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Integrating variant channels in engaging “life-stage” audiences to make informed Family Planning choices in Uganda Sylvia Mariettah .N. Katende1, Kim Case Burns2, Francis Nsanga1, Milton Byaryamureeba1, Espilidon Tumukurate1, Jonathan Magoola Okalangh1 1Uganda Health Marketing Group (UHMG), Kampala, Uganda; 2John Hopkins University Centre for Communication Programs (JHUCCP) BACKGROUND • Uganda’s fertility at 6.7 children per woman • 40.1 % unmeet need among married women • 23% contraceptive use in rural, 18% among uneducated • Key barriers: fear of side effects, myths & misconceptions & socio-cultural issues • Also wide exposure gap to media messages by residence & education level Source: Uganda Demographic Health Surveys: 2006, 2011 UGANDA HEALTH MARKETING GROUP METHODOLOGY Objective: Increase proportion of audience making informed choices of a method • 3 year phased national multi-media campaign • Men & women of reproductive age (18-49), Health providers • Urban, peri-urban & rural dwellers in the priority districts with high TFR and unmet need • Phase1: Mass media to create awareness • Phase 2: Mass media, interpersonal & community based channels in to increase self-efficacy • Channels were linked & mutually supportive • Theme: What is your Smart Choice? UGANDA HEALTH MARKETING GROUP UGANDA HEALTH MARKETING GROUP METHODOLOGY Life stage/Audience Positioned FP Method Channels 18-24 years Sexually Active but wants to delay child birth Condoms Pills Jingle, Radio Quizzes Toll free Hotline Roadshows Flyers 25-34 years Child Bearing plus want to space births Injectables Implants Community Outreaches Roadshows Merchandise e.g. Aprons 35-49 years Want to limit or stop child birth IUDs Implants Peer education Community media Health Providers Opinion Leaders Whole range Flip Charts, Job Aides Advocacy meetings UGANDA HEALTH MARKETING GROUP UGANDA HEALTH MARKETING GROUP IN PICTURES UGANDA HEALTH MARKETING GROUP UGANDA HEALTH MARKETING GROUP RESULTS Phase 1 • 35.7% overall recall in the first 3 months. 70.4% exposed to campaign in 11 months • 55% of those exposed at least took one self reported positive action e.g. 24% discussed FP with partner and 19% with a health provider Source: Uganda BCC surveys: October 2012, June 2013 UGANDA HEALTH MARKETING GROUP UGANDA HEALTH MARKETING GROUP DOSAGE EFFECT DUE TO EXPOSURE TO MULTI-CHANNELS Not Exposed (N=1,226) 2.5 1 Source (N=724) 2+ Sources (N=675) 2.2 2 2 2 Odds Ratio 1.7 1.5 1.3 1.2 1 1 1 1 0.5 0 Current use of FP among sexually active female respondents Discussion of FP with partner among sexually active respondents UGANDA HEALTH MARKETING GROUP Partner's approval of FP among all sexually active respondents UGANDA HEALTH MARKETING GROUP RESULTS Phase 2 • Radio alone reached 62.8% of the 15-24 radio population in the first 3 months • Road shows mainly attracted men and youth. • 1006 of these were referred for free FP services • Hotline registered 11,240 callers in 10 months (65% were youth 20-29) Source: Operational data and Independent media reach analysis (2014) UGANDA HEALTH MARKETING GROUP RESULTS "My wife and I have 5 children and wanted to stop at that. I always mistook her insistence on using family planning as searching for ways to adultery. When I heard about the hotline on radio, I immediately called in for advice. The counselor asked me to call back with my wife on the line and we discussed the contraceptive options. Together we chose the implant for 5 years. My wife had it inserted shortly afterwards at Bubutu Health center". Mafabi Moses (Manafwa District) UGANDA HEALTH MARKETING GROUP UGANDA HEALTH MARKETING GROUP Conclusion • Integration of media is effective in reaching & engaging more audiences • Audience friendly media increases the likelihood of effective reach e.g. hotline & music among young people and illiterate • Community based & Interpersonal channels were an easier way to reach the rural dwellers • Evaluating the contribution of each channel to the overall impact of a campaign remains a challenge UGANDA HEALTH MARKETING GROUP UGANDA HEALTH MARKETING GROUP Strategic Approach UGANDA HEALTH MARKETING GROUP