Association between exposure to mass media family planning messages and utilization of modern contraceptive among urban and rural youth women in ethiopia

  • International Journal of Women's Health, Volume 12, Year 2020

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Study Justification:
– Family planning is important for reducing poverty, promoting gender equity, preventing sexually transmitted infections, and reducing maternal and child mortality.
– Understanding the association between exposure to mass media family planning messages and the utilization of modern contraceptives among youth women in Ethiopia can inform effective interventions and policies.
Highlights:
– The study used data from the 2016 Ethiopia Demographic and Health Survey.
– A comparative cross-sectional study design was employed.
– The sample included 6401 women, with 4061 from rural areas and 2340 from urban areas.
– No significant association was found between exposure to mass media family planning messages and modern contraceptive use in rural areas.
– Surprisingly, women exposed to mass media family planning messages in urban areas were less likely to use modern contraception by 62%.
– The study identified structural and intermediary factors, such as religion, location, household wealth, education, and the number of children, that influence modern contraceptive utilization.
Recommendations:
– Address cultural, geographical, and socioeconomic barriers to improve the impact of modern contraceptive use.
– Develop targeted interventions for urban areas to address the lower utilization of modern contraception among women exposed to mass media family planning messages.
Key Role Players:
– Ministry of Health: Responsible for developing and implementing policies and programs related to family planning.
– Non-governmental organizations (NGOs): Involved in community outreach, education, and service delivery.
– Media organizations: Collaborate to disseminate accurate and comprehensive family planning messages.
– Health professionals: Provide counseling and services related to modern contraception.
Cost Items for Planning Recommendations:
– Development and implementation of targeted interventions: Includes costs for research, program design, training, and monitoring.
– Media campaigns: Budget for producing and airing family planning messages on radio, television, newspapers, and mobile phones.
– Service delivery: Funding for clinics, supplies, and trained healthcare providers.
– Monitoring and evaluation: Allocate resources for data collection, analysis, and reporting to assess the impact of interventions.
Please note that the provided cost items are general categories and not actual cost estimates. Actual costs will depend on the specific context and scope of the interventions and programs.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is based on a comparative cross-sectional study using the 2016 Ethiopia Demographic and Health Survey (EDHS) dataset. The study design and methodology are described, and multivariate logistic regression analysis was performed to assess the association between exposure to mass media family planning messages and the utilization of modern contraceptives. The study provides adjusted odds ratios with a 95% confidence interval to declare statistically significant associations. However, the abstract does not provide information on potential limitations or biases in the study design or data collection process. To improve the evidence, it would be helpful to include a discussion of limitations and potential sources of bias, as well as recommendations for future research to address these limitations.

Background: Family planning helps to reduce poverty, increase gender equity, prevent the spread of sexually transmitted infections, and reduce maternal, infant, and childhood mortality. Hence, this study aimed to examine the association between exposure to mass media family planning messages and the utilization of modern contraceptives among urban and rural youth women in Ethiopia. Methods: A comparative cross-sectional study using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set was applied. The data were analyzed with SPSS version 20. Multivariate logistic regression analysis was performed to assess the association between exposure to mass media family planning messages and the utilization of modern contraceptives by controlling confounders. An adjusted odds ratio with a 95% confidence interval was considered to declare a statistically significant association. Results: The total sample was comprised of 6401 women (4061 from rural and 2340 from the urban area). There was no association between women exposed to mass media family planning messages and the utilization of modern contraceptives in rural areas. Surprisingly, this study showed that women exposed to mass media family planning messages in an urban area were less likely to use modern contraception by 62% (AOR: 0.38; 95% CI: 0.21, 0.68). Conclusion: The present study revealed that there was no significant association between women exposed to mass media family planning messages and utilization of modern contraceptives in rural areas. But, women exposed to mass media family planning messages in urban areas were less likely to use modern contraception. The study showed the role of inequalities in modern contraceptive utilization as shaped by structural and intermediary factors including religion, location, household wealth, education, and the number of children. This implies that the use of modern contraceptive use may be more impactful if cultural, geographical, and socioeconomic barriers are addressed.

