A Mirror of Life Improves the Health and Wellbeing of Nigerian Women & Girls

July 19, 2021 • News

woman carrying a bucket on her head filled with bottled soda drinks. The label on the bucket reads, "Jolokoto."woman carrying a bucket on her head filled with bottled soda drinks. The label on the bucket reads, "Jolokoto."

Throughout its broadcast, Jolokoto reached many thousands of people and had positive, lasting impacts in the lives of Nigerians — and on all life on Earth.


Why Nigeria? Why Now?

Nigeria is just one of 54 nations on the African continent, but as humanity moves further into the 21st century, it may play an outsized role in global population growth. In fact, the United Nations projects Nigeria might contribute as much as 10% of total global population growth between now and 2050. This is one reason that Population Media Center prioritizes Nigeria in our strategic efforts, working there since 2006.

Nigeria’s potentially dramatic population growth has many drivers. The country already has the 7th largest population in the world, at 211 million. The average number of children born to a Nigerian woman (i.e. total fertility rate) is around five, which is very high compared to most countries in the world. When combined, these two factors add up to annual population increases of over 5 million people per year. By 2050, annual increases are expected to accelerate to 7.3 million people per year — unless fertility decreases further than currently expected.

When it comes to population projections, a lot of attention is paid to total fertility rates, because they are so influential to future demographic trends. But, like many measures in life, numbers can mask the complexity of what is being measured. When it comes to fertility rates, they might best be thought of as emergent properties of complex social systems. There are many subtle and not-so-subtle forces at work when it comes to how many children women give birth to in any given time and place.

Population Media Center’s research and 20 years of practical experience have taught us that key drivers of high fertility include low status of women and girls, large family size traditions, and bias against contraception. The latter is based primarily on rumors, myths, misinformation about the safety and efficacy of modern birth control technologies — and the subjugation of women’s real preferences (for example, when spouses, parents, religious edicts, and patriarchal social norms control contraceptive use and childbearing decisions more than the women themselves do.)

Therefore, when PMC began development of a 120-episode radio serial drama in 2019, customized for broadcast audiences in the Southwest Nigerian states of Oyo and Ogun, we had a strong idea of how to best impact Nigeria’s future demographic trajectory: by providing immediate and transformative opportunities for Nigerians today. As always, our goal was to help people live healthier and more prosperous lives.

The biggest part of our script for this new drama included helping adolescent girls avoid unintended pregnancy. Unfortunately, complications relating to pregnancy and childbirth are the leading cause of death for girls aged 15-19 globally, so every unintended pregnancy avoided averts a mortal risk to these still growing girls. Moreover, in countries where abortion is prohibited or highly restricted (such as Nigeria), unsafe abortions are often what happens when unintended pregnancies occur.

To counter these dynamics, we wanted to help build a socially supportive environment for all the people of these states to access and utilize the sexual and reproductive health services available to them. Increasing uptake of family planning and long-acting reversible contraception were also goals, along with increasing access to post-abortion care (PAC) services. This is why we worked with the sexual and reproductive health clinics operating in Oyo and Ogun area to design our program, and why we would eventually promote government-run reproductive health clinics (“Green Dot” clinics) with our drama and social media activities. Overall, these partners combined to operate close to 200 sexual and reproductive health service sites in the broadcast area.

Bringing Jolokoto to Life

In early 2019, PMC team held a 3-week in-depth workshop in the city of Abuja for writers and producers on how to develop an entertaining radio show using the PMC Theory of Change. This workshop was led by Dr. Kriss Barker, PMC Vice President, International Programs. Lindsay Reid , PMC Program Manager, and Eric Chiyombwe, Deputy Representative of PMC-Zambia also attended. Dr. Arije from the Institute of Public Health (IPH) presented the report of findings of the Situation Analysis and Formative Audience Research.

Writing and production of the show began in May 2019. After the scripts were approved by the producers, the production team rehearsed the scenes with the voice actors, and then proceeded to the studio for recording and production. PMC-Nigeria uses its own recording studio for the production of the radio serial drama.

