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 Aug 05, 2019 |  12:42 pm |  1919



The study investigated communication strategies influencing the promotion of family planning in Maradi State. Four research questions were asked and four objectives were formulated.The research design adopted was survey combined with focus group discussion, observation guide and In-dept Interview. A sample of six hundred and five (605) respondents among women of reproductive age between15-45, were selected from seven local government areas including Maradi Metropolis using multistage sampling technique. Questionnaire was used to collect information from the subjects. Mean score statistics and Standard Deviation were used for the purpose of data analysis. Checklists for observation were also used as instruments to collect data. The findings revealed that inadequate family planning messages caused problems of misunderstanding the benefits of family planning. These problems might be due to inappropriate methods being used to communicate with people. The conclusion drawn from the findings of this study show an important knowledge gap exists with respect to family planning benefits. The analysis of the data revealed that respondents were of the opinion that communication channels have significant impact on the population and face to face communication is considered as the best strategy in promoting family planning in Maradi State. The main recommendation from this study is for the State Health-Director to organize job-training, workshops and seminars at interval for health workers on family planning. Communication messages should also be edited locally and not at national level as it is know. The establishment of a family planning communication audit should be conducted in Maradi State. National, regional and community radio and television stations should conduct discussions that will help women to understand their reproductive life, rationalize work and shift emphasis from funding to report family planning communication activities. Religious and traditional leaders (Imams, Pastors and chiefs) should have regular communication with their followers on the need for family planning as stated in their engagement protocol held with the UNFPA.



1.1    Background to the Study

For most health issues, the main goal of learning is to be able to communicate. Thompson (1994: 30) notesthat: “it is through communication that people send and receive messages effectively and negotiate meaning.” Nowadays, how to communicate effectively in health matters becomes much more important than reading and writing. As a result, communication strategies have turned into a crucial topic for all health workers. Recognizing the urgent need for family planning and the increasingly important role of communication in family planning programmes, The United States Agency for International Development (USAID) began, as early as the 1970s to address communication issues. A lot of strategies were implemented including: risk communication, persuasive or behavioural communication, media advocacy, entertainment education, interactive health communication, development communication and participatory communication.

The ability to communicate is essential to the success of any undertaking and an important family planning factor in the achievement of its objectives. We have entered an age of knowl­edge and the key to accessing and harnessing that knowledge lies in the ability to communicate. Therefore, a successful communications strategy will enhance considerably, the value of family planning programmes in Niger Republic in general and in Maradi State in particular. But sometime, the family planning communication message contents delivered by health workers are not effective.

Health Communication is “the means by which information about health is imparted and shared with other people” (Northouse, 1998). Put more formally, it is the “transfer of health information between a source and one or more receivers; a process of sharing meanings, using a set of common rules” (Northouse, 1998). To deal with health issues, we communicate information in many different ways. Frequently, it is done through spoken language in radio, television through traditional rulers, religious leaders and/or social mobilizers. We disseminate also the same information in a written language through newspapers, leaflets, journals, magazines and bulletins, but non-verbal communication also plays a significant role in our interactions especially when we are sending health message to people in face to face communication. Thus, our body posture, our expressions and even the clothes we wear also contribute to the messages that we give out.

Effective communication is central to our ability to promote family planning as communicators in the society. Communication is the key aspect of all relationships between family planning service providers and family planning users and/or non users, whether these occur in family, educational, work or social settings. Indeed, when such relationships break down or become stressful, the central complaint frequently relates to poor communication.

The area of healthcare is no exception. Communication problems can occur at many different levels. So, effective communication is now generally acknowledged to be central to effective healthcare. It is no longer seen as an add-on extra; rather it is recognized by many as being at the heart of patient care, playing a pivotal role. As Kreps (2003), noted: “Communication is pervasive in creating, gathering and sharing health information. It is a central human process that enables individual and collective adaptation to health risks at many different levels”. For example, a significant event in relation to health communication in the United Kingdom was the publication of the Patients’ Charter which informed patients that they had a right to be given a clear explanation of any treatment proposed, including any risks involved and alternatives to the recommended treatment. At about the same time, an international conference on health communication produced the ‘Toronto Consensus Statement’ on the relationship between communication practices and health outcomes (Simpson. 1991).

