Evaluation of a Communication Intervention Programme on Birth Spacing in Bihar, India

1. 34th Annual Conference Indian Association for the Study of Population Gokhle Institute of Politics and Economics, Pune December 13-15, 2012 Evaluation of a Communication Intervention Programme on Birth Spacing in Bihar, India Puspita Datta, Kali Prosad Roy, Nayanjeet Chaudhury Population Services International India

2. PSI had four phases of birth spacing campaign programme in Bihar and Jharkhand. This paper based on 4th phase Programme aim: to generate informed demand for modern spacing method and improve people’s perception towards use of modern spacing methods oral contraceptive pills (OCP), condom and injectable contraceptives. Objective: To assess the impact of the intervention on use of modern spacing methods and perception towards birth spacing in Bihar. Background & Objective

3. Methodology: Study Universe Project Area 10 districts Banka, Mumger, Lakhaisarai, Khagaria, Bhagalpur, Begusarai, Samastipur, Patna, Purba Champaran and Pashchim Champaran The sample frame included category villages and all towns – more than 5000 population Target Respondents Men – 21 to 34 years, currently married, not sterilized (himself and spouse) Women – 15 to 29 years, currently married, not sterilized (herself & spouse)

4. Methodology: Sampling Design and sample size Systematic 2 Stage Stratified Sampling Design Selection of PSUs Villages and urban wards was treated as PSU PSUs were selected following PPS sampling Selection of Respondents Listing of households in each sample PSU – this list served as sampling frame Selection of respondents following systematic random sampling 20 respondents (10 Male & 10 Female) were sampled in each PSU

5. Methodology: statistical tools Bi-variate and multivariate regression Reliability test Segmentation analysis & CIS approach to finalize the campaign theme UNIANOVA

6. PSI’s Behavior Change Framework What is the health problem? What behaviour are we trying to influence? What are the drivers of that behaviour? What is our specific marketing approach? HEALTH STATUS CHANGE/REINFORCE BEHAVIOUR POPULATIONS AT RISK OR NEED MOTIVATION Attitudes Belief Intention Locus of control Subjective norm Threat Outcome expectation Willingness to pay OPPORTUNITY Availability Quality of care Brand appeal Brand attributes Social norm ABILITY Knowledge Social support Self efficacy POPULATION CHARACTERISTICS SOCIAL MARKETING INTERVENTION

7. Data Collection for Determinants of Behaviour Data collected by obtaining opinion of respondents on a 5 point Li-kert scale Programme activities: Mid media Mass media – 2 TV commercials Static media – hoardings/posters/shop signage/wall painting, tin plate Product placement Communication themes: Availability Spousal Support /social support

8. Research findings

9. Profile of Respondents Mean age of respondent: male – 28 yrs ,female 24 yrs Mean age at marriage: male – 22 yrs, female 17 yrs Level of education: male illiterate -21 %, female illiterate-38% Main occupation: unskilled worker Monthly household income - less than 7000/month Majority of them are – Hindus and OBCs General Media habit: Television, followed by Radio

10. Profile of Respondents: family size • Mean number of children – 2 • Future intention – women respondent -57.4%, male respondent -66%

11. Awareness about Birth Spacing methods Sig. diff (p<.05) from all categories Adjusted proportions calculated by controlling for key population characteristics 

12. Sig. diff (p<.05) from all categories Current Use of Birth Spacing methods Adjusted proportions calculated by controlling for key population characteristics 

13. Sig. diff (p<.05) from Baseline Increase in Mean Score Adjusted mean calculated by controlling for key population characteristics  page 13

14. Exposure to Communication Channels

15. Dose Response: Key Behaviour-Current use of three spacing methods Sig difference (p<.05) wrt. all other categories Adjusted proportions calculated by controlling for key population characteristics 

16. Sig. diff from Baseline Sig. diff from those exposed twice Dose Response: Key Determinants of perceived availability page 16 Adjusted mean calculated by controlling for key population characteristics 

17. Sig. diff from Baseline Sig. diff from those not exposed in EL Sig. diff from those exposed twice Increase in Mean Score: Perceived Social Support with exposure page 17 Adjusted mean calculated by controlling for key population characteristics 

18. Sig. diff (p<.05) from all categories Media Mix: Key Behaviour-Current use of three spacing methods Adjusted proportions calculated by controlling for key population characteristics 

19. Conclusions and Implications • Behavioral segmentation of target audience is a pragmatic approach for identifying determinants to design communications • The intervention contributed significant increase in current use of modern reversible contraceptives • A minimum of 4 exposures is needed to lead to change in behaviour • Combination of mass media and mid media contributed significant increase in current use of modern reversible contraceptives than any one media alone

20. Thank You