Despite decades of family planning (FP) programming, contraceptive prevalence across the West African region remains low and fertility remains relatively high.[1]
FP use can positively affect the health and well-being of women and their families and is associated with a number of positive outcomes, including increased women’s empowerment, decreased maternal mortality, improved maternal and child health, and improved economic status.[2, 3, 4, 5] Even with these benefits, in Togo, only 24% of married women between the ages of 15 and 49 reported currently using a modern FP method, despite an approximate 34% unmet need for contraception.[6] Factors related to FP non-use among those with unmet need include socio-cultural norms and practices, economic constraints, travel-related barriers to accessing FP services, and low education levels among women.[7]
Social and behavior change campaigns or interventions can provide information about FP method safety and benefits, while also challenging the social and gender norms that restrict FP access and use. To promote client trust in FP methods and providers, the West Africa Breakthrough ACTION (WABA) project developed a quality assurance campaign entitled Confiance Totale (“total confidence” in English). As part of this campaign, WABA disseminated a series of nine 45-second radio public service announcements on seven radio stations in Togo, in the three most commonly used languages, 15 times per day, according to Development Media International Saturation + methodology. These spots focused on promoting confidence in FP methods and services, couple communication about FP use, postpartum FP, and healthy birth spacing. As the campaign took place in the midst of COVID-19, some of the radio spots encourage FP access and use in the context of the pandemic.
Following the broadcasts, WABA conducted a household survey to investigate the relationship between campaign exposure and reproductive health outcomes of interest, to what extent the 2020 and 2021 Confiance Totale broadcasted messages reached the desired audience during the COVID-19 pandemic, and the extent to which these messages may have affected intermediate and behavioral outcomes. In addition, the study team sought to understand whether there were different effects among the men and women sampled. This report shares the results of this study and includes a discussion about implications for future family planning social and behavior change programs.
[1] Koffi, T. B., Weidert, K., Bitasse, E. O., Adjoko, M., Mensah, E., Emina, J., Mensah, S., Bongiovanni, A., & Prata, N. (2018). Engaging men in family planning: Perspectives from married men in Lomé, Togo. Global Health: Science & Practice, 6(2), 317–329. https://doi.org/10.9745%2FGHSP-D-17-00471
[2] Ahmed, S., Li, Q., Liu, L., & Tsui, A. O. (2012). Maternal deaths averted by contraceptive use: an analysis of 172 countries. The Lancet, 380(9837), 111–125. https://doi.org/10.1016/S0140-6736(12)60478-4
[3] Canning, D., & Schultz, T. P. (2012). The economic consequences of reproductive health and family planning. The Lancet, 380(9837), 165–171. https://doi.org/10.1016/S0140-6736(12)60827-7
[4] Cleland, J., Conde-Agudelo, A., Peterson, H., Ross, J., & Tsui, A. (2012). Contraception and health. The Lancet, 380(9837), 149–156. https://doi.org/10.1016/S0140-6736(12)60609-6
[5] Prata, N., Fraser, A., Huchko, M. J., Gipson, J. D., Withers, M., Lewis, S., Ciaraldi, E. J., & Upadhyay, U. D. (2017). Women’s empowerment and family planning: A review of the literature. Journal of Biosocial Sciences, 49(6), 713–743. https://doi.org/10.1017/S0021932016000663
[6] World Bank. (2022, December 1). Contraceptive prevalence, any method (% of married women ages 15–49)—Togo. https://data.worldbank.org/indicator/SP.DYN.CONU.ZS?locations=TG
[7] Ayanore, M. A., Pavlova, M., & Groot, W. (2016). Unmet reproductive health needs among women in some West African countries: A systematic review of outcome measures and determinants. Reproductive Health, 13(1), 1–10. https://doi.org/10.1186/S12978-015-0104-X/TABLES/3