The statement made eight key points:

-          Communication problems in medical practice are important and common;

-          Patient anxiety and dissatisfaction are related to uncertainty and lack of information, explanation and feedback;

-          Doctors often misperceive the amount and type of information that patients want to receive;

-          Improved quality of clinical communication is related to positive health outcomes;

-          Explaining and understanding patient concerns, even when they cannot be resolved, results in a fall in anxiety;

-          A greater participation by the patient in the encounter improves satisfaction, compliance and treatment outcomes;

-          The level of psychological distress in patients with serious illness is less when they perceive themselves to have received adequate information;

-          Beneficial clinical communications is routinely possible in clinical practice and can be achieved during normal clinical encounters, without unduly prolonging them, provided that the clinician has learned the relevant techniques.

Now, there is a substantial body of evidence to show that healthcare providers who communicate well with patients are more likely to secure positive outcomes for patients, themselves and others. Thus, “they are more likely to make more accurate and comprehensive diagnoses, to detect emotional distress in patients, to have patients who are more satisfied with their care and less anxious, and who agree with and follow the advice given” (Lloyd and Bor, 1996).

In addition, “patients who are dealt with by professionals with good communication skills have been shown to have improved health indices and recovery rates” (Davis and Fallow field, 1994). Thus, in what is now cited as a classic series of studies by Greenfield (1985), informing and involving patients in their cases led to significant reductions in blood pressure and improvement in diabetic control that were comparable with the introduction of a new drug.

About health communication in the New Media Landscape, technology and communication systems may enable disruptive innovations and creative solutions that can be brought to bear on many challenging health care problems. The availability of information at the optimal time and place may better inform lifestyle choices, promote preventive healthcare, improve interdisciplinary coordination of care, and enable more informed selection of health care providers and services

As mentioned earlier, many of the communications involve the use of language (either spoken or written). It is health workers’ capacity for these forms of language that distinguishes them from their audience. Indeed, it has been suggested that non-verbal elements account for over 80 per cent of the content or meaning that is conveyed in face-to-face interactions. In most situations, effective communication depends on the appropriate and simultaneous use of both verbal and non-verbal channels. This is so natural that, even on the telephone, people tend automatically to use all sorts of gestures that cannot be seen by the person at the other end of the line (GTZ,

2006)      . It distinguishes between intrapersonal (i.e. within person) and interpersonal (i.e. between person) communication, with the former being used for such activities as reflection, problem solving and self-evaluation, whereas the latter involves interacting with others.

1.1.1     Maradi profile

Maradi is the third largest city in Niger Republic and it is the commercial centre of the country. It is located in the South-Centre of Niger territory between the parallel 13o 16 o 26’North and the Meridian 6o 16 East (DRP/PF/PE, 2009). It is limited in the East by Zinder region; in the West by Tahoua region; in the North by the regions of Agadez and Tahoua, in the South by the federal Republic of Nigeria. Maradi State has 41,796 square kilometers (about 3% of the national territory).The land square is divided into: agricultural zone (71, 5%), pastoral zone (25%) and forestry zone with 3, 5% (DRP/PF/PE, 2009).

Communication channels in Maradi State

The Niger Republic press is governed by Ordinance No. 99-67 of 20thDecember 1999(Illia,

2007)      . Maradi State has several communication channels. These are:

-          Printing papers

There are 2 private French-language printing papers (Garkuwa and le Gardien). Both of them are fortnightly papers.

-          Public and private Televisions

Four (4) private television channels and 1 public TV currently broadcast in Maradi State. These are: TV Tenere, TV Duniya, TV Canal 3, TV Niger 24 and the public television called “Tele Sahe/”. With limited means of production, the private TV cover their schedules with shows imported, cheap and low quality which content is often not adapted to local realities.

Public and private Radios

Radio stations broadcast their programmes in French as well as local languages, including Hausa. These private radio stations (Garkuwa FM, AMA FM, Anfani FM, Dunya FM, Saraounia FM and Tenere FM), generally are more critical of government actions than is the public radio (La Voix du Sahel).According to Marie (1996), “la Voix du Sahel “orthe Voice of Sahelhad a large coveragein the audio area in Maradi State.

Community radios

Community radios have emerged in Maradi State in 2001. To date, 6 community radio stations are scattered throughout the State. These are: Radio Anur (Mayahi),Radio Ayiwa Kai (Gazaoua),Radio Tchincthia (Souloulou), Radio Gabi (Gabi), Radio Bermo (Bermo) and Radio Tessaoua (Tessaoua).

1.2    Statement of the Problem

In the past 26 years, traditional family planning methods were used by minority of women in Maradi State. It was later, in August 1988 when Niger Family Health and Demography Project (NFHDP) started that modern family planning methods were introduced. Along the years, there has been an increase in the use of communication channels to spread health-related information such as family planning promotion.

