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ORIGINAL ARTICLE

Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative

Susan Krenn, Lisa Cobb, Stella Babalola, Mojisola Odeku and Bola Kusemiju
Global Health: Science and Practice December 2014, 2(4):427-443; https://doi.org/10.9745/GHSP-D-14-00009
Susan Krenn
aJohns Hopkins Center for Communication Programs, Baltimore, MD, USA
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Lisa Cobb
aJohns Hopkins Center for Communication Programs, Baltimore, MD, USA
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  • For correspondence: lcobb@jhu.edu
Stella Babalola
aJohns Hopkins Center for Communication Programs, Baltimore, MD, USA
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Mojisola Odeku
bJohns Hopkins Center for Communication Programs, Nigerian Urban Reproductive Health Initiative, Abuja, Nigeria
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Bola Kusemiju
bJohns Hopkins Center for Communication Programs, Nigerian Urban Reproductive Health Initiative, Abuja, Nigeria
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Figures & Tables

Figures

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  • Figure 1.
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    Figure 1.

    Ideation Model of Communication

    Source: Health Communication Capacity Collaborative (2014).8

  • Figure 2.
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    Figure 2.

    Nigerian Urban Reproductive Health Initiative (NURHI) Interventions

    Abbreviations: FP, family planning; FPPN, Family Planning Providers Network; PMVs, patent medicine vendors.

  • Figure3
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    A poster produced by the NURHI project for the “Get It Together” campaign encourages partners to discuss family planning together.

  • Figure4
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    A couple attends a family planning counseling session in Ibadan, Nigeria.

  • Figure 3.
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    Figure 3.

    Percentage of Women Not Currently Using Contraception Who Intend to Use a Method in the Next 12 Months at Baseline (2010/11) and Midterm (2012), by NURHI Project City

    *** P < .001.

  • Figure6
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    Members of a radio listeners' club listen to and discuss the family planning radio magazine and drama, Second Chance, produced by NURHI.

  • Figure 4.
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    Figure 4.

    Contraceptive Prevalence at Midterm Among Married Women Who Were Not Using a Modern Method at Baseline, by Level of Exposure to NURHI Activities, N = 1,992

    Significance of differences across groups: P < .001.

  • Figure 5.
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    Figure 5.

    Change in Perceived Peer Support for Family Planning Between Baseline and Midterm, By Level of Exposure to NURHI Activities, N = 4,331

    Significance of change in perceived peer support is P < .05 for zero exposure and P < .0001 for low, medium, and high levels of exposure.

  • Figure 6.
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    Figure 6.

    Contraceptive Prevalence at Midterm Among Married Women Who Were Not Using a Modern Method at Baseline, by Level of Ideation at Midterm, N = 1,992

    Significance of differences across groups: P < .001.

  • Figure 7.
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    Figure 7.

    Family Planning Users Served by NURHI-Supported Clinics and Through Associated Outreach Visits, January 2011–May 2013

    On average, outreach visits contributed, in the third year of the project, 15.2% of total family planning services provided by NURHI-supported clinics and 31% in the fourth project year.

Tables

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    Table 1. Modern Contraceptive Prevalence Rate Among Married Women, at Baseline and Midterm, by NURHI Project City
    CityBaselineMidtermPercentage Point Change
    Abuja31.9%34.2%+2.3
    Ibadan33.3%36.9%+3.6*
    Ilorin26.9%34.9%+8.0***
    Kaduna19.6%35.1%+15.5***
    • ↵* P < .05; *** P < .001.

    • View popup
    Table 2. Ten Ideation Factors at Baseline and Midterm That Predict Contraceptive Use
    Ideation FactorDescriptionBaselineMidtermSignificance of Change
    Contraceptive methods knowledgePercent of married or cohabiting women with knowledge of at least 3 modern methods55.5%69.2%P < .001
    Beliefs/attitudes about family planningPercent of married or cohabiting women with highly positive attitudes toward family planning53.7%70.9%P < .001
    Attitudes toward government officials talking about family planningPercent of married or cohabiting women who approved of government officials speaking publicly about family planning83.0%91.4%P < .001
    Attitudes toward religious officials talking about family planningPercent of married or cohabiting women who approved of religious leaders speaking publicly about family planning58.6%72.2%P < .001
    Spousal communicationPercent of married or cohabiting women who discussed the number of children with spouse during the last 6 months29.8%30.8%Not significant
    Percent of married or cohabiting women who needed spousal permission to use family planning75.4%77.4%Not significant
    Perceived peer behaviorPercent of married or cohabiting women with most friends using a modern contraceptive method8.2%17.6%P < .001
    Perceived self-efficacyMean score for perceived self-efficacy to take relevant actions in favor of contraceptive use (range, 0–6)3.13.6P < .001
    Family size preferencesPercent of married or cohabiting women who indicated wanting families of 3 or fewer children14.7%17.4%P < .05
    Perceived peer supportPercent of married or cohabiting women who perceived peer support for family planning22.8%42.4%P < .001
    Personal advocacyPercent of married or cohabiting women who encouraged friends to go for family planning services17.1%24.2%P < .001
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Global Health: Science and Practice: 2 (4)
Global Health: Science and Practice
Vol. 2, No. 4
December 01, 2014
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Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative
Susan Krenn, Lisa Cobb, Stella Babalola, Mojisola Odeku, Bola Kusemiju
Global Health: Science and Practice Dec 2014, 2 (4) 427-443; DOI: 10.9745/GHSP-D-14-00009

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Using behavior change communication to lead a comprehensive family planning program: the Nigerian Urban Reproductive Health Initiative
Susan Krenn, Lisa Cobb, Stella Babalola, Mojisola Odeku, Bola Kusemiju
Global Health: Science and Practice Dec 2014, 2 (4) 427-443; DOI: 10.9745/GHSP-D-14-00009
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US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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