Association of Mass Media Communication with Contraceptive Use in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Surveys

Abstract

Literature abounds with evidence on the effectiveness of individual mass media interventions on contraceptive use and other health behaviors. There have been, however, very few studies summarizing effect sizes of mass media health communication campaigns in sub-Saharan Africa. In this study, we used meta-analytic techniques to pool data from 47 demographic and health surveys conducted between 2005 and 2015 in 31 sub-Saharan African countries and estimate the prevalence of exposure to family planning-related mass media communication. We also estimated the average effect size of exposure to mass media communication after adjusting for endogeneity. We performed meta-regression to assess the moderating role of selected variables on effect size. On average, 44% of women in sub-Saharan Africa were exposed to family planning-related mass media interventions in the year preceding the survey. Overall, exposure was associated with an effect size equivalent to an odds ratio of 1.93. More recent surveys demonstrated smaller effect sizes than earlier ones, while the effects were larger in lower contraceptive prevalence settings than in higher prevalence ones. The findings have implications for designing communication programs, setting expectations about communication impact, and guiding decisions about sample size estimation for mass media evaluation studies.