Diffusion Processes and Fertility Transition Selected Perspectives (2001) / Chapter Skim
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7 Mass Media and Fertility Change
7 Mass Media and Fertility Change
Pages 208-239
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From page 208... ...
Excluding four oil-rich outlier countries, a regression equation fitting a linear and quadratic term shows that televisions per capita accounted for 74 percent of the variance in fertility in 1997. This is a substantially better prediction of fertility than one gets from measures of gross national product per capita (indicated by an index of purchasing power parity)
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From page 209... ...
However, although these associations are consistent with a claim of media effects on fertility, they are far from definitive. They are not definitive, of course, because causal inferences from cross-sectional bivariate correlations are always tentative.
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From page 210... ...
It will turn out that tests of this last area of effect, evaluations of family planning communication programs, are the most common on the ground, but we suspect that the middle three hypotheses may deserve the most attention. FIVE HYPOTHESES ABOUT MEDIA EFFECTS ON FERTILITY Economic and Time Competition Effects First, most hypotheses about media effects focus on their content, the effects of exposure to ideas in the media.
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From page 211... ...
There is good evidence that deliberate family planning efforts have accelerated the decline in fertility (Freedman, 1997~. There is also a fair consensus that other forms of public investment, in areas such as health care, female education, and social security, have important effects on fertility decisions.
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From page 212... ...
The authors also point to the consistently smaller family size on these soap operas than the current norms in Brazil, and how soap operas provided an early introduction to controversial ideas such as divorce, abortion, and premarital sex to a large Brazilian audience. News broadcasts may highlight reductions in child mortality, so that couples may take those reductions confidently into account when they decide how many children to bear.
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From page 213... ...
Mass Media Effects on Fertility Through Deliberate Information, Education, and Communication Programs Family planning programs in many countries have tried to use mass media-based programs to influence contraceptive decisions and behavior sometimes trying to increase awareness of the need for fertility control, sometimes providing information to increase utilization of available services, sometimes marketing specific products. Those programs may use a variety of approaches: didactic programs, advertising approaches, entertainment education approaches.
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From page 214... ...
The Issue of the Social Process Around Media Effects Media may be influential because of their direct effects on what people know and do, but they are also likely to be effective because they affect the social process around individual decision making. Media content may serve as a stimulus for discussion in which multiple individuals exposed to the same message develop a shared response; exposure to media content may create permission for open discussion of taboo topics in social networks; people considering adopting a new behavior inconsistent with the way things are done locally may gain from media exposure a sense of belonging to a broader social network; one individual exposed to media content may pass on what he or she learns to others inside his or her social network.
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From page 215... ...
The Issue of Active Audiences Versus Universal Effects (Strong Audiences Versus Strong Media) Since the beginnings of mass media research, a consistent controversy has been the extent to which effects are universal, widely shared among audience members, or contrarily, highly conditional on characteristics of individual audience members and their social networks.
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From page 216... ...
The established diffusion literature stresses a claim that media effects are largely on awareness, on getting people to think about a new behavior. In contrast, that literature is skeptical about whether media have much influence on decisions to adopt behaviors (Rogers, 1995)
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From page 217... ...
That hypothesis expects direct learning effects, but also credits media with effects because they initiate person-to-person discussion and diffusion, which produce change, and because they crystallize latent demand telling people how to act to realize what it is they have chosen to do. The Issues of the Nature of the Relationships Between Media Exposure and Fertility Outcomes This issue of what media can affect also relates to two final issues the time lag for effects and the shape of the relationship.
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From page 218... ...
Any assessment of the effects of mass media needs to ask whether the evidence used as the basis for inference is consistent with hypothesized expectations for how each of these operate. Thus far we have laid out the various paths through which mass media might influence fertility, and pointed to a series of conceptual controversies in mass media research that bear on the search for evidence.
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From page 219... ...
Nonetheless, there are rival hypotheses to the idea that these associations establish that media indeed have the hypothesized effects: one is that television ownership is a very good measure of average economic position of people in a country, and correlates with fertility because it is a measure of income. It may correlate better than do measures of wealth, such as purchasing power parity per capita, because it is a better measure of average income than that measure which is distorted as a measure of average income by income inequities.
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From page 220... ...
Nonetheless these data are also consistent with a media effects hypothesis. An additional analysis enhances their argument.
