FAMILY PLANNING UNMET NEED COMMUNICATION CAMPAIGN.
EVERYDAY HEALTH MATTERS NEWSLETTER
PRE-TEST REPORT
JULY, 2011
Background:
Health Communication Partnership is in the process of designing a news letter for its Nurse Mildred campaign that was launched recently. The objectives of the pretest were to:
- Find out whether the news letter is convincing.
- Find out if the language used is simple enough for the rural audience to understand and also not offensive
- Find out whether the illustrations and pictures are communicating the message
- Find out if the design and layout is okay
Pretest Areas:
This being a national campaign, the news letter was pre-tested in five districts namely Mbarara in the western region, Kampala and Masaka representing the central region, Gulu and Soroti districts in the northern and eastern regions respectively.
Pre-test Methodology:
A total of six Focus Group Discussions (FGDs) were conducted in the five districts listed above with adult men aged between 30-40 years and women aged between 20–35 years. The FGD respondents were mobilized by local mobilizers with the help of HCP Partner staff working in each of the districts.
FGDs each comprising of 12 respondents were conducted in each of the districts as follows,
- Group 1; Males aged 30 – 40 years
- Group 2; Females aged 20 – 30 years
- Group 3; Females aged 30 – 35 years
The FGDs were conducted by the male and female graduate Research Assistants who were recruited from the pool normally used by HCP. They underwent a half day training where they were oriented to the Nurse Mildred campaign, news letter, tools to be used in the pre-test exercise as well as writing the pre-test report.
Selection and screening of FGD respondents:
HCP worked with Partner Staff in each of the Districts to identify local mobilizers who identified and invited FGD respondents. They mobilized FGD participants with the following characteristics:
- Currently married or cohabiting women and men
- Living in rural areas or peri-urban areas
- Do not use a modern family planning method, yet do not want to get pregnant now or whose spouses/partners do not use family planning and yet do not want to get another child now.
- Literate in English
- Women aged between 20 – 35 years
- Men aged between 30-40 years
- Not peer educators, health educators or local council officials.
The screening criterion was sent out to the identified mobilizers before selection of FGD respondents. Before commencing the group discussions, the Research Assistants screened the mobilized FGD respondents for the above characteristics so that those who did not qualify were not allowed to participate in the FGDs.
Focus Group Discussion Venues:
The local mobilizers with the help of Partner Staff in each of the Districts were also tasked with:
- Identifying and hiring FGD venueswithin the locality of where the FGD respondents live.
- Devoid of interruptions like noise and people.
- Private to allow people express their opinions without fear.
Pre-test schedule
A total of 6 FGDs were conducted during the pre-test exercise, with one FGD in each of the districts except Gulu where two were conducted.
Focus Groups Discussions:
The focus groups were organized as follows:
District / Type of FGD / No. of FGDs / No. of RespondentsMasaka / Females aged (20-30) / 1 / 12
Kampala / Females aged 30-34 yrs / 1 / 12
Gulu / Females (20-30 yrs) / 2 / 24
Males (30-44 yrs)
Mbarara / Females (20–30 yrs) / 1 / 12
Soroti / Males (30-40 yrs) / 1 / 12
Total / 6 / 72
Key Findings:
ARTICLE A: A WORD FROM NURSE MILDRED
Lessons learned from this article:
An overwhelming majority of the respondents (from all groups except males from Mbarara) believed that from this article, they learned that they ought to seek correct family planning information from qualified health workers.In an effort to explain this, a female respondent from Gulu stated that:
“Women should not fear using modern family planning methods but they must avoid listening to wrong information from drug shop operators,people in dispensaries and all those who are not qualified medical practitioners”
Respondents across groups also agreed to have learnt that there is insufficient information about modern family planning. Respondents attributed this to the following statements; modern family planning methods are safe, learn the truth about family planning methods from a health worker, most women want to wait to have children but are not using modern family planning methods.
“Most Ugandans are ignorant about modern family planning and should be enlightened about it. This is because there are many people who would like to use family planning but fear side effects due wrong information”.
(Male respondent-Gulu)
Modern family planning methods are safe. As one of the lessons learned,this was greatly associated to a statement in the article that read: “modern family planning methods are safe”, and some family planning myths dispelled in the article. Howeverrespondents from Mbarara misconceived MFP safety to mean that no side effects are associated with modern family planning methods.
