Population Media Center Announces Results of Program in Nigeria

July 15, 2010 • Family Planning, Reproductive Health, Africa, Nigeria, Daily Email Recap

In Nigeria, which has one of the highest birth rates in the world, 92% of married women do not use contraceptives and 55% say they never intend to, according to the 2008 Demographic and Health Survey (DHS). The fertility rate is 5.7 children per woman, and the women think 7 children is the ideal number. The men think 9 children is the ideal number. Only 0.2% of Nigerians say they don’t use contraceptives because services are not available, and only 0.2% cite cost as a barrier.

Of all births in Nigeria:
87% were wanted at the time and another
7% were wanted, but not until later
4% were unwanted.

Overcoming this situation takes more than access to contraceptive services. It requires helping people understand the personal benefits in health and welfare for them and their children of limiting and spacing births.

Population Media Center’s program in northern Nigeria had significant effects in changing desired family size among women who were listening. The 208-episode drama program, Ruwan Dare (“Midnight Rain”), was broadcast in Kano, Kaduna, Katsina, and Sokoto states from July 2007 to June 2009. The program storylines promoted and modeled birth spacing and smaller family size. The main characters in the drama featured couples who often discussed family planning issues and both positive and negative views related to making a decision to use contraceptives to space children and achieve smaller family size.

Results from the final evaluation show that 70% of respondents in the four states listened to the broadcast one or more times per week. These percentages confirm similar listenership levels found in clinic monitoring reports during broadcast.

At the time of the baseline survey in the four states where we were planning to broadcast, the mean desired number of children for all respondents was 7.43 (females 7.71, males 7.03), and this decreased significantly* to 5.93 by the endline survey, most notably among females (females 5.39, males 6.96). *Non-parametric t-test p<.0001

• The likelihood of respondents saying they did not want to have another child was 5.7* times greater at endline compared to baseline. (*Adjusted odds ratio with p=.0001 controlling for sex, urban/rural location, education, age, marital status, and state).

• The likelihood of respondents saying they “currently use something to delay or avoid pregnancy” was 5.6* times greater at endline compared to baseline. (*Adjusted odds ratio with highly significant p=.0001 controlling for sex, urban/rural location, education, age, marital status, and state).

o On this indicator, listeners were 2.4* times as likely as nonlisteners to say they “currently use something to delay or avoid pregnancy.” (*Adjusted odds ratio with p=.01 when controlling for sex, urban/rural location, education, age, marital status, and state).

To monitor the effects of the program on listeners’ behaviors, PMC established 11 clinic research sites in the four states. Four rounds of client exit interviews were conducted during the broadcast period. The survey data was analyzed to determine motivating factors for new clients seeking reproductive health and family planning services. The results showed that Ruwan Dare achieved significant success with increasingly higher percentages of new clients reporting seeking services because of listening to Ruwan Dare. (See Table 1).

Monitoring Period Percent motivated by Ruwan Dare

Round 1: October 2007 – December 2007 55%
Round 2: January 2008 – April 2008 66%
Round 3: May 2008 – July 2008 64%
Round 4: September 2008 – December 2008 67%

Table 1. Percent of new clients motivated by Ruwan Dare radio serial drama.

• The likelihood of respondents saying they had talked with their spouse or partner “once or twice” or “more often” about family planning in the last three months was 4.5* times greater at endline compared to baseline. By sex there were notable differences regarding this indicator: for males there was a notable relative increase of 48% from baseline to endline; however for females there was a sharp relative increase from baseline to endline of 172%. (*Adjusted odds ratio with highly significant p=.0001 controlling for sex, urban/rural location, education, age, marital status, and state). This result shows that the program strongly benefited both females and males in increasing the amount of discussion of reproductive health with their partner.

o On this indicator, listeners were 1.7* times more likely than non listeners to say they talked to their spouse or partner “once or twice” or “more often” about family planning in the last three months (*Adjusted odds ratio with p=.04 controlling for age, urban/rural location, education, marital status, and state).

The likelihood of respondents saying they “discussed the practice of family planning with family, friends, or neighbors” in the past three months was 2.7* times greater at endline compared to baseline. (*Adjusted odds ratio with p=.0001 controlling for age, education, state, and marital status).

• On this indicator, listeners were more 1.9* times more likely than nonlisteners to say they “discussed the practice of family planning with family, friends, or neighbors” in the past three months. (*Adjusted odds ratio with p=.0002 controlling for age, education, and marital status).

• The likelihood of respondents thinking that “couples should space children 2.5 to 3 years apart” was 1.5* greater at endline compared to baseline. (*Adjusted odds ratio with p=.0009 controlling for sex, urban/rural location, education, age marital status, and state).

o On this indicator, listeners were 1.9* times more likely than nonlisteners to think that “couples should space children 2.5 to 3 years apart.” (*Adjusted odds ratio with p=.0003 controlling for sex, urban/rural location, education, age marital status, and state).

• Listeners were 1.7* times more likely than nonlisteners to say “yes” when asked if “couples should share responsibility for making decisions about family size.” (*Adjusted odds ratio with p=.00001 controlling for sex, urban/rural location, education, age marital status, and state).

• Respondents who were not married or in a union were asked if they would “ever use contraceptives if married;” the likelihood of answering “yes” was 1.9* greater at endline compared to baseline. (*Adjusted odds ratio with significant p=.01controlling for sex, urban/rural location, education, age, marital status and state).
• The likelihood of respondents thinking that “people should plan how many children they have” was 1.4* times greater at endline compared to baseline. (*Adjusted odds ratio with significant p=.01 controlling for sex, urban/rural location, education, age, marital status and state).

• On this indicator, listeners were nearly two times as likely as nonlisteners to think that “people should plan how many children they have.” (Adjusted odds ratio (1.9) with significant p=.01 controlling for sex, urban/rural location, education, age, marital status and state).

• Listeners were 1.6* times as likely as nonlisteners to think that “children 12-14 should be taught about using condoms to avoid AIDS.” (*Adjusted odds ratio with significant p=.04 controlling for marital status, state, and education).

• The likelihood of respondents saying that using contraceptives is not “against the will of Allah” was 3.6* times greater at endline compared to baseline. (*Adjusted odds ratio with highly significant p=.0001 controlling for sex, location, education, age, marital status and state).

o On this indicator, listeners were 1.5* times more likely than nonlisteners to say that using contraceptives is not “against the will of Allah.” (*Adjusted odds ratio with highly significant p=.04 controlling for sex, location, education, age, marital status and state).

• Listeners were 1.7* times more likely than nonlisteners to “know a place to obtain a method of family planning.” (*Adjusted odds ratio with highly significant p=.01 controlling for sex, location, education, age, marital status and state).


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