Exposure to mass media family planning messages among post-delivery women in Nigeria: testing the structural influence model of health communication

Association between mass media exposure and HIV testing uptake in Cameroon

In sub-Saharan African countries, mass media is critical in disseminating health information, including the need for HIV testing. Yet, in Cameroon, there is a dearth of studies examining how exposure to mass media is effective in the uptake of HIV testing. Using the 2018 Cameroon Demographic and Health Survey, we examined the association between exposure to mass media and HIV testing among sexually active women (n = 12,619) and men (n = 5,607). Our findings revealed a generally low uptake of HIV testing although more women (78%) have ever tested for HIV compared to men (67%). Adjusting for demographic, socioeconomic, and psychosocial factors, we found for both women and men their exposure at least once a week to the Internet (aOR = 1.57, p<0.001 for women; aOR = 1.76, p<0.001 for men), print media (aOR = 1.59, p<0.05 for women; aOR = 2.04, p<0.001 for men), radio (aOR = 1.34, p<0.01 for women; aOR = 1.57, p<0.001 for men), and television (aOR = 1.74, p<0.001 for women; aOR = 1.94, p<0.001 for men) was significantly associated with a higher likelihood of testing for HIV compared to their counterparts with no exposure at all. Our findings underscore the importance of further integrating mass media in HIV messaging in Cameroon as the country aims to achieve UNAIDS target 95-95-95 by 2023.

Factors Impacting Chinese Older Adults' Intention to Prevent COVID-19 in the Post-COVID-19 Pandemic Era: Survey Study

BACKGROUND

Understanding the factors influencing individuals' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of "no longer controlled" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people's decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention.

OBJECTIVE

This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure.

METHODS

In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China.

RESULTS

The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001).

CONCLUSIONS

This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.

Identifying Profiles of Support for Legal Abortion Services in Zambia: A Latent Class Analysis

Relative to neighboring countries, Zambia has among the most progressive abortion policies, but numerous sociopolitical constraints inhibit knowledge of pregnancy termination rights and access to safe abortion services. Multistage cluster sampling was used to randomly select 1,486 women aged 15-44 years from households in three provinces. We used latent class analysis (LCA) to partition women into discrete groups based on patterns of endorsed support for legalized abortion on six socioeconomic and health conditions. Predictors of probabilistic membership in latent profiles of support for legal abortion services were identified through mixture modeling. A three-class solution of support patterns for legal abortion services emerged from LCA: (1) legal abortion opponents (∼58 percent) opposed legal abortion across scenarios; (2) legal abortion advocates (∼23 percent) universally endorsed legal protections for abortion care; and (3) conditional supporters of legal abortion (∼19 percent) only supported legal abortion in circumstances where the pregnancy threatened the fetus or mother. Advocates and Conditional supporters reported higher exposure to family planning messages compared to opponents. Relative to opponents, advocates were more educated, and Conditional supporters were wealthier. Findings reveal that attitudes towards abortion in Zambia are not monolithic, but women with access to financial/social assets exhibited more receptive attitudes towards legal abortion.

Exposure to mass media family planning messages among men in Nigeria: analysis of the Demographic and Health Survey data

Background

Family planning (FP) is essential for improving health and achieving reproductive goals. Although men are important participants in FP decision-making within households in Nigeria, a country with one of the highest rates of maternal mortality, we know very little about their exposure to mass media FP messages.

Methods

Drawing theoretical insights from the structural influence model of health communication and using the 2018 Nigeria Demographic and Health Survey (n = 13,294), and applying logistic regression analysis, we explored the factors associated with men's exposure to mass media FP messages in Nigeria.

Results

A range of socioeconomic, locational, and demographic factors were associated with men's exposure to mass media FP messages. For example, wealthier, more educated, and employed men were more likely to be exposed to mass media FP messages than their poorer, less educated, and unemployed counterparts. In addition, compared to those in rural areas and other regions, men in urban areas as well as South East Region, were more likely to be exposed to mass media FP messages. Finally, younger men and those who belong to the traditional religion were less likely to be exposed to mass media FP messages, compared to their older and Christian counterparts.

Conclusions

Based on these findings, we discuss implications and recommendations for policymakers as well as directions for future research.

Perspectives of Muslim Religious Leaders to Shape an Educational Intervention About Family Planning in Rural Tanzania: A Qualitative Study

INTRODUCTION

Uptake of effective contraceptive methods can be hindered by poor understanding and uncertainty about its compatibility with religious beliefs. We sought to understand the perspectives of Muslim religious leaders in rural Tanzania on family planning (FP) and acceptable strategies for providing FP education to leaders and their communities.

