PMC Announces Results in Rwanda

September 20, 2010 • Rwanda, PMC in the News

PMC Rwanda’s Radio Drama Umurage Urukwiye (“Rwanda’s Brighter Future”) Report on Impact (August 2010)

In Rwanda, the fertility rate is 5.5 children per woman, according to the 2008 Demographic and Health Survey (DHS), a figure that has not changed appreciably since 1992. Knowledge of family planning is nearly universal in Rwanda: 97 percent of married women and 99 percent of currently married men have knowledge of at least one modern method of contraception. Only 27 percent of married women use modern methods of contraception, but this figure represents nearly a tripling from 2005, when the DHS showed only 10 percent of married women used modern methods of contraception. As of 2008, fully 71 percent of married women who were not currently using contraception intended to do so in the future, a 22 percent increase in less than three years.

Among the reasons for non-use, perceived religious opposition has dropped by 58 percent since the 2005 survey. Partner opposition dropped by 65 percent. Fear of negative health effects of contraception remains a significant barrier (12% of the non-users cited this concern), but this reason has dropped by more than a third since the previous survey. Cost and lack of access to family planning methods remain insignificant as reasons for non-use, at less than 1 percent each.

At the time of the 2005 survey, the desired number of children among married women was 4.5; by 2008, that had dropped to 3.6. If contraceptive use continues to climb, we can expect the fertility rate to drop by the time of the next survey.

At the time of the 2005 survey, 59 percent of women had not seen or heard any family planning messages on radio, TV or in print in the previous few months. That question was not asked in the 2007-2008 survey. Population Media Center started broadcasting a radio serial drama to promote family planning use in July 2007. The extent to which it played a role in the dramatic progress Rwanda made prior to the 2008 survey, which was carried out from December 15, 2007 to April 20, 2008, is impossible to determine. However, here is what we do know about the program, its popularity, and its impacts on listeners.

PMC’s 312-episode program, Umurage Urukwiye (“Rwanda’s Brighter Future”), was broadcast nationwide from July 2007 to August 2009 on Contact FM and Radio Salus. It addressed a combination of issues, including reproductive health, prevention of HIV/AIDS, preservation of wildlife habitat, preservation of natural resources, land conservation, sustainable farming practices, and promotion of civil harmony. PMC carried out this project with support from UNFPA, the Flora L. Thornton Foundation, the Mulago Foundation, the Arcus Foundation, the U.S. Fish & Wildlife Service, and USAID.

Listenership:

• Results from the final evaluation show that 37% of Rwandans listened to the broadcast one or more times. Listenership for males (44%) was higher than for females (32%). Unmarried respondents (40%) were more likely to listen to the program than married respondents (35%). Listenership levels found in both clinic monitoring (57%) and monitoring at tree seedling distribution points (52%) confirmed the popularity of the broadcast.

• More than half of all listeners (females 52%, males 58%) said they talked to someone about the drama.

Desired Family Size
Population Media Center’s program had significant effects in changing desired family size among those who were listening. At the time of the baseline survey the mean desired number of children for all respondents was 3.61 (females 3.73, males 3.44), and this decreased significantly* to 2.94 by the endline survey, with both females and males showing similarly significant decreases (females 3.02, males 2.81). (*Non-parametric t-test with p<.0001). • On this indicator, listeners were 1.5* times more likely than nonlisteners to desire three or fewer children, as opposed to four or more. (*Adjusted odds ratio with p=.0159 controlling for age, sex, and urban/rural location). Family Planning
Clinic exit interviews showed that 15% of new reproductive health clients cited the PMC drama as their reason for seeking services. Of those seeking family planning, 9% cited the program as their source of motivation. The analysis of the survey data showed:

• The likelihood of respondents saying they “currently use something to delay or avoid pregnancy” was 1.6* times greater at endline compared to baseline. (*Adjusted odds ratio with p=.0083 controlling for age and marital status).

