Birth Control in Kinshasa: It’s Not All About Availability
In December, a new study from the Democratic Republic of Congo’s capital city, Kinshasa, analyzed the barriers preventing women from accessing birth control. The researchers observed that the rate of contraceptive use in Kinshasa, at 19 percent, was higher than any other province in the country, but still much lower than they expected since there were 395 places to access a variety of contraception services.
Twenty-seven percent of married women and 42 percent of sexually active unmarried women between the ages of 15-49 were not using any form of birth control. If there was a high availability of contraceptives, then shouldn’t a higher percentage of women be using contraceptives?
In order to identify the barriers to using contraceptives, the researchers created focus groups of men and women to better understand why more people weren’t using birth control in Kinshasa. The researchers identified that the main deterrents were the fear of side effects, misinformation, or lack of knowledge, not to mention the sociocultural norms surrounding the use of modern contraceptives: was using birth control normal?
During the focus group sessions, the researchers found that both men and women believed there were significant health risks in using contraceptives. One woman explained that “people who use these methods have complications such as cancer and sterility.”
Another significant barrier were the sociocultural norms perceived by both men and women. Many men believed that the decisions regarding family planning are the responsibility of husbands, and not with the couple as a whole, since the husband provides financial support and is the head of the household. Many men also believed that using modern methods of contraceptives would be disrespectful to African culture.
These fears and beliefs, and others like them, exist all over the world and it’s this misinformation that Population Media Center (PMC) seeks to combat and change. PMC is a US nonprofit specializing in entertainment that changes lives. Not only does good entertainment draw huge audiences, but it can also relay important and personal information in non-threatening ways that, when combined with behavior change science, can change deeply entrenched social norms. PMC frequently addresses contraception, intersecting with issues of gender equality, women’s rights, and women’s health.
PMC has produced several radio dramas in the DRC which deal directly with family planning and contraceptive use. Vivra Verra (“Time Will Tell”) showed impressive results after broadcasting 156 episodes over almost two years. Listeners were 2.3 times more likely than non-listeners to consider family planning decisions as a couple. Vivra Verra listeners were also 2.2 times more likely than non-listeners to go to a clinic and obtain information about the side effects of contraceptives. Combating fatalism and those social norms that dismiss modern contraceptive, Vivra Verra listeners were 3.5 times more likely than non-listeners to say that a couple does has the right to determine how many children they have.
Cultural norms and misinformation – even if they result in strong emotional attachments and values – are not immutable. It takes specific types of interventions to work on deeply-entrenched beliefs. PMC’s specifically designed story arcs that spread over hundreds of episodes are designed to impact huge audiences that benefit and individual and social norm change that can be sustained.
PMC’s radio show Agashi (“Hey! Look Again!”), which airs in Burundi, further demonstrates PMC’s entertainment strategy success. Agashi listeners were 2.3 times more likely than non-listeners to report that their spouse is open to a discussion on family planning. A woman who listened to Agashi relayed some of its impact, saying “The problem that befell Ngendo’s family, which happened because he had so many children, taught us well. Now, my husband and I trust health professionals, as they give us advice about using contraceptives, which we have used without any problem.”
ABOUT POPULATION MEDIA CENTER (PMC):
Population Media Center is a nonprofit leader in entertainment-education, dedicated to women’s rights and empowerment, population stabilization, and the environment. For the past two decades, PMC’s entertainment programming has promoted social and cultural change and has helped 500 million people in more than 50 countries.