evaluation of a communication intervention programme on birth spacing in bihar, india 34th annual...
TRANSCRIPT
Evaluation of a Communication Intervention Programme on Birth Spacing in Bihar, India
34th Annual ConferenceIndian Association for the Study of PopulationGokhle Institute of Politics and Economics, Pune December 13-15, 2012
Population Services InternationalIndia
Puspita Datta, Kali Prosad Roy, Nayanjeet Chaudhury
Background & Objective• PSI had four phases of birth spacing campaign programme in Bihar
and Jharkhand.
• This paper based on 4th phase
• Programme aim: to generate informed demand for modern spacing method and improve people’s perception towards use of modern spacing methods
– oral contraceptive pills (OCP), condom and injectable contraceptives.
Objective:
• To assess the impact of the intervention on use of modern spacing methods and perception towards birth spacing in Bihar.
Methodology: Study Universe• Project Area
–10 districts Banka, Mumger, Lakhaisarai, Khagaria, Bhagalpur, Begusarai,
Samastipur, Patna, Purba Champaran and Pashchim Champaran
• The sample frame included category villages and all towns – more than 5000 population
• Target Respondents–Men – 21 to 34 years, currently married, not sterilized (himself
and spouse)–Women – 15 to 29 years, currently married, not sterilized (herself
& spouse)
Methodology: Sampling Design and sample size
• Systematic 2 Stage Stratified Sampling Design
• Selection of PSUs
– Villages and urban wards was treated as PSU
– PSUs were selected following PPS sampling
• Selection of Respondents
– Listing of households in each sample PSU – this list served as sampling frame
– Selection of respondents following systematic random sampling
– 20 respondents (10 Male & 10 Female) were sampled in each PSU
Gender Sample size
Baseline(Oct 2010)
End line(March 2012)
Female 667 756
Male 637 755
Total 1306 1511
Methodology: statistical tools
• Bi-variate and multivariate regression
• Reliability test
• Segmentation analysis & CIS approach – to finalize the campaign theme
• UNIANOVA
PSI’s Behavior Change Framework
CHANGE/REINFORCE BEHAVIOUR
POPULATIONS AT RISK OR NEED
HEALTH STATUS
OPPORTUNITYAvailability
Quality of careBrand appeal
Brand attributesSocial norm
ABILITY
Knowledge
Social support
Self efficacy
MOTIVATIONAttitudes
BeliefIntention
Locus of controlSubjective norm
ThreatOutcome expectation
Willingness to pay
SOCIAL MARKETING INTERVENTION
What is the health problem?
POPULATION CHARACTERISTICS
What behaviour are we trying to influence?
What are the drivers of that behaviour?
What is our specific marketing approach?
Data Collection for Determinants of Behaviour
• Data collected by obtaining opinion of respondents on a 5 point Li-kert scale
Strongly
disagree
1
Disagree Somewhat
2
Neither Agree nor disagree
3
Agree
Somewhat
4
Strongly Agree
5
Communication themes:AvailabilitySpousal Support /social support
Programme activities:Mid mediaMass media – 2 TV commercialsStatic media – hoardings/posters/shop signage/wall painting, tin plateProduct placement
Research findings
Profile of Respondents• Mean age of respondent: male – 28 yrs ,female 24 yrs
• Mean age at marriage: male – 22 yrs, female 17 yrs
• Level of education: male illiterate -21 %, female illiterate-38%
• Main occupation: unskilled worker
• Monthly household income - less than 7000/month
• Majority of them are – Hindus and OBCs
• General Media habit: Television, followed by Radio
Profile of Respondents: family size
21.5
26.323
19.4
9.7
0
10
20
30
40
50
1 2 3 4 5
Number of children
•Mean number of children – 2
•Future intention – women respondent -57.4%, male respondent -66%
Awareness about Birth Spacing methods
Sig. diff (p<.05) from all categories
Adjusted proportions calculated by controlling for key population characteristics
Knowledge of spacing method
86.8
67.1
33.5
93.0
77.5
52.4
0
20
40
60
80
100
Any spacing method Three or more modernspacing method
Three spacing methodrelated to programme
Base line End line
Current Use of Birth Spacing methods
Adjusted proportions calculated by controlling for key population characteristics
Sig. diff (p<.05) from all categories
Current use of spacing method
18.314.8 13.9
21.218.5 17.2
0
10
20
30
40
50
Any spacing method Any modern spacingmethod
Three spacing methodrelated to programme
Base line End line
page 13
3.193.42
2.46 2.56
3.603.32
3.59
3.243.55
3.90
1
1.5
2
2.5
3
3.5
4
4.5
5
Perceivedavailability
Perceivedsubjective
norm
Perceivedsocial support
Perceivedintention to
space births
Perceived selfefficacy
Me
an
Sc
ore
Baseline Endline
Increase in Mean Score
Sig. diff (p<.05) from Baseline
Adjusted mean calculated by controlling for key population characteristics
Exposure to Communication Channels
44.7 44.1 45.9
83.7 85.9
0
20
40
60
80
100
Mid Media News paper TVC Static Any Media
Pe
rce
nta
ge
13.4 13.7 13.9 14.4
23.1
0
10
20
30
Baseline Not Exposed-Endline
Twice Thrice 4 times ormore
Pe
rce
nta
ge
Adjusted proportions calculated by controlling for key population characteristics
Dose Response: Key Behaviour-Current use of three spacing methods
Sig difference (p<.05) wrt. all other categories
page 16
3.20 3.27 3.22 3.30 3.40
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
5.00
Baseline Not Exposed-Endline
Twice Thrice 4 times ormore
Me
an
Sc
ore
Perceived availability
Dose Response: Key Determinants of perceived availability
Adjusted mean calculated by controlling for key population characteristics
Sig. diff from Baseline
Sig. diff from those exposed twice
page 17
2.39
3.083.20 3.28 3.37
1
1.5
2
2.5
3
3.5
4
4.5
5
Baseline Not Exposed-Endline
Twice Thrice 4 times ormore
Me
an
Sc
ore
Perceived social support
Increase in Mean Score: Perceived Social Support with exposure
Adjusted mean calculated by controlling for key population characteristics
Sig. diff from Baseline
Sig. diff from those not exposed in EL
Sig. diff from those exposed twice
15.116.9 17.2
21.1
0
10
20
30
Not Exposed Mass media Mid Media Mass and MidMedia
Pe
rce
nta
ge
Adjusted proportions calculated by controlling for key population characteristics
Media Mix: Key Behaviour-Current use of three spacing methods
Sig. diff (p<.05) from all categories
• Behavioral segmentation of target audience is a pragmatic approach for identifying determinants to design communications
• The intervention contributed significant increase in current use of modern reversible contraceptives
• A minimum of 4 exposures is needed to lead to change in behaviour
• Combination of mass media and mid media contributed significant increase in current use of modern reversible contraceptives than any one media alone
Conclusions and Implications