METHODS

We conducted in-depth interviews with Muslim leaders from 4 communities in northwest Tanzania. Open-ended questions explored leaders' views on FP in relation to their communities, Muslim texts and teaching, and their experience as leaders. We also investigated how FP education could be provided in their communities and asked practical questions regarding seminar implementation. Interviews were conducted in Kiswahili and transcribed and translated into English. Data were coded independently by 2 investigators using NVivo 1.5.1 and analyzed thematically.

RESULTS

We interviewed 17 male and 15 female Muslim leaders. All leaders supported FP as a concept in which births are spaced, interpreting this as espoused by the Qur'an and a basic right of children raised in Islam. Leaders uniformly endorsed the use of breastfeeding and the calendar method to space births but had divergent and sometimes opposing views on other methods, including condom use, oral contraceptives, and intrauterine devices. All leaders acknowledged the need for FP education among their congregants and were in favor of helping to teach an FP seminar in their communities.

CONCLUSION

Our data reveal insights into how education for Muslim leaders may equip them to promote birth spacing and enhance understanding of FP in their communities in ways that are concordant with Islamic teaching. Our findings will guide the design and pilot-testing of an educational intervention for Muslim religious leaders to promote knowledge and uptake of FP in rural Tanzania.

Can High Exposure Help to Close Gaps? The Influence of COVID-19 Preventive Messages on Behavioral Intentions by Educational Attainment in Chile

The literature in the field of health communication has shown the existence of gaps between groups of different socioeconomic levels both in exposure to health campaign messages and in the influence these messages exert on individuals' health decisions. In this article, we examine the association between educational attainment and exposure to messages promoting COVID-19 preventive behaviors, namely, physical distancing, handwashing, and masks wearing in Chile. In addition, we model the association between exposure to these messages and the intentions to carry out the behaviors, as well as the differences attributable to educational attainment in the influence of exposure. A cross-sectional population survey combining online and telephone techniques was conducted among 3,592 adults in Chile. Regression analysis revealed that lower educational level and frequency of television use were positively associated with greater exposure to preventive messages. Exposure to preventive messages, in turn, was positively associated with intentions to maintain the three behaviors examined. Individuals in the lower educational attainment group had lower intentions to engage in two of the three behaviors, but those in these segments who were more exposed to preventive messages were as likely as their more educated counterparts to intend wearing masks and adhering to physical distance. The findings of this study underscore the importance of reaching the least educated segments with campaign messages in the context of public health crisis, since these messages can close gaps between the more and less educated group in their intentions to engage in preventive behaviors.

Individual and community-level determinants of knowledge of ovulatory cycle among women of reproductive age in 29 African countries: a multilevel analysis

Background

Knowledge of the ovulatory cycle (KOC) can help reduce the chances of unwanted pregnancies and may improve a woman’s reproductive health. However, little is known about the factors associated with knowledge of the ovulatory cycle across Africa. Therefore, we aimed to investigate the individual/household and community level determinants of KOC among women of childbearing age in 29 African countries.

Methods

We used data from the Demographic and Health Surveys of 29 African countries conducted between 2010 and 2020. Bivariate and multivariate multilevel logistic regressions were used to examine the association between women’s correct knowledge of the ovulatory cycle and individual/household and community-level factors. The results were reported using adjusted odds ratios (AOR) with a 95% confidence interval (CI).

Results

The pooled results showed that correct KOC among women was 15.5% (95% CI 14.2–17.0%), varying from 11.5% in Liberia to 57.1% in the Democratic Republic of Congo. Regarding regional distribution, the highest prevalence of KOC was observed in West Africa (38.8%) followed by East Africa (21.3%) and was lowest in Southern Africa (15.6%) and Central Africa (15.5%). After adjusting for potential confounders, at the individual level, we found the odds of KOC to be higher among older women (40–44 years-aOR 3.57, 95% CI 1.90–6.67, 45–49 years-aOR 2.49, 95% CI 1.29–4.82), and women with higher educational level (aOR 2.58, 95% CI 1.40–4.75); at the community level, higher KOC was among women exposed to media (aOR 2.24, 95% CI 1.32–3.81).

Conclusions

Knowledge of ovulatory cycle among women of reproductive age was found to be low in the region and varied by country. Women’s age and educational level were the individual-level factors associated with increased knowledge of ovulatory cycle while community-level media exposure was found to be associated with increased knowledge of ovulatory cycle in this study. This finding highlights the need for appropriate strategies (possibly use of mass media) to increase knowledge of ovulatory cycle among women of reproductive age, especially among adolescents in Africa.