• Listeners were 1.6* times more likely than nonlisteners 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=.0506 controlling for age, sex, urban/rural location, education, and marital status).

• Listeners were 1.4* times more likely than nonlisteners to agree that “having fewer children reduces the health risk to the mother.” (*Adjusted odds ratio with p=.0181 controlling for sex, education, and marital status).

• Listeners were 2.9* times more likely than nonlisteners to say “yes” when asked if they could obtain a condom themselves and would not need to rely on someone else. (*Adjusted odds ratio with p=.0009 controlling for sex).

• Listeners were two* times more likely than nonlisteners to know of a place to get a male condom. (*Adjusted odds ratio with p=.0007 controlling for sex, age, education, and urban/rural location).

• Listeners were 2.1* times more likely than nonlisteners to know of a place to get a female condom. (*Adjusted odds ratio with p=.0052 controlling for sex, education, and urban/rural location).
• The likelihood of respondents knowing that a female condom can prevent pregnancy was 1.4* times greater at endline compared to baseline. (*Adjusted odds ratio with p=.0007 controlling for sex, urban/rural location, education, age, and marital status).

o On this indicator, listeners were 2.3* times more likely than nonlisteners to know that a female condom can prevent pregnancy. (*Adjusted odds ratio with p<.0001 controlling for sex, urban/rural location, education, age, and marital status). HIV/AIDS
Clinic exit interviews showed that, of those seeking voluntary counseling and testing (VCT) for HIV/AIDS, 17% cited the program as their source of motivation. Of clients seeking help with preventing mother to child transmission of HIV, 24% cited the program as their reason. The analysis of the survey data showed the following:

• Listeners were two* times more likely than nonlisteners to have heard about a medication mothers can take to prevent transmission of HIV/AIDS to a baby. (*Adjusted odds ratio with p=.0319 controlling for age and education).

• Listeners were 2.7* times more likely than nonlisteners to want to know their HIV status by getting a blood test. (*Adjusted odds ratio with p=.0030 controlling for education).

• The likelihood of respondents saying “yes” when asked “apart from AIDS, have you heard of sexually transmitted infections?” was 2.6* times greater at endline compared to baseline. (*Adjusted odds ratio with p<.0001 controlling for age, education, marital status, and urban/rural location). o On this indicator, listeners were 2.2* times more likely than nonlisteners to say "yes" when asked "apart from AIDS have you heard of sexually transmitted infections?" (*Adjusted odds ratio with p=.0027 controlling for sex, age, and urban/rural location). Preservation of Mountain Gorillas and Natural Resources
In an effort to reverse the problem of erosion of farmland, the government of Rwanda sponsors a reforestation program. Tree seedlings are made available at nurseries throughout the country, and there is a designated national tree seedling planting day. PMC’s drama capitalized on that effort and featured characters that planted trees to stabilize farmland and encouraged others to do the same. An independent survey found that 11% of those buying tree seedlings were motivated by the program. In addition:

• Listeners were 1.5* times more likely than nonlisteners to cite population growth as the primary cause of environmental degradation and loss of gorilla habitat. (*Adjusted odds ratio with p=.0013 controlling for sex, education, and urban/rural location).

• The likelihood of respondents knowing that protection of gorillas and their habitat can reduce poverty and bring tourists was 3.4* times greater at endline compared to baseline. (*Adjusted odds ratio with p=.0471 controlling for sex, age, education, and urban/rural location).

o On this indicator, listeners were 1.6* times more likely than nonlisteners to know that protection of gorillas and their habitat can reduce poverty and bring tourists. (*Adjusted odds ratio with p=.0167 controlling for sex, age, education, and urban/rural location).

• Listeners were 1.5* times more likely than nonlisteners to have talked with their spouse or partner in the past three months about the connection between family planning and conservation of natural resources. (*Adjusted odds ratio with p=.0196 controlling for sex, age, education, marital status and urban/rural location).


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