However, such communication channels (leaflet, radio and television) are often used by health workers and other ‘non-official sources’ to disseminate family planning information and the reliability of some of those has been called into question. A variety of communication strategies has been implemented by health workers ranging from family planning promotion campaigns, traditional rulers, religious leaders, Information Education and Communication (IEC) leaflet, radio and television and other communication channels to promote general awareness, to community mobilization activities and interpersonal communication.

Despite these, evidences emerging between 2005 and 2011show a weak utilization of family planning in Maradi State. It was recorded 4% in 2005 at state level while in Maradi Metropolis it was 5% (Chaibou, 2007). In 2011, family planning ratio in Maradi State recorded 6.75% whereas the expected national objective was 23% (DRSP/MI, 2011). With this, there seem to be a problem with the way family planning was being provided, hence, the need to identify and explain some of the possible causes of the problem. For example, people think that contraception pills give Cancer and practicing family planning is against their religion. Therefore, with the observed negative trend, there is need to assess the effectiveness of communication strategies used inpromoting family planning in Maradi State.

1.3    Research Questions:

The following research questions will be answered:

1.      What are the communication strategies used by health workers to promote family planning in Maradi State?

2.      How familiar are the people with the communication strategies and/or family planning products in Maradi State?

3.      What are the challenges communicating with the people on family planning in Maradi State?

4.      How do people perceive family planning communication messages delivered by health workers in Maradi State?

1.4     Aim of the Study:

The aim of this study is to assess the effectiveness of communication strategies for family planning promotion in Maradi State.

1.5     Objectives

To achieve the purpose of this study, the following research objectives are stated:

1.      Identify the communication strategies used by health workers to promote family planning in Maradi State

2.      Identify the people’s familiarity with family planning communication strategies and product

3.      Identify the challenges of communicating with people on family planning

4.      Determine peoples’ perception on family planning communication messages delivered by health workers in Maradi State.

1.6     Significance

Some works (Maman, 2004 and Souley, 2005 in Chaibou, 2007) have been done on family planning services and its challenges in Maradi State but they have been limited to adult women, married people in specific areas. However, none of theses studies has focused specifically on the entire state and none focused on both sexes. This study is meant to help assess the communication strategies of contraceptive and family planning services need for couples (young and old) in Maradi State and their difficulties in communicating with family planning providers or services. The outcome of the study will enablepeople to identify services need themwith respect to good family planning communication and services.

The study will also provide information on the level of awareness; utilization and difficulty that people may be having in accessing reproductive health services. It helps to assess the quality of communication strategies and information that people are having on contraceptives which often shape their attitude toward its use. The study helps to identify the need of Maradi people regarding their sexual health. The result of the study could also assist the Ministry of Public Health (MSP) and the Ministry of Population, Woman Promotion and Child Protection (MP/PF/PE) on how to structure policies and strategies on health programme for people. It will also help the Ministry of National Education (MEN) in developing an appropriate reproductive health/sex education curriculum for schools which cans by extension, reduce unwanted pregnancy among school children and in the long term, prevent Vesico-Vaginal Fistula (VVF).

1.7    Scope of the Study

This study was to be conducted in Maradi State of Niger Republic during three mounts (October, November and December 2012). It covered all the seven (7) local government areas including Maradi Metropolis. The target population of the survey was Women of Reproductive Age (WRAs) between 15-45 years old in Maradi State distributed into the seven areas, namely, Aguie, Dakoro, GuidanRoumji, Madarounfa, Maradi Metropolis, Mayahi and Tessaoua. The region is composed of seven Districts Health Centres (DHC), one regional hospital (based in Maradi Metropolis), 125 Integrated Health Centres (IHC) and 8 pharmacies (public and private). In addition, there are also many private clinics run by private physicians that provide family planning services in the region.

The target audiences in this study are individuals and groups at the state level, but it could also concern national or international level with whom the research is seeking to develop a synergy and to share information on family planning promotion. Thus, the local communities, state agents, funding agencies, or researchers are all involved. Because each target group has specific characteristics and is faced with different problems or situations, a specific communication strategy is needed for each.

1.8    Operational Definition of Terms

Assessments is the process of gathering and discussing information (on family planning) from multiple and diverse sources in order to develop a deep understanding of what people know, understand, and can do with their knowledge as a result of their educational experiences.

Communication strategy: In this study, communication strategies are the synchronization of communication actions, images and worlds to achieves a desired effect in promoting family planning in Maradi State Family planning: Family planning means planning when and how many children to have and how to prevent unwanted pregnancy. It also means working out a plan with partner on how to deal with procreation within the context of a sexual relationship. For the purpose of this work, we define family planning as “having children that are planned for and not children conceived by accident”.

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