and in 2020, 95% of callers reported being satisfied with their Ligne Verte experience.

Taking a consumer-centered approach, listening to user feedback, and making evidence-based recommendations to improve the Ligne Verte project has led to an overall increase in caller satisfaction.

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