Pilot episodes for the show were pretested to make sure the language, messages, and characters in the drama were understandable, entertaining, culturally appropriate, believable, realistic, and acceptable to the target audience. The creative teams then refined the storylines and character profiles based on the results of the pretests. After all edits for the episodes were reviewed by the production team, and approved by an executive panel, they were burned onto CDs and dispatched to each radio station for broadcast.

Prior to broadcast launch, the PMC-Nigeria team met with various stakeholders and started a promotional campaign. The PMC-Nigeria team held meetings with representatives of the Federal Ministry of Health, Ministry of Budget and National Planning, Ogun State contingents, and many others. The show was promoted in various ways. Radio stations deployed various jingles and spots alongside in-house promotions to add value to the process. Additionally, there were 60 TV spots of 1-minute jingles on two TV stations in each Ogun and Oyo.

Jolokoto, (“Mirror of Life”) was broadcast on 16 radio stations, ten in Oyo State, and six in Ogun State. Each week, two original episodes were broadcast, and repeated at a different time each week, to allow listeners to access any episodes they might have missed.

Our Audiences Know Where to Walk — And How to Talk the Talk

After Jolokoto’s last broadcast, PMC conducted a cross-sectional endline survey to assess the program’s impact. Consenting respondents between ages 15 – 25 were interviewed from 18 local governments (LGA) across Oyo and Ogun states. The survey found that one in five Nigerians aged 15-25 (20%) in Oyo and Ogun said they had heard about the show, which equates to more than 500,000 Nigerian youth having heard about Jolokoto.

Some very promising measures came out of this endline, when compared to the baseline research PMC initially conducted. In terms of helping to prevent unintended pregnancy, several influential measures can be seen. When compared to baseline research conducted by PMC, the percentage of 15 to 25 year olds living in rural areas of the two states who knew of reproductive health clinics where they could obtain contraceptives such as inter-uterine devices (IUDs), implants, or injectables to prevent pregnancy increased from 29% to 57%. In peri-urban areas this knowledge increased from 32% at baseline, to over 60% at endline.

Listeners to Jolokoto were also significantly more likely to have discussed family planning frequently or sometimes with a spouse or partner in three months prior to the survey than non-listeners — over twice as likely, in fact. Listeners were also significantly more likely to have communicated with siblings about the importance of using contraception to prevent pregnancy in past six months — again, over twice as likely. This natural, organic dissemination of the knowledge Jolokoto promoted is key to broad and lasting social norm change within a community.

Another way that PMC evaluates our shows is by measuring how well they create demand for pre-existing sexual and reproductive health information and services. In the case of Jolokoto, we were especially interested in the extent to which our drama motivated calls to contraceptive “hotlines” and other counseling services operated by the sexual and reproductive health clinics in the broadcast zone. Surveys showed that thousands of calls were directly attributable to Jolokoto between August 2019 and 2020.

These data points add up to immediate progress on the lives and health of Nigerians living in Oyo and Ogun states — and subtle but substantive progress on Nigeria’s demographic future. Every unintended pregnancy avoided, every time a young woman’s chances to live out her dreams and aspirations are maintained, every time the social fabric of Oyo and Ogun states shifts towards one that values health and respect for women and girls, then that is a victory in the long-haul work we specialize in.

Taking an even bigger step back, all these small but meaningful victories in Oyo and Ogun states also mean progress on the larger challenge PMC is concerned with: slowing down global population growth and, as soon as possible, creating the conditions for it to end. Though there has not been a formal census in Nigeria since 2006, a reasonable estimate is that Oyo and Ogun states have a combined population of around 15 million people, which represents about 7% of the total Nigerian population of 211 million. Importantly, across Nigeria’s overall population pyramid, the age groups of 15 to 19, and 20 to 24, account for about 9.8% of the nation’s population.

PMC’s drama, Jolokoto, reached around 11% of young people in Oyo and Ogun states. This is an incredible and cost-effective focus of resources, especially considering that 46% of Jolokoto listeners said the program helped them achieve an improved relationship with their partners and family members.

All of our work is grounded in an ethical imperative: We want to improve the chances of future generations establishing sustainable living scenarios with the planet. We are completely convinced that the best way to do that is by helping create immediate improvements to lives of people today.

In Oyo and Ogun states, with the help of Jolokoto, it is mission accomplished.

 


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