Exposure to family planning messages and contraceptive use among women of reproductive age in sub-Saharan Africa: a cross-sectional program impact evaluation study

Abstract

Many women of reproductive age in sub Saharan Africa are not utilizing any contraceptive method which is contributing to the high burden of maternal mortality. This study determined the prevalence, trends, and the impact of exposure to family planning messages (FPM) on contraceptive use (CU) among women of reproductive age in sub-Saharan Africa (SSA). We utilized the most recent data from demographic and health surveys across 26 SSA countries between 2013 and 2019. We assessed the prevalence and trends and quantified the impact of exposure to FPM on contraceptive use using augmented inverse probability weighting with regression adjustment. Sensitivity analysis of the impact estimate was conducted using endogenous treatment effect models, inverse probability weighting, and propensity score with nearest-neighbor matching techniques. The study involved 328,386 women of reproductive age. The overall prevalence of CU and the percentage of women of reproductive age in SSA exposed to FPM were 31.1% (95% CI 30.6–31.5) and 38.9% (95% CI 38.8–39.4) respectively. Exposure to FPM increased CU by 7.1 percentage points (pp) (95% CI 6.7, 7.4; p < 0.001) among women of reproductive age in SSA. The impact of FPM on CU was highest in Central Africa (6.7 pp; 95% CI 5.7–7.7; p < 0.001) and lowest in Southern Africa (2.2 pp; 95% CI [1.3–3.0; p < 0.001). There was a marginal decline in the impact estimate among adolescents (estimate = 6.0 pp; 95% CI 5.0, 8.0; p < 0.001). Exposure to FPM has contributed to an increase in CU among women of reproductive age. Programs that are geared towards intensifying exposure to FPM through traditional media in addition to exploring avenues for promoting the appropriate use of family planning method using electronic media remain critical.

Determinants of adolescent pregnancy in Zambia: A secondary data analysis of 2018 Zambia Demographic and Health Survey

“…Our study revealed a signi cant association between exposure to messaging on contraception through newspapers and adolescent pregnancy. This nding aligns with previous studies suggesting that media platforms, such as newspapers, play a crucial role in disseminating information about family planning, potentially lowering the risk of adolescent pregnancy [89][90][91]. However, exposure to messages through radio and television did not signi cantly in uence adolescent pregnancy risk in our study.…”

Individual and community level factors for modern contraceptives utilization among reproductive aged women in Amhara region, Mixed effect multi-level modeling, Data from Mini-EDHS, 2019

“…The final report of this study indicated that having mass media exposure to family planning messages had a significant association with contraceptive utilization. This is consistent with pooled reports in Sub Sahara African countries [ 45 ], and the Philippines [ 46 ]. This might be related to the mass media message about family planning having a significant effect on endorsing and validating negative attitudes about the lesser side effects, issues, and myths of contraceptive use.…”

Prevalence and factors associated with contraceptive use among sexually active adolescent girls in 25 sub-Saharan African countries

“…Similarly, a previous study of adolescent girls in 32 SSA countries that did not specifically target sexually active adolescent girls found an overall low prevalence of contraceptive use of 18.9% [ 32 ]. Another study conducted in 26 SSA found low (22.6%) prevalence of contraceptive use among adolescent girls in general, with no specificity for sexually active adolescent girls [ 33 ]. Low prevalence of contraceptive use among girls and women in SSA, particularly in Chad, is linked to socio-cultural and religious norms, preventing girls from accessing reproductive health services [ 30 ].…”