Family Planning

Family Planning and Social and Behavior Change Communication

C-Change is conducting research to understand how social norms inform family planning and reproductive health (FP/RH) choices. Results from the research are used to inform the implementation of social and behavior change communication (SBCC) programs that will effect positive changes in family planning behaviors at individual, family, and community levels.

Efforts to improve FP and RH outcomes, for women in particular and the family and greater society in general, benefit from attention to the ways gender norms inform behaviors such as contraceptive use, delay of first births, and healthy timing and spacing of pregnancy. C-Change is working to improve understanding of the relationship between gender and social norms and family planning and to design appropriate SBCC-based intervention programs. 
 

Zambia - Social Norms and Uptake of FP Methods

C-Change has partnered with CARE in Zambia’s Lundazi district to determine the effects of community-informed behavior change communication strategies on family planning (FP) uptake. Specifically, the program is investigating how social norms influence FP uptake and the best ways to reach HIV-infected individuals with FP information. To begin, the program integrated FP counseling services and distribution of FP commodities (pills, injectables, implants, and condoms) into an existing TB/HIV/AIDS program at the clinic and community level. CARE provided training to clinic staff and community health workers on delivering FP and HIV services and on how to facilitate dialogues at the community level.

Then, in late 2009, baseline assessments were conducted to learn more about misconceptions around FP methods and the role that gender relations and exposure to FP information plays in uptake of these services.

C-Change used the baseline results and input from the communities and community health workers (traditional birth attendants, TB supporters, and FP distributors) to develop and implement communication strategies that address social norms and barriers to FP use. Community leaders assisted these efforts with input on the leverage points to promote healthy behaviors. All of this information will inform subsequent SBCC interventions, including dialogues and the development of SBCC materials and messages. C-Change anticipates distributing these materials in late summer 2010.

Tanzania - Gender Norms and Operations Research

In Tanzania, C-Change conducted a qualitative study among young married men and women to determine the role of gender norms and female empowerment in decisions regarding contraceptive use. Published in October 2009, the report of the study is titled "Gender Norms and Family Planning Decision-Making in Tanzania: A Qualitative Study." The findings from the study underscored the importance of addressing factors related to both gender and to misinformation and exaggerated fears about modern contraceptive methods. The study concluded that FP messages and interventions should engage both men and women and encourage equitable decision-making.

Results from this research are informing the development of radio messages being used in the subsequent gender-integrated social and behavior change communication (SBCC) intervention study in the Mwanza and Dodoma areas of Tanzania. The study is testing the effectiveness of radio programming that addresses male gender norms in support of a community-based distribution of contraceptive program.  The T-MARC project is managing the program.

In one area, listeners are hearing gender-integrated FP messages, specifically messages that emphasize male support of women's FP decision making.  In the other area, listeners of the radio station hear FP messages that do not integrate gender messaging. The FP-only messages emphasize traditional emphasis on benefits of family planning, with no reference to men's support of women's decision making.

Follow-up surveys that include gender scales will measure changes in male and female family planning knowledge and attitudes and men's responses to women's  contraceptive decisionmaking. Results are expected in Spring 2011.
 

An Integrated Communication Program in Albania

Elsewhere, C-Change’s efforts to challenge social norms related to FP and RH require other approaches. In Albania, C-Change is implementing a program to combat misperceptions and misinformation about modern contraceptive methods. Before the 1990s, access to modern contraceptives was limited, and abortion was the accepted way to end a pregnancy. An integrated communication program is seeking to change social norms among young men and women in Albania. It includes a mass media campaign with messages developed for broadcast and print media and community-based interventions. The program is also training journalists as family planning “champions” by providing information on how to incorporate messages that promote healthy reproductive behaviors and lifestyles into media coverage.

C-Change will evaluate the added value of intensive interpersonal communication with a focus on young men and women. Research will also examine the factors underlying contraception method choice to inform the development of additional programs.