Respondents also learnt the need forboth men and women to be involved in the use of modern family planning methods. Regarding this, respondents from several groups agreed that since men and women are involved in the production of children, it is only when consensus is reached between both parties involved that the best benefits of family planning such as having a small and manageable family and well spaced children will be realized. In Kampala a male respondent was quoted to have said that:
“From this article, I have learned that in Uganda today, you can learn how to use modern family planning methods therefore, a woman should work together with her partner and explain family planning tohim to ensure success of modern family planning methods”
In addition, a female respondent from Gulu said that:“I have learned that modern family planning is the best and most effective methods to be used by couples / partners”
Call to Action:
Respondents across all groups indicated that the messages in this article are calling upon all people in the reproductive age who would like to have children to embrace modern family planning by obtaining reliable information on spacing their children, and deciding on how many children to have from qualified health workers,. Regarding seeking for information from trained health workers, a female participant form Mbarara said:
“The massage calls upon women to seek correct information on family planning from health workers rather than waiting until it is too lateto plan for a family”
In relation to encouragement by the article to use modern family planning methods, respondents also noted that the article is citing benefits that will be enjoyed as a result of using modern family planning methods, therefore people should not pay attention to the myths and rumors circulated by ill informed persons but they should instead concentrateon the expected benefits.
“This article is telling me to know the truth about modern family planning and use modern family planning methods so that I can have a small manageable family inthese difficult financial situations”.
(Female respondent-Gulu)
Clarity of Messages:
Overall the article was well understood among the grater majority (97.2%)of the respondents from different districts and different sexes. 100% of the respondents from Kampala, Masaka, and Gulu could clearly read, interpret and understand the messages and statements in the article. Whileone in every 12 respondents in Soroti, Mbarara, and Gulu females could not clearly understand at least one word. In Gulu one respondent did not know the meaning of the word myth, while in Soroti the respondent was not comfortable with the statement: “Learn the truth about family planning from a health worker”. In Mbarara a respondent wondered: “how can a qualified nurse not give examples in her message? Is she half baked?”
ARTICLE B:NABAGEREKA ON FAMILY PLANNING
Lessons learned
Respondents discussed the importance of family planning and it was agreed across all groups that family planning is important for mothers, children and the community as a whole.
In this regard respondents listed an array of factors including: the opportunity that family planning offers to the mothers to heal before the next birth, the possibility of having well spaced children and a quality/manageable family where parents can afford to educate and feed their children.
“Modern family planning methods are important for the mother, the children as well as the father. Once you use the modern family planning methods, you will be able to have enough time to heal from the first birth before the next child birth”
(Female respondent-Gulu)
Additionally, there was general consensus among members from all groups that they learntaboutdifferent side effects resulting from different modern family planning methods. This understanding was qualifiedby a statement in the article that talked about family planning having side effects just like any other drugs.
One of the main lessons reported to have been learnt by all participants from all groups, was the need to obtain all the necessary information about family planning from the health workers. This was qualified by Nabagereka’s call to all people who need family planning facts to go and ask health workers as many questions as there can be.
Call to Action:
Respondents from all districts were in agreement that the messages were encouraging them to seek all medical advice concerning family planning from medical health practitioners.
“From this article, I get the Idea that we should not listen to rumors about Family Planning but instead seek the right information from medical persons”.
(Male respondent-Gulu)
There was also general consensus among all groups about the compulsion to use family planning methods with immediate effect. This belief was associated to messages talking about the rapid population growth and the raising standards of living indicating that it is only with modern family planning that people will have manageable families.
It was also commonly mentioned that the messages are inciting people to use modern family planning without fear. While stressing the need to use modern family planning methods, participants also noted thatpeople should bear in their minds that there are side effects associated with modern family planning methods just like any other drugs. In Soroti a male respondent said that:
“This letter is guiding me to use family planning, take note of side effects that may arise, be vigilant of myths and not to worry about the side effects of family planning”
(Male respondent-Soroti)
Clarity of the Message:
Respondents were also asked whether they had difficulties in clearly understandingany words and statements inthe article. Of the72 respondents, close to 100% (94.4%) said they could clearly understand everything in the article. While very few (4.2%) did not understand at least one word. Among the female participants in Mbarara and Gulu one in every 12 members could not understand the meaning of the word “myth” while only 1 out 12 participants in Soroti said he did not know the meaning of “a quality family”.