The current comparative cross-sectional study analyzed using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. A detailed description of the study design and methodology of the survey was found elsewhere.12 A two-stage stratified cluster sampling was used. Since Ethiopia has nine regional states and two city administrations, stratification was done by separating each structural division into urban and rural areas, except Addis Ababa (entirely urban). Therefore, a total of 23 sampling strata have been created. Then, each stratum was again further divided into enumeration areas (EAs) or clusters prepared by the 2007 Population and Housing Census as a sampling frame. In the first stage, a total of 645 EAs were selected. Of which, 202 were from urban areas. In the second stage, a fixed number of 28 households per cluster were selected randomly from the household listing. A total of 15,683 women (15–49 years) were interviewed, making up response rates of 95%. The analytic sample for this study was 6401 women (4061 from the rural area and 2340 from the urban area). The sample utilized in this study included (i) women who were the age group between 15 and 24 years residing in rural areas (n= 4061); and (ii) women who were the age group between 15 and 24 years residing in the urban area (n= 2340) (Figure 1). Flow chart showing how the weighted sample used in the study was derived. The outcome of this study was the utilization of modern contraception (pill, intrauterine device, injection, diaphragm, condom, sterilization, or implant). In this variable, we coded as ‘yes’ if respondents were utilized any of the modern contraception otherwise “not”. The main exposure variable in this study was family planning messages through different media (radio, television, newspaper/magazines, and mobile phones). The EDHS asks women whether they have been exposed to family planning messages on radio, television or print media (eg, magazines and newspapers), and through text messages in the last few months. Given that these four variables were highly correlated, we decided to create a variable called ‘mass media exposure to family planning messages’. In this variable, we coded as “yes” if respondents were exposed to family planning messages on at least one of the four media outlets (0, no; 1, yes). This categorization conforms with the coordination in the dissemination of media messages on central issues such as health, where television, radio, newspaper, and mobile phone media sources concurrently promote public health programs such that an individual who has access to any one of these media sources would be able to obtain the same information on a given public health issue. To further account for possible confounding factors, we included age, religion, marital status, educational status of women, wealth index, and the number of children as independent variables. The wealth index was categorized into five categories according to the 2016 EDHS as the poorest, poorer, middle, richer and richest. The data were analyzed using Statistical Package for Social Science (SPSS) version 20. All statistical procedures incorporated complex sampling design analysis applied in the 2016 EDHS. Frequencies and weighted percentage of study variables were calculated. Rao–Scott chi-square test was used to examine the relationship between modern contraceptive use and each of the independent variables separately for urban and rural residents. Multivariate logistic regression analysis was performed to assess the association between exposure to mass media family planning messages and modern contraceptive use by controlling confounders independently for urban and rural residents. All independent variables were entered into a multivariate logistic regression analysis model irrespective of the p-values in the statistical significance in the bivariate analysis. Adjusted odds ratios (AOR) were used to declare statistically significant association. Ethical clearance for the study is not required since it is a secondary data analysis from the 2016 EDHS database. The researchers have received the survey data from USAID–DHS program and then the researchers of this study have maintained the confidentiality of the data. The consent was obtained from the study participants before study commencement.

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Based on the provided information, here are some potential recommendations for innovations to improve access to maternal health:

1. Targeted Mass Media Campaigns: Develop and implement targeted mass media campaigns that specifically address the barriers and misconceptions surrounding modern contraceptive use in both urban and rural areas. These campaigns should be designed to reach and engage youth women, utilizing various media outlets such as radio, television, newspapers, and mobile phones.

2. Mobile Health (mHealth) Interventions: Utilize mobile health interventions, such as text message reminders and educational apps, to provide accessible and personalized information about family planning and modern contraceptive methods. These interventions can help overcome geographical barriers and reach women in remote areas.

3. Community Health Workers: Train and deploy community health workers to provide education, counseling, and support on family planning and modern contraceptive methods. These workers can play a crucial role in addressing cultural and religious beliefs, as well as providing accurate information and dispelling myths.

4. Integration of Maternal Health Services: Integrate family planning and modern contraceptive services into existing maternal health programs and facilities. This can ensure that women have access to comprehensive reproductive health services during pregnancy, childbirth, and postpartum periods.

5. Financial Incentives: Explore the use of financial incentives, such as conditional cash transfers or vouchers, to encourage women to utilize modern contraceptive methods. This can help overcome financial barriers and increase uptake among low-income women.

6. Public-Private Partnerships: Foster collaborations between the public and private sectors to improve access to modern contraceptives. This can involve working with pharmaceutical companies to ensure a steady supply of affordable contraceptives and partnering with private healthcare providers to expand service delivery.

