Family Planning Use in Nigeria
According to a baseline survey conducted in 2010 and 2011 in the cities of Abuja Federal Capital Territory (FCT), Benin, Ibadan, Ilorin, Kaduna and Zaria by the Nigerian Urban Reproductive Health Initiative (NURHI) and the Measurement, Learning & Evaluation (MLE) Project, among women, radio is an important source of family planning information. More than 57 percent of women with knowledge of family planning at baseline received family planning messages through the radio.
NURHI baseline data indicated that modern contraceptive use was quite low in urban Nigeria. Reported key barriers to family planning use included resistance to modern contraceptive use by religious and community leaders, low self-efficacy and pervasive myths and misconceptions.
Reaching Out Through Radio Drama, Testimonials and Live Call-in
NURHI reaches out to women and men through entertaining and educational weekly radio programs. Part of NURHI’s comprehensive, integrated ‘Get it Together’ campaign reaching the urban poor, the radio program educates listeners about family planning. The program further serves to urge listeners to meet with NURHI-trained social mobilizers from their communities who have the ability to link them to quality family planning services.
The weekly one-hour radio program includes drama serials, testimonials, music, quizzes and a half-hour live call-in session where callers’ questions are answered by a variety of guests including religious leaders, couples and family planning experts. The radio program utilizes an aspirational approach to help listeners see the connections between family planning use and real benefits to their own lives. The program addresses myths and misconceptions by modeling characters who overcome barriers to contraceptive use and become satisfied family planning users. For example, to overcome the fear that using contraceptives will harm a woman’s womb or cause deformed babies, many stories incorporate characters that, after discontinuing the use of contraceptives, are able to get pregnant and have a healthy child. The program also models support from key influencers such as husbands, friends, religious and community leaders as well as service providers.
“Before now I thought family planning was meant for prostitutes. Since I started facilitating and listening to the Second Chance program my mindset has changed. I thank God I got to know about family planning through NURHI. Since my wife and I learned about family planning, there have been no bedroom fights or quarrels….” – Mr. Abdulhakeem Olanrewaju, electrician and radio drama facilitator, Abuja FCT
Because of the wide diversity among Nigerian cities, separate radio programs were developed for each city – Abuja FCT, Benin, Ibadan, Ilorin and Kaduna – encompassing the local language, context and entertainment preferences. In Abuja FCT, for example, the drama is fast paced with multicultural characters, reflecting Abuja FCT’s true slum residents who hail from all corners of the country. Ilorin’s program is based on Yoruba culture only, heavily incorporating the local love of music. In the northern city of Kaduna, the program uses the term ‘child birth spacing’ rather than ‘family planning’ to reflect cultural, political and religious sensitivities surrounding birth and child preferences. Between 2012 and 2013, a total of 308 shows were broadcast in the 5 cities.
“Since I became a member of the Second Chance [Abuja FCT] listeners’ group, my orientation about family planning changed. I now see family planning as a way of life, something that is good for the community and the family at large.” – Debbie Igba, event planner and manager, Abuja FCT
Results to Date
Mid-term survey results indicate that the NURHI program overall is heading in the right direction. The targeted urban areas saw contraceptive prevalence rates increase between 2.3 and 15.5 percentage points among women in union from baseline to mid-term – the highest increase was seen in Kaduna from 19.6 percent to 35.1 percent. There was also an increase in intention to use family planning by 7 to 10 percentage points in each city. Results indicate that more than 83 percent of women have been exposed to at least one NURHI activity on the television, radio, in their communities or in their clinics.
The radio program proved to be an important factor influencing these trends. One in four slum residents– which equates to about 4 million listeners–tuned into the first 26 episodes of the radio programs, and data shows that people who listened to the radio program were significantly more likely to use family planning.
“I didn’t know the details about family planning before. I was scared because I have been told that it causes disease and infertility. But from listening to this program, I had a better understanding and the misconceptions corrected. I then went to do IUCD and since then I have had peace with my husband.” – Mrs. Kike Ayeni, petty trader, Ibadan
The radio program also contributed to a decrease in religious and social barriers and helped reduce myths and misconceptions.
- Overall, there was an increase in the percentage of women who approved of religious leaders speaking publicly about family planning from 56.8 percent at baseline to 71.5 percent at mid-term.
- The percentage of women who perceived peer support for family planning rose overall from 22.8 percent at baseline to 42.1 percent at mid-term.
- Generally, there were lower percentages of women in agreement with the myths at mid-term than at baseline, though this continues to be an area of NURHI focus.
These results indicate that the research-based Get it Together radio program has been a key element in increasing poor women’s access to family planning in urban slums and that it can be an effective tool in encouraging and modeling satisfied family planning use, promoting family planning use as a social norm and reducing myths and misconceptions.