Intervention Development: Calibrating Content of a Family Planning Radio Campaign to the Context in Kano State, Nigeria
Maternal deaths and health burdens from unintended pregnancies are a large-scale problem in low- and middle-income countries. This thesis provides recommendations for tailoring the radio campaigns of Family Empowerment Media (FEM) – a non-profit working to facilitate the use of and access to effective contraceptives – to the local context of Kano State, Nigeria.
A reviewer praised the research for addressing a large-scale problem, aiming to solve a bottleneck in scaling out an evidence-based solution to that problem, and offering analysis that could be used to tailor previously evaluated campaigns to the local context.
This thesis relates to our research direction on global development policy.
Lia (centre) studied the Master of Science programme Developing and Evaluating Interventions at the University of Glasgow. She wrote her thesis with the non-profit organisation Family Empowerment Media, where she now serves as the Director of Programmes.
What was your thesis topic?
The master’s thesis identifies barriers and drivers to effective contraceptive usage in Kano State, Nigeria. It informs the content of a family planning radio campaign in the region that aims to reduce maternal deaths and other health burdens from unintended pregnancies.
In what ways do you think your topic improves the world?
Two hundred eighteen million sexually active women in low- and middle-income countries do not use effective contraceptives despite wanting to avoid pregnancy. This unmet need results in 111 million unintended pregnancies and 70,000 maternal deaths yearly. Every fifth maternal death occurs in Nigeria, where lack of knowledge is among the top reasons for contraceptive non-use. Family Empowerment Media (FEM) is a new evidence-driven non-profit organisation committed to eliminating maternal deaths and other health burdens from unintended pregnancies. FEM produces and airs radio-based social and behaviour change campaigns on family planning to empower women and men who want to delay or prevent pregnancy to consistently use contraception. By 2027, FEM aims to reach 30 million listeners and avert one maternal death for every $2,600 in funding.
FEM has collected extensive formative research data in its first target location Kano State, Nigeria. The thesis analyses this data and draws conclusions on which barriers and drivers to contraceptive usage FEM’s campaign should address. It also suggests traits that radio drama role models must possess to appeal to target listeners. FEM implemented these recommendations in its pilot and rollout campaigns that have reached 5.5 million listeners in Kano. Thus, the research project directly contributed to increasing the impact of FEM’s intervention and improving maternal health in the region. The thesis also presents learnings for other organisations in the field. Overall, it demonstrates how master-level theses can successfully bridge the research-implementation gap.
What do you think the stronger and weaker parts of your research are?
Strengths: The research project identifies solutions directly applicable to FEM’s work. It analyses data that FEM has collected and makes recommendations for developing campaign content. It also identifies questions and improvements for further research. FEM has implemented these recommendations.
The project uses data source triangulation. It bases its conclusions on a critical review of quantitative survey data and qualitative interviews. It also assesses data from different populations such as target listeners and health professionals. Thus, the dissertation addresses the research topic from multiple perspectives.
Weaknesses: I am a white German who did not grow up in Kano State and does not speak Hausa, the language in which the data was collected. As a result, I likely misinterpreted parts of the interviews. Data analysts who grew up in Kano would have been able to analyse the original transcripts, assess Hausa connotations, and interpret the data within its cultural context. I also reinforced power structures that allow German researchers to conduct projects in Nigeria while only enabling a few Nigerians to do the same in Germany.
The quality of the collected data limited the data analysis. To improve data quality, qualitative and quantitative research tools could build upon each other, focus groups could integrate interactive elements or be replaced by individual interviews, and interviewers may ask more follow-up questions.
In what ways have you changed your mind since you finished writing it?
The dissertation uses the term modern contraceptives to describe childbirth spacing methods promoted by Family Empowerment Media. I now avoid this term and use effective contraceptives instead. Unlike modern, the term effective does not encourage judgement on the modernity of behaviour and the development of societies and nations. Instead, effective captures what FEM truly cares about, i.e., providing access to contraceptive methods that have a high probability of preventing unwanted pregnancy.
The dissertation analyses FEM’s first formative research data collected in early 2021. Family Empowerment Media has since conducted numerous research activities in Kano State, such as surveys with 1,000 participants, in-depth prototyping interviews with target listeners, and assessments of caller feedback. The organisation has also worked closely with government, community, and religious stakeholders. Based on these sources, I now believe that addressing religious barriers is even more important than outlined in the dissertation. I also learned that impactful campaigns need to promote self-efficacy, communicate strategies to manage changes in bleeding patterns, and provide a comprehensive overview of contraceptive methods to cater to listeners at later stages of behaviour change. While topics such as improved health and provision for children may be discussed in dramas, religious permissibility and side effects can best be addressed in talk shows with respected religious leaders and health professionals. FEM’s most recent campaign in Kano State incorporates these learnings.
What recommendations would you make to others interested in taking a similar direction with their research?
If you are, like me, a privileged outsider to the context you are researching, reflect if you are the right person to do this work and who would conduct the research if you did not. Approach the project with a learning attitude, acknowledging where you lack knowledge and embracing the opportunity for intercultural learning.
Research only contributes to achieving public health outcomes when findings are implemented. Plan the dissimilation of research findings early and ensure that the right stakeholders can use your results. Communicate open questions and ambiguous findings while identifying concrete action points to inform decision making. If possible, you could work with an evidence-driven implementing organisation. Numerous organisations would value your support to their research and are waiting for you to reach out.
First published 8/12/22, updated 15/12/2022 to reflect results of the Exceptional Research Award