The association between media exposure and enrollment in health insurance in Nepal: Implications for health policy

Exposure to mass media plays a crucial role in behavior change or decision‐making. The study used a cross‐sectional survey design. A total of 810 households were randomly selected for data collection by using a validated interview schedule. The study examined exposure to radio, television (TV), hoarding boards (billboards), newspapers, and brochures, pamphlets, and posters as media platform “independent variables” and enrollment in health insurance (HI) as the “dependent variable.” Data showed that 60% of the respondents had exposure to HI information with electronic (radio and TV) media and 33% had exposure via printed or displayed media. All these media were significantly associated with enrollment in HI. But exposure to HI‐related information from radio (adjusted odds ratio [aOR] = 1.91, 95% confidence interval [CI] = 1.39–2.61, p < 0.001), TV (aOR = 1.72, 95% CI = 1.25–2.38, p < 0.01), and hoarding board (billboard) (aOR = 1.87, 95% CI = 1.25–2.81, p < 0.01) were the significant predictor for enrollment in HI. The study findings suggest that it would be best to consider the use of these predictor communication channels when making strategic communication plans to promote HI enrollment in Nepal.

Knowledge and Information Exposure About Family Planning Among Women of Reproductive Age in Informal Settlements of Kira Municipality, Wakiso District, Uganda

Introduction: A high unmet need for family planning (FP) prevails in sub-Saharan Africa. Knowledge, awareness creation, and ensuring accessibility are frequently used to increase FP uptake. However, evidence on knowledge or information dissemination about FP among marginalized populations in urban settings in Africa is limited. This study explored the knowledge of FP methods, media exposure, and contact with FP providers among women from an informal settlement in Uganda.

Methods: Using a cross-sectional study design, we interviewed 626 women aged 15–49 years living in informal settlements of Kira municipality, selected through multistage sampling. Using a standard questionnaire, data was collected on socioeconomic characteristics, knowledge of FP methods, and access to media FP messages among others. Binomial log-linear regression was used to assess disparities in exposure to media FP messages or provider information. Data were analyzed using STATA version 14, at a 5% level of statistical significance.

Results: Nearly all women in the survey were aware of FP methods (99.7%). On average, each woman was aware of 10 FP methods. The most commonly known methods were male condoms (98.2%), injectables (97.4%), and the oral contraceptive pill (95.2%). Use of any contraceptive was found among 42.7% of respondents. Exposure to media was found in 70.6% of the respondents, mostly through television (58.5%) and radio (58.3%). Discussing FP with a provider was significantly associated with media exposure (aPR 1.4, 95% CI: 1.24–1.56). Less than 50% of women who were not using FP had contact with an FP provider. Women in union (aPR 1.6, 95% CI: 1.01–2.68) and those with access to media messages (aPR 2.5, 95% CI: 1.37–4.54) were more likely to have contact with a provider to discuss FP.

Conclusion: There is high general awareness about FP methods and media exposure, but method use was low. Further exploration of women's understanding of FP methods and the fit between existing education programs and FP knowledge needs in this urban setting should be conducted. The potential for mobile health solutions in this urban population should be explored. Future studies should focus on the knowledge and understanding of FP among unmarried and nulliparous women and those with no access to media information.

Association Between Mass Media Use and Maternal Healthcare Service Utilisation in Malawi

Introduction

Using data from Malawi Demographic and Health Survey (2015–16), in the present study, we aimed to assess the role of exposure to family planning information through various mass media on the utilization of maternal healthcare services.

Methods

The sample population included 13,217 women aged 15–49 years with a history of at least one childbirth. Outcome measures included essential maternal healthcare services such as early and adequate use of antenatal care, skilled delivery service. Multivariate logistic regression models were used to find the association between maternal healthcare services and exposure to family planning messages by controlling for sociodemographic characteristics.

Results

Women who reported receiving family planning message through internet [odds ratio=1.48, 95% CI=1.15, 1.91], radio [odds ratio=1.15, 95% CI=1.05, 1.26], TV [odds ratio=1.53, 95% CI=1.32, 1.76] and mobile phone [odds ratio=1.23, 95% CI=1.02, 1.48] had higher odds of having timely ANC care. For using adequate number of ANC, the associations were significant for TV [odds ratio=1.41, 1.23, 1.62] and mobile phone [odds ratio=1.20, 95% CI=1.01, 1.43] only. For the use of facility delivery, a strong association was observed for poster [odds ratio=1.43, 95% CI=1.12, 1.82] and TV [odds ratio=2.99, 95% CI=1.78, 5.03]. The odds of using all three services varied noticeably between urban and rural areas, eg, receiving family planning messages through internet increased the odds of antenatal care and facility delivery services in the urban areas only, whereas that from poster was associated only for facility delivery and only in the rural areas.