7. Empowerment and Gender Equality: Address underlying social and gender norms that hinder women’s access to modern contraceptives. Promote women’s empowerment, gender equality, and reproductive rights through advocacy, education, and policy reforms.

It is important to note that these recommendations should be tailored to the specific context and needs of Ethiopia, taking into account cultural, geographical, and socioeconomic factors.
AI Innovations Description
Based on the study titled “Association between exposure to mass media family planning messages and utilization of modern contraceptives among urban and rural youth women in Ethiopia,” the following recommendation can be developed into an innovation to improve access to maternal health:

1. Targeted and tailored messaging: Develop and implement family planning messages that are specifically designed to address the cultural, geographical, and socioeconomic barriers faced by women in both urban and rural areas. These messages should be delivered through various media outlets, including radio, television, newspapers/magazines, and mobile phones, to ensure maximum reach and accessibility.

2. Community engagement and education: Conduct community-based awareness campaigns to educate women and their families about the benefits of family planning and the available modern contraceptive methods. This can be done through workshops, seminars, and interactive sessions that address the concerns and misconceptions surrounding contraception.

3. Mobile health (mHealth) interventions: Utilize mobile phone technology to provide information, counseling, and reminders about family planning and contraceptive use. Develop mobile applications or text messaging services that can deliver personalized and timely messages to women, helping them make informed decisions about their reproductive health.

4. Strengthening healthcare infrastructure: Improve the availability and accessibility of modern contraceptives by ensuring that healthcare facilities, especially in rural areas, are well-stocked and equipped to provide a wide range of contraceptive methods. This includes training healthcare providers on family planning counseling and services.

5. Empowering women: Promote women’s empowerment through education and economic opportunities, as these factors have been shown to positively influence contraceptive use. By addressing gender inequalities and empowering women to make decisions about their reproductive health, access to maternal health can be improved.

It is important to note that these recommendations should be implemented in a comprehensive and integrated manner, taking into account the unique needs and challenges faced by women in different settings. Collaboration between government agencies, non-governmental organizations, healthcare providers, and community leaders is crucial for the successful implementation of these innovations.
AI Innovations Methodology
Based on the provided description, the study aims to examine the association between exposure to mass media family planning messages and the utilization of modern contraceptives among urban and rural youth women in Ethiopia. The methodology used in the study is a comparative cross-sectional study using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set.

Here is a brief summary of the methodology used in the study:

1. Study Design: The study utilized a comparative cross-sectional design, which involves collecting data at a single point in time to compare different groups or populations.

2. Data Source: The study used the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. The EDHS is a nationally representative survey conducted every few years to collect data on various health indicators in Ethiopia.

3. Sampling: A two-stage stratified cluster sampling method was used. The country was divided into urban and rural areas, and a total of 645 enumeration areas (EAs) were selected. In the second stage, a fixed number of 28 households per cluster were randomly selected.

4. Sample Size: The total sample size for the study was 6,401 women, with 4,061 from rural areas and 2,340 from urban areas.

5. Variables: The main outcome variable was the utilization of modern contraception, which included methods such as pills, intrauterine devices, injections, diaphragms, condoms, sterilization, or implants. The main exposure variable was exposure to family planning messages through different media outlets (radio, television, newspapers/magazines, and mobile phones).

6. Data Analysis: The data were analyzed using SPSS version 20. Frequencies and weighted percentages of study variables were calculated. The relationship between modern contraceptive use and independent variables was examined using the Rao-Scott chi-square test. Multivariate logistic regression analysis was performed to assess the association between exposure to mass media family planning messages and modern contraceptive use, controlling for confounding factors.

7. Ethical Considerations: Ethical clearance was not required for this study as it involved secondary data analysis from the 2016 EDHS database. The researchers maintained the confidentiality of the data, and consent was obtained from the study participants before the study commenced.

In summary, the study utilized a comparative cross-sectional design and analyzed data from the 2016 EDHS to examine the association between exposure to mass media family planning messages and the utilization of modern contraceptives among urban and rural youth women in Ethiopia. The methodology included sampling, data analysis, and ethical considerations to ensure the validity and confidentiality of the study.


Statistics:
Citations: 6
Identifiers:
DOI: 10.2147/IJWH.S266755
Research Areas:
Disparities, Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Social Determinants
Study Countries:
Ethiopia
Study Design:
Case-Control Study, Cross Sectional Study
Study Approach:
Quantitative
Participants Gender:
Female
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