ARTICLE C:ENJOYING PLANNING OUR FAMILIES
Lessons learned
The need to reasonably plan for a family by using modern family planning methods in order to enjoy the resulting benefits was cited across all groups. Each of the groups identified several benefits that they learned from the article and these revolved around good health to the mother, peace of mind, happiness to the entire family, a beautiful wife,and manageable families indicated by the ability to educate children to higher levels of education just like Francis and his wife managed to educate their eldest child up to university.
“It is important to practice family planning because people will be able to realize peaceful minds and manage their families: In a well planned family even though unexpected circumstances like death happen, the surviving partner will be able to manage the family”
(Male respondent-Soroti)
The respondent also recognized the availability of different types of family planning methods to choose from so that if one particular family planning method fails then the couple has more options to consider until a more suitable method is identified. In this regard couple involvement was highly emphasized across all groups. In Soroti one respondent provoked the discussion when he said that:
“I have learned that if you plan and decide on a family planning method together as a couple, you will both be happy. Look how happy Joseph and his wife are…”
Call to Action:
Respondents from three out four groups reported to have realized the need to visit a health worker. Participants from Kampala, Masaka and Mbarara were all in agreement that the messages are telling them to consider modern family planning methods by visiting the health centre and deciding on a particular family planning method with the help of a health worker. In her effort to clarify his observation the respondent who provoked the discussion on this idea said:
“These messages are telling us to visit a health workerso that we can make informed decisions on what family planning method to use”.
(Female-Masaka)
Respondents also mentioned having few and well spaced children as one of the guiding messages they envisaged from this article. This came up from every group and the correspondingunderstanding about this pointed to all confessors having few children
“This article is telling me to start using the modern family planning methods if I want to have fewer children and disembark from many children: Better 1 or 2 but not 10 children”
(Female- Gulu)
Clarity of Messages:
An overwhelming majority of the respondents (98.6%) were comfortable with the words and could clearlyunderstand the massage in the article.However one female participant from Mbarara complained that she could not comprehend Suzan’s marital status (whether she was married or a single mother).
ILLUSTRATIONS ON PAGE ONE:
Relevance of the illustrations on the massage and problems
On average majority of the respondents appreciated the whole idea of matching messages with pictures. In particular the messages were well appreciated and only one respondent from Mbarara needed to know the type of pills that Nbageraka uses to complement her beautiful look. Howeverthe majority of the participants complained about the picture of Nurse Mildred in article A, Nabageraka’s picture in article B, the green background in C.
Description of the problem on the illustrations:
The only complain registered on Nurse Mildred’s picture on article A was that the message is appealing but it is accompanied with contradicting rude face from Nurse Mildred:
“The face of Nurse Mildred is not welcoming at all; it is typical of the rude non smiling nurses we know about;this face scares…”
(Male respondent –Soroti)
Regarding the picture of Nabagereka in Article B, respondent who cited problems were not comfortable with the fact that she did not appear with a small family: one respondent from Mbarara even provoked excitement from the other members when she said that Nabagereka should have appeared along with Kabaka.
Pictures in article C were blamed for not having few children that messages emphasized and the unclear green backgroundsof the words. However female respondents from Mbarara also mentioned that the faces of Francis and Akello did not match the fact that they had a child in the University because they appear to be younger.
Improvements on the illustrations:
The respondents suggested the following improvements on the respective illustrations: Nurse Mildred’s picture should pause with a smile (if her teeth can be seen). Let Nbagereka and couples in article C appear with few children (one or two children), and that the green background colour in article C should be replaced with a brighter colour. Respondents further suggested that let Francis and Akello’s pictures be replaced by those of an older couple. Still on article C one respondent suggested the enlargement of Collins picture.
ARTICLED: Health workers explanation of family planning
Lessons learned:
The leading lesson cited among respondents across all groups was the existence of manageable side effects arising as a result of using modern family planning methods. Many respondents mentioned bleeding, weight gain and the postponement of periods as some of the side effects they learned about.