Carlos Palma
Pilar Sebastian
Haydée Lemus
Publication Date
June 1, 2015

"Indigenous Guatemalans have faced a multitude of barriers to access and use of family planning services....While the Guatemalan family planning law was a historic advancement towards empowering all Guatemalans to access and use of family planning, few patients or providers knew the details of the law or their legal rights around family planning, thus preventing the law from becoming a transformative and empowering avenue to family planning for Guatemalans as intended." - from the Health COMpass

Based upon the 2005 Ley de Acceso Universal y Equitativo de Servicios de Planificación Familiar, a family planning law enacted in 2009, and a "Barriers to Access" study, the Organización Panamericana de Mercadeo Social - Pan American Social Marketing Organization (PASMO), part of the global network of Population Services International (PSI), "developed strategies to create awareness of and demand for modern methods of family planning among both users and providers using a combination of interpersonal communication (IPC) techniques, mass media, entertainment education, and provider behavior change communication (PBCC)."

This document presents strategies of a 2012 PlanFam campaign to increase knowledge among the Maya populations about Guatemala’s family planning (FP) law so that both consumers and providers had information to comply with the law and thus increase access to methods of contraception. Partners for the campaign included United States Agency for international Development (USAID) and local non-governmental organisations (NGOs).

Six barriers identified through a  USAID Barriers to Access study included:

  • "Bias of providers towards indigenous women 
  • Unsuitable conditions where family planning services are provided 
  • Lack of appropriate information, educational materials, and counseling for indigenous populations 
  • Limited integration of community-based providers in the community 
  • Beliefs within the community regarding family planning and associated behavior 
  • Restricted social and familial environments limiting the autonomy of women"

An SBCC campaign to increase knowledge about the FP law was implemented in conjunction with demand generation activities and provider BCC activities. FP as a human right was the basis of the message framing, particularly focused for young men and women in rural areas.

"Messaging about the family planning law was planned for distribution along the same communication channels as those used for demand generation for family planning, including community health workers, mass media (radio and print), educators, facilitators, and health practitioners employed through the Ministry of Health. Communication materials were to be developed based on formative research and tested via focus groups with members of the target populations." 

The following materials were created and tested through focus groups in two phases: 5 radio spots (30 seconds each) in Spanish and 5 Mayan languages; 1 video (10 minutes) in Spanish and 5 Mayan languages; 1 poster in Spanish; 5 pamphlets in Spanish; 1 comic book in Spanish; and 1 flipchart in Spanish. Audio and visual messages were translated into 5 main Mayan languages of the region, whereas print materials were not translated because a small percentage of the population reads a Mayan language.

Launched in 2013 for 3 months and 2014 for an additional month, the campaign used the following channels to disseminate messages:

  • "Mass media - radio and print; distributing pamphlets in health clinics
  • Interpersonal communication - training of community health workers, educators, health providers about the FP law
  • Entertainment education and community activities - health fairs, kiosks, puppets
  • Community mobilization - meetings with local authorities"

The evaluation phase included an AdTrac study of 188 men (49%) and 196 women (51%), 18-49 years old, involving a face-to-face questionnaire of open and closed questions testing recall of messages on FP law. Those exposed to the campaign recalling portions of the law increased by nearly 15% through: health centre exposure (49.4%); radio (15.7%); and image recall (21.3%). A materials evaluation yielded the following information:

  • "Radio: 34.8% were exposed to at least one spot. Of those, 60.3% listened to the spot on the radio, the rest through other channels (health fairs, kiosks, etc.). 84.2% of people that listened to a spot recalled the key messages.
  • Video: 16.5% were exposed to a video. Of those, 44.8% saw the video at the health service. A 92.6% recall the key messages of the video.
  • Pamphlet: 32.3% were exposed to a pamphlet. Of those, 59.4% saw the pamphlet at the health service and 4.7% saw it with a community health worker from the PlanFam project. 71.7% recalled the key messages.
  • Comic book: 16.5% were exposed to the comic book. Of those, 60 % saw the comic book at the health service and a 16.7% saw it at a school facility. 63% recalled the key messages.
  • Poster: 73.2% were exposed to the poster. Of those, 72.5% saw the poster at a health service, 9.2% on the street, and 7% at a school facility. 80.8% recalled the key messages.
  • Flipchart: Only 8.5% were exposed to the flipchart. Of those, 50% saw it at the health service, 11% saw it at a FP clinic, and 5.6% with a community health worker from the PlanFam project. 64% of those who saw it recalled the key messages."

The evaluators concluded that posters were most effective for key message recall, radio was second and found that people exposed to the campaign recalled FP as a human right and liked the materials and approved of the message on family planning. Printed materials have continued to circulate after the project's completion.