Promoting Informed Choice
Through Communication

Examples from around the world illustrate how the mass media can promote informed choice even before people seek services. While these campaigns did not aim explicitly to improve people's ability to make informed choices, evaluation demonstrated that they did make people better aware of family planning choices. More interested in learning about health services, and more likely to visit providers.

Bolivia—Las Manitos

In 1994 the Bolivian Ministry of Health launched the mass media campaign Las Manitos (“Little Hands”), urging that “Reproductive health is in your hands.” The campaign featured the “little hands” logo in television and radio spots, clinic videos, posters, and other print materials. A primary message of the campaign was that, by becoming more aware of their contraceptive options, couples could take responsibility to make reproductive health decisions that best suited their own needs (441).

One television spot featured a young couple strolling through a playground surrounded by children. The wife says, “Juan and I want to have children, but not as many as my friend Elena. We don't know what to do.” A nurse appears on the screen and explains to the viewers, “The solution is in your hands. Reproductive health centers can help you decide as a couple the number of children you want to have and when. ...For this, there are methods that are safe and reliable. You decide.” A narrator concludes, “Reproductive health is in your hands. Ask for information in a health center where you see `the hands.'“

The campaign showed that mass media messages inform the public about contraceptive methods, motivate people to seek reproductive health services, and encourage them to take responsibility for their own health decisions. Evaluation found that nearly 12% of television viewers and 6% of radio listeners surveyed remembered the campaign's message, “Obtain family planning information at health centers.” Also, 7% of television viewers and 6% of radio listeners remembered the message, “Reproductive health is in your hands.”

Among women ages 18 to 35 who saw or heard campaign messages often, awareness of modern contraceptive methods increased from 83% to 95%. The percentage of women who approved of family planning also increased, from 86% to 91% (441). Among people who sought reproductive services during the campaign, 28% reported that they were motivated by the television and radio spots, and 39% reported “self” as the source of motivation (441).

From 1996 to 1997 Cameroon's social marketing program, Le Programme de Marketing Social au Cameroun (PMSC), an affiliate of Population Services International (PSI), carried out the adolescent reproductive health program Horizon Jeunes in the town of Edéa. The campaign used youth-oriented promotional events, peer education and counseling, radio talk shows, brochures, and other media formats to promote safer sex, inform youth about condoms and oral contraceptives, promote visits to health centers, advocate contraceptive use, and encourage young people to talk about responsible sexual behaviors (444).

Evaluation showed that the program's strategy of using combined mass media approaches was able to inform specific groups about contraceptive options, encourage discussion with health workers and others in the community, and encourage youth to make healthy decisions about sex. In 13 months knowledge of contraceptive methods among young women and men increased substantially in Edéa compared with little increase in a comparison site where there had been no campaign. Among men in Edéa, knowledge of condoms increased from 65% to 71%, knowledge of the pill increased from 13% to 39%, and knowledge of the IUD and of injection increased from 4% to 27%.Among women in Edéa, knowledge of condoms increased from 39% to 74%, knowledge of the pill, from 23% to 60%, and knowledge of IUD and of injectables, from 7% to 35% (444).

The percentage of youth who discussed contraceptives and sexuality increased, from 84% before the campaign to 90% among men and from 86% to 92% among women. Specifically, discussion with health workers increased from 17% to 28% among men and from 15% to 38% among women. The proportion of young women who said that they were responsible for their own protection from STIs and unintended pregnancies increased from 74% to 84% (444).

In 1994 Egypt's Ministry of Health and Population, with support from USAID and the assistance of JHU/CCP, and The Futures Group International, established the “Ask, Consult” project within the private health sector. The project was developed to train private-sector physicians and pharmacists in the latest developments in contraceptive technology and counseling techniques and to supply them with family planning informational materials for clients, since most had had no family planning training in the last five years. Some 95% of pharmacists had never been trained in family planning (389).

The project illustrates how a private-sector communication project can improve access to family planning. It informed people about additional service locations, increased choices by marketing new contraceptive methods, and encouraged people to ask questions and seek information from providers. A communication campaign was launched to promote participating providers as sources of reliable contraceptive information and to associate them with the “Ask, Consult” logo, or “mark of confidence.”

The campaign included television and radio spots and billboards, point-of-sale promotional items, clinic signage, public relations, and client leaflets encouraging people to ask the newly trained pharmacists and physicians about contraceptive options. Advertisements also informed people about specific contraceptive methods, including the newly available progestin-only oral contraceptives.

Within about five years, more than 7,000 pharmacists and 3,000 private physicians were trained, given up-to-date contraceptive information and educational materials, and stocked with a broad range of family planning methods, including the new progestin-only pills. Moreover, 89% of television-viewing women remembered seeing a family planning message on TV within the previous six months. Of these, 42% said they spoke to their husbands about family planning as a result of the message, 37% said they wanted more information, and over half visited a clinic for family planning advice. (227). The “Ask, Consult” logo helped to start conversations about family planning between clients and providers, evaluation found (389). Also, sales of progestin-only pills increased from 63,000 packets in 1997 to over 600,000 in 2000 (200).