Mass media improving SRH

1. creates awareness and increases knowledge about SRH
   1. health consequences, how to prevent, how/where to treat
2. changes attitudes/values and encourages behavioral adoption (adopting recommended behaviors)
3. creates an agenda for public debates

   Anmerkungen:

   •    ●“A  mass communication programme dealing with sensitive issues socially validates open discussion of these issues, thus making them part of the everyday agenda” - so when a campaign deals with sensitive issues such sex or HIV/AIDs it allows for a discussion of these issues which is very important because sometimes stigma and shame or taboo stop people from talking about these issues   
   1. as SRH topics can be sensitive to societies

Anmerkungen:

•    1.Mass media must be supported by interpersonal and group communication.     2. Support of community leaders, public opinion leaders and decision-makers can lead to stronger results.    3. Media campaign should use diverse broadcast and distribution channels, combining television, radio, print and traditional media, in order to maximize penetration and impact.   4. The message that a campaign is trying to convey has to be CLEAR.   

1. evaluation
   1. challenges
      1. 1)Determining knowledge of target audience before program implementation begins 2)Finding adequate control groups… a lack of comparative perspective 3)Isolating programme communication– change not always directly attributed to intervention , 4)Instability that impacts audience exposure
2. 1. What specific challenges might characteristics of either the audience or the environment pose? 2. How can the media used in any given campaign be customized to better reach the target audience or to better fit the context within which that audience exists? 3. Other media: what are the effect can the other media have on attitudes, practices, and beliefs?
   1. cannot to be effective in transmitting SRH-related ideas if the contents ignore sociocultural, political, religions contexts of the place implemented. the contents must be context-specific.
   2. even though the mass media succeeded in changing attitudes/values transmitting ideas/encouraging certain behavioral changes, if SRH services were not available, the targeted population can hardly adopt those recommended behaviors and therefore does not help improve SRH. The mass media (communication) can be useful in improving SRH only when SRH services are accessible, available, affordable to the population.
   3. have to change the mode of mediums, according to the targeted audience. basically socioeconomic status and geographical characteristics. Afford to have TV/radio? education level/literacy ...
   4. The mass media contents not particularly for SRH purposes can pose a challenge of spreading misinformation, myths, adverse health practices.

1. three components of service delivery
   1. quality of care
   2. program image
   3. accessibility
      1. cognitive barriers
         1. The extent to which potential clients are aware of the locations or service/supply points and of the services available at these locations
      2. psycho-social barriers
         1. psycho-social factors preventing potential clients from using services; affecting use and demand of services
            1. e.g.: fears of negative social stigma associated with service use, fears regarding submitting to specific procedures such as pelvic exam, fear of side-effects, social restrictions on women travelling alone to seek services
            2. e.g., societal family size norms, demand for children and the acceptability of FP

1. although it potentially improves SRH outcomes by increasing knowledge/awareness, encouraging public discussion, changing attitudes and norms, and ultimately promoting service use it is hard to measure the mass media's effects ...
   1. e.g., very difficult to ascertain direct cause and effect: just as it is very difficult to prove that a community’s increased knowledge of SRH is the direct effect of a mass media campaign, it is difficult to assert any direct behavioural or health improvements as a result of the knowledge and discussion increase.

1. different kinds of media
   1. posters
      1. can increase knowledge and promote behavioral change among illiterate populations
   2. TV

      Anmerkungen:

      •    The first novella using the Sabido Method to promote family planning, was Acompaname (“Accompany Me”). Acompaname showed the personal benefits of planning one’s family, by focusing on the issue of family harmony. The results of Acompaname, as reported by the Mexican government’s national population council (CONAPO), were: 1.Phone calls to the CONAPO requesting family planning information increased from zero to an average of 500 a month. Many people calling mentioned that they were encouraged to do so by the television soap opera. 2. More than 2,000 women registered as voluntary workers in the national program of family planning. This was an idea suggested in the television soap opera. 3. Contraceptive sales increased 23 percent in one year, compared to a seven percent increase the preceding year. 4. More than 560,000 women enrolled in family planning clinics, an increase of 33 percent (compared to a one percent decrease the previous year).   
      1. can expose more rural populations to a more urban values and lifestyle (# of children, use of contraceptives)

         Anmerkungen:

         •    Westoff and Koffman, (2011). “The Association of Television and Radio with Reproductive Behavior”, Population and development review, Vol.37(4),p.749-759.    In a study done by Westoff and Koffman wherein they used National Surveys conducted between 2000 & 2008 from 48 developing countries they found that Women who watch TV only sometimes are 1.6 times more likely to use modern contraception than women who dont watch tv Women who watch TV daily are 2.4 times more likely to use modern contraception than women who dont watch tv 52% of Women who watch TV daily report no births in the past 5 years compared with 30% for Women who don’t watch TV   
         1. e.g., Acompaname (“Accompany Me”) in Mexico showing the personal benefits of planning one’s family, by focusing on the issue of family harmony.
   3. Radio
      1. Rural population, particularly in SSA
   4. social media
      1. can share/ask for information with anonimity, can be used in conservative societies
         1. but the information exchanged needs to be monitored for quality and reliability, and the users’ confidentiality and privacy need to be maintained.”
   5. play/theatre
      1. in places without other MM avaialble

1. e.g., HIV: unprotected sex -> AIDS/deaths -> condom use/limit # of partners/abstances -> HIV testing, address stigma
2. increases knowledge on SRH; encourage use of services (FP, HIV, STI); address stigma; change attitudes (sexual practice norm/value, family size value)
3. FP campaign: intention to use female condom in Tanzania (Agha & Rossem, 2002)

   Anmerkungen:

   • Agha S, Van Rossem R: Impact of mass media campaigns on intentions to use the female condom in Tanzania. Int Fam Plan Perspect 2002, 28(3):151-8. Available at: http://www.jstor.org/stable/3088258 . Accessed August 10, 2014
4. HIV awareness campaign in Nigeria. exposure to the campaign increased the likelihood for individuals to discuss HIV/AIDS issues with a partner and to know that condom use reduces the risk of HIV transmission (Keating et al. 2006)

   Anmerkungen:

   •  a mass media campaign intended to maximize the use of family planning, HIV/AIDS, and child survival services in Nigeria found that individuals exposed to the campaign were more likely to discuss HIV/AIDS issues with a partner and to know that condom use reduces the risk of HIV transmission than persons not exposed 
5. maternal health campaign: increased use of antenatal, postnatal and delivery care services

   Anmerkungen:

   •  For instance, a study in Indonesia uncovered that husbands exposed to the mass media campaigns (television, radio, print materials), which were designed to promote male involvement in birth preparation were more likely to report new knowledge on birth preparedness and to participate in birth preparation than those not exposed
   1. increased knowledge about care and improved participation of men in antenatal care, childbirth and postnatal care: Indonesia (2010); Malawi (2015)