Conclusion

The findings indicate a positive association on media communication regarding family planning on the uptake of maternal healthcare services.

Association between media exposure and family planning in Myanmar and Philippines: evidence from nationally representative survey data

BACKGROUND

Although women in South Asia and South-east Asia have developed their knowledge regarding modern contraceptive and other family planning techniques, limited information exists on the influence of mass media exposure on the utilization of contraceptives and family planning. The current study examined the association between media exposure and family planning in Myanmar and Philippines.

METHODS

The study analyzed data from the 2017 Philippines National Demographic and Health Survey (NDHS) and 2015-16 Myanmar Demographic and Health Survey (MDHS). Three family planning indicators were considered in this study (i.e., contraceptive use, demand satisfied regarding family planning and unmet need for family planning). A binary logistic regression model was fitted to see the effect of media exposure on each family planning indicator in the presence of covariates such as age group, residence, education level, partner education level, socio-economic status, number of living children, age at first marriage, and working status.

RESULTS

The prevalence of contraception use was 57.2% in the Philippines and 55.7% in Myanmar. The prevalence of demand satisfied regarding family planning was 70.5 and 67.1% in the Philippines and Myanmar respectively. Unmet need regarding family planning was 16.6% and 19.9% in the Philippines and Myanmar respectively. After adjusting for the covariates, the results showed that women who were exposed to media were more likely to use contraception in Philippines (aOR = 2.24, 95% CI = 1.42-3.54) and Myanmar (aOR 1.39, 95% CI = 1.15-1.67). Media exposure also had a significant positive effect on demand satisfaction regarding family planning in the Philippines (aOR = 2.19, 95% CI = 1.42-3.37) and Myanmar (aOR = 1.34, 95% CI = 1.09-1.64). However, there was no significant association between media exposure and unmet need in both countries.

CONCLUSIONS

The study established a strong association between mass media exposure and the use and demand satisfaction for family planning among married and cohabiting women in Philippines and Myanmar. Using mass media exposure (e.g., local radio, television- electronic; newspapers) to increase both access and usage of contraceptives as well as other family planning methods in these countries could be pivotal towards the attainment of United Nations Sustainable Development Goal 3 (SDG 3) of improving maternal health.

Prevalence of institutional delivery and its correlates amongst women of reproductive age in Mozambique: a cross-sectional analysis

Background

The healthcare system in Mozambique is striving to reduce the high maternal and child mortality rates and stay on par with the Sustainable Development Goals (SDG 3.1). A key strategy to curb maternal and child mortality is to promote the use of professional childbirth services proven to be highly effective in averting maternal deaths. Currently, little is known about the use of childbirth services in Mozambique. The present study investigated the prevalence of professional healthcare delivery services and identified their sociodemographic correlates.

Methods

This study used cross-sectional data on 7080 women aged 15–49 years who reported having a child during the past 5 years. The data were collected from the 2011Mozambique Demographic and Health Survey. The outcome variables were the choice of childbirth services that included 1) place of delivery (respondent’s home versus health facility), and mode of delivery (caesarean section versus vaginal birth). Data were analyzed using descriptive and multivariate regression methods.

Results

The prevalence of health facility and C-section delivery was 70.7 and 5.6%, respectively. There was a difference in the use of professional birthing services between urban and rural areas. Having better educational status and living in households of higher wealth quintiles showed a positive association with the use of facility delivery services among both urban and rural residents. Regarding ethnicity, women of Portugais [2.688,1.540,4.692], Cindau [1.876,1.423,2.474] and Xichangana [1.557,1.215,1.996] had relatively higher odds of using facility delivery services than others. Antenatal care (ANC) visits were a significant predictor of facility delivery services both in urban [OR = 1.655, 95%CI = 1.235,2.218] and rural [OR = 1.265, 95%CI = 1.108,1.445] areas. Among rural women, ANC visit was a significant predictor of C-section delivery [1.570,1.042,2.365].

Conclusion

More than a quarter of the women in Mozambique were not using health facility delivery services, with the prevalence being noticeably lower in the rural areas.