Carol Underwood
Zoé Hendrickson
Anna Leddy
Publication Date
March 21, 2015

The Johns Hopkins Center for Communication Programs (CCP) and The Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society (HBS)


"Research has demonstrated the multi-level and multifaceted linkages between measures of gender equity/equality and family planning (FP) practices. Yet, major gaps in knowledge about the complex relationship between gender equity and reproductive health (RH) outcomes, including FP use, remain."

The analysis, a review by Health Communication Capacity Collaborative (HC3) researchers of existing data sets from the four HC3 country programmes, was aimed "to determine if there is a significant relationship between gender equity and current use of family planning, and also whether exposure to communication intervention components is significantly associated with gender equity. Data sets came from the following communication programs in four countries:

  • Malawi: The Support for Service Delivery Integration Communication (SSDI) Program
  • India: The Urban Health Initiative
  • Nigeria: The Nigerian Urban Reproductive Health Initiative (NURHI)
  • Tanzania: EngenderHealth ACQUIRE (ATP)" 

The research questions guiding the analysis were:

  1. "Is there a significant relationship between gender equity and current use of family planning?
  2. Is exposure to communication intervention components significantly associated with gender equity?
  3. Does gender equity affect the relationship between intervention exposure and current use of family planning?"


By programme, some of the C4D interventions include:

  • SSDI - a baseline survey conducted in 2012 "to assess participants’ baseline exposure to communication programs designed to address FP..." and aimed to support planning for a subsequent programme.
  • The Urban Health Initiative (see related summaries below) - Working in four countries (Senegal, Nigeria, Kenya, and India), these campaigns, supported by efforts to improve quality of care, access, and funding and policy mechanisms, include:
    • Sambhal lunga, an entertainment education (EE) spot on radio and TV that features a woman who decides to "take control" by seeking out a provider of FP service -  "Sambhal lunga highlighted the importance of women’s roles in FP decision-making, which is a key component of many measures of gender equity.";
    • female sterilisation spots, also for TV and radio, reflecting this choice for those not desiring more children;
    • male sterilisation TV and radio spots, highlighting consultation and the benefits of this decision in a marriage;
    • community events, such as folk shows, magic shows, and broadcast of messages through a vehicle speaker (miking); and
    • Happy Dampatti Pratiyogita, a multi-pronged approach utilising "television interviews, television short stories, local contests, and other dissemination techniques (e.g., wall paintings, mobile phone messaging, or newspapers)" promoting FP services and celebrating couples who accept FP". "Happy Dampatti addressed partner communication, which is also intimately linked to gender norms at the household level."
  • NURHI (see relatesd summaries below) - "utilizes communication programs disseminated on television and on radio to increase individuals' awareness of and engagement with FP. In addition to these entertainment programs, a mass media campaign entitled "Know, Talk, Go" uses multiple forms of media to increase knowledge and improve communication around FP." NURHI also advocates for FP at the policy level and uses information and communication technology (ICT) for capacity building among healthcare providers.
  • ATP (see related summaries below) - a mass media campaign to increase FP use and individual knowledge of long acting and permanent contraceptives methods (LA/PMs). The programme utilised the phrase "Have a Plan for Your Family" to “tie radio and print-based materials to the ACQUIRE campaign.”

The document details the methodology used in each of these 4 country studies and lists key findings as the following:

  • "Through the analysis of data from communication programs in four countries, this report found that exposure to communication campaigns was associated with use of modern contraception in Malawi, India and Nigeria. 
  • Evidence suggested that more equitable gender norms were associated with a greater likelihood of using family planning. However, this report was unable to determine whether the communication programs were related to, or affected, this relationship. This may have been due to the fact that these programs (except ACQUIRE) did not explicitly address gender relations in their activities. Further studies are urgently needed to address this report’s second research question and explore how family planning-related communication interventions affect measures of gender equity.
  • There was no evidence that gender equity played a mediating or moderating role in the relationship between exposure to communication messages and contraceptive use.
  • Communication interventions should address gender norms more purposively if they are to have lasting effects on gender norms. It cannot be assumed that family planning messages will indirectly influence gender norms and attitudes.
  • Too often researchers fail to acknowledge the structural and social factors that influence individual level behaviors. Refinement of existing measures of gender equity is needed."

The research concludes that communication programmes designed to influence gender constructs and FP ideation and use "should be more explicit and strategic in addressing the norms they are designed to influence. They also recommended that researchers move beyond the individual when evaluating these programs to integrate other levels of gender equity, including couples, the community and society overall."

Click here to view an infographic that visually demonstrates the role gender equity played in the above-described 4 SBCC programmes.


HC3 website, June 1 2015; and email from HC3 to The Communication Initiative on December 21 2016.