Rationale for the National Family Planning Campaign - International ...

Unmet and Met Contraceptive
Needs and Trends
Designing a Family Planning Campaign for Rural
Women in Zambia
Dr. Reuben K. Mbewe, Ministry of Health, Zambia
Uttara Bharath‐Kumar, Bharath Kumar, Health Communication Partnership, Zambia

Current FP situation in Zambia
Demand‐side Demand side gaps include –
concerns regarding side effects of
modern methods,
limited awareness of method
choice (what, where and when to
access methods),
and desire for large families,
especially among men.
The mean ideal family size is 5.3
children according to men
compared to 4.7 for women (2007
ZDHS)

What is the current situation with family
planning in Zambia?
Fertility is high and increasing, especially in rural
areas ‐ TFR of 7.5 (ZDHS 2007)
High umet need for family planning (27% of all
married women) persists. (2007 ZDHS).
When asked about the last baby they had, 26% said
they had not wanted any more children and 16% said
they had wanted a child later, not then. So effectively
for 42% of women, their last baby was unplanned.

Current Situation –
Current contraceptive prevalence is 33%
Maternal mortality ratio 591/100000 live births
cont.
Unsafe abortion due to unplanned pregnancies is one of
the major causes of mortality

Barriers to FP uptake
2007 Zambia DHS found that method‐related method related concerns
are the second most common reason for NOT using FP
(second to fertility related reasons.)
These include:
fear of side effects,
health concerns,
belief that methods interfere with the body’s body s normal
processes etc.
In other words, we have more than anecdotal evidence
that there are concerns about the safety, efficacy and
side effects of modern methods

FP Communication Working Group
The Ministry of Health called upon partners
involved in the area of reproductive health to
brainstorm what needed to be done to address
these issues.
Together this committee came up with a creative
brief that contained the following critical points
that the campaign should address.

Existing tools
Clinic tools for health providers:
Family planning counseling kit
Wall chart of contraceptive methods
Family planning technical handbook
Glossary of sexual and reproductive
health terms in 7 Zambian languages

For the community:
Existing tools
Action for Health with Sister Evelina‐ Evelina
radio programme (3 out of 26
episodes on FP)
Community Health Information Cards
Our Family, Our Choice (video,
discussion guide and booklets)

Communication Gaps?
While these tools helped support facility‐level facility level and
community‐level community level health educators.
At a national level, there was an absence of
reminders about and discussions around family
planning.

To contribute to
increases in modern
contraceptive use
among Zambian
women, with a
particular focus on
underserved rural
communities.
Campaign Goal

What is needed?
In this context,
Ministry of Health and
partners wished to
redouble efforts to
expand access to and
create informed
demand for family
planning.
Particular attention
would be paid to rural
audiences

Communication Objective
Increase approval and use of modern family
planning methods, especially in the rural areas.
Promote positive images of empowered women
and supportive spouses
Revitalize the national family planning logo to
tie campaign materials together and raise public
awareness of family planning.

Key Benefits to be Communicated
Modern Methods: Modern family planning methods
are safe and effective for women to use.
Family Planning: is when a couple decides when, how
many and at what intervals they want to have
children.
Helps the mother and children be healthier as they
have more time to recover their health and grow
well, respectively
Helps the family manage its available resources so
the children they have planned can grow well and
be educated.

Concept outlines
Concept 1: Married women (a group of
peers discuss among themselves)
A group of women talk about and
reveal challenges of large family,
closely spaced children. One
declares she is using FP. Others talk
of some myths and fears.
Safety, effectiveness of modern FP
methods – reassuring the women

Concept 2: Men
Concept outlines
Two men discuss the issue of one
having too many children and the
other with only one/two/three.
Small family man’s man s wife is using a
modern method.
Myths and fears like concern about
wife’s wife s unfaithfulness etc (addresses
them)
Shows how men can be supportive
of their partners using a modern
method while still ‘being being a man’.
man

Concept outlines
Concept 3: Family Planning is for All
(Young, married woman and a
service provider)
Enjoy their early married life
together. Support to resist
pressure from family to
immediately have a baby. They
are still young and can delay the
birth of their first child.

Call to Action
Family planning
methods are safe
and they work! Go
to your nearest
health centre and
learn more about
how you can
choose the family
planning method
that is best for you.

Creative considerations
In the 2007 ZDHS:
74% of men and 59% of women listen to
the radio and 37% of men and 31% of
women watch television.
Missed opportunities: six in ten men and
women of ages 15‐19 15 19 had not heard of
family planning in the media.

Creative considerations
Where they did get
information about
family planning at
all, radio was cited
as the most
important source of
family planning
information and
television next

Multi‐media Multi media approach
Given the increasing exposure of rural areas to
television and radio (community radio in particular),
electronic media was seen as a key part of the
campaign.
Literacy is not high among rural women so they was
need for very pictorial and easy‐to easy to‐read read posters in
the clinic waiting rooms and community centres
that serve as reminders about family planning.

Channels
5000 health care provider buttons that say “Talk Talk to me
about Family Planning” Planning with the FP logo
3 short television spots (English + 7 Zambian languages)
3 short radio spots: (5 minutes each): Spots on TV and
radio in English + 7 Zambian languages (for broadcast
on ZNBC, community radio stations, other TV
stations, ZANIS)
Posters: Simple and pictorial. Each of the posters
reflect the message from each of the three TV/Radio
spots.
Posters:
Booklet: Based on the “Our Our Family, Our Choice” Choice all‐ all
methods booklet
Booklet:

From Brief to Campaign
With the creative brief in place and the channels
selected, Health Communication Partnership
Zambia, one of the members of the FP
Communication Working Group, was tasked with
turning the creative brief into a campaign.
Launched in late August, exposure and effects of
this campaign will be evaluated by MOH and
partners in the next six months to a year.

Percent of women currently using a modern contraceptive method, by
exposure to Our Family Our Choice
video and VCT services in past 12
months
Source: 2009 Zambia HCP Endline Survey (n=1,765)
Controlling for Age, Education, Urban residence, Parity, and perceived spousal approval of FP