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From page 221... ...
that was independent of but correlated with their media use. It is customary and legitimate to express wariness about making causal inferences from correlational data of this sort, even with the extra longitudinal information from the Moroccan data.
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From page 222... ...
and Population Services International (PSI) as well as particular national programs, have created sophisticated contraceptive social marketing programs.
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From page 223... ...
Both evaluations involve interrupted time series and estimate changes in the number of adopters visiting family planning clinics. The Colombia results describe the reversal of a twoyear decline in clinic adopters during the first nine months of a radio campaign, with effects fading during the final months.
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From page 224... ...
The Johns Hopkins program has been the major channel through which the USAID has provided support to countries that wish to include IEC in their population programs. Johns Hopkins has been a major advocate for an approach often called Entertainment-Education, which is a broad title for a number of distinct programs that incorporate population messages in entertainment formats, including the use of music videos, serial dramas, feature films, and advertising spots.
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From page 225... ...
Another published evaluation of a serial drama campaign was undertaken in Zambia, but was not, in fact, a family planning campaign. Rather it was an AIDS campaign, but with an ultimate objective of affecting rates of condom use.
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From page 226... ...
. If we focus on behavioral outcomes relevant to family planning, there is a significant association between ward-level exposure and change in women's "always or sometimes use of family planning." The authors also report evidence from time series data of new adopters at 34 family planning clinics divided between the treatment and comparison areas.
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From page 227... ...
In their useful analyses of African DHS, Westoff and his colleagues establish a substantial association between self-reports of exposure to family planning messages on the mass media and reproductive beliefs, attitudes, and behaviors. TABLE 7-2 Summary of Mass Media Intervention Projects Country/Project Colombia Iran/Isfahan Peru Guatemala Brazil Nigeria Zimbabwe The Gambia Zambia Tanzania Yes Effect on Effect on Population Clinic Demand Behavior Comments Yes Yes No Yes Yes Yes Mali Nepal Yes Fading after project end Fading after project end No No?
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From page 228... ...
also use the DHS data already described above to show that self-reports of exposure to family planning messages on radio were positively associated with several outcomes in the five countries for which data were available about such exposure. These include significant associations with knowledge of modern methods and intention to use a method in all five countries studied and with current use of any fertility control method in three out of five countries studied.
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From page 229... ...
The link between reception and outcome is critical and one that Freedman (1997) has recently highlighted for understanding changes in fertility preferences due to family planning programs.
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From page 230... ...
It is often random and even chaotic. The media, especially radio and increasingly television for developing countries, carry many messages in their programs, but in many countries the serial narratives making up the prime listening and viewing hours deal consistently with family matters that legitimate or at least open for debate problems facing their societies regarding women and their roles, families, premarital sex, and other modernizing pressures.
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From page 231... ...
increases in demand for clinic services. The evidence that falls between the two types, reporting on the association of exposure to family planning messages but not tied to a specific program, is more optimistic.
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From page 232... ...
These have included the Stanford Heart Disease Prevention Program, the Minnesota Heart Health Program, and the Community Intervention Trial for Smoking Cessation (COMMIT) trial (Farquhar et al., 1990; COMMIT, 1995; Luepker et al., 1994~.
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From page 233... ...
That is the way that programs that are considered strong family planning programs operate. Elsewhere one of us has speculated about the way that someone might initiate new practices related to high blood pressure: How might the NHBPEP have worked?
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From page 234... ...
If the question at issue here is how media affect fertility in the broadest sense, although these projects get the lion's share of research, they may represent only quite a small share of the influence. They examine a small proportion of all the media content developed to affect fertility because for most programs media effects cannot be isolated from other program effects.
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From page 235... ...
But there is a third type of possible effect: the effects of continuing messages delivered through the IEC efforts of general profamily planning programs. The explicit evidence relevant to these programs is that self-reported attention to media family planning messages, not in the context of a discrete intervention, is related to fertility-related behavior in the African sites studied by Westoff and Bankole.
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From page 236... ...
Freedman, R 1997 Do family planning programs affect fertility preferences?
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From page 237... ...
Baron 1998 The impact of a family planning multimedia campaign in Bamako, Mali. Studies in Family Planning 29~3~:309-323.
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From page 238... ...
Sood 1999 Effects of an entertainment-education radio soap opera on family planning behavior in Tanzania. Studies In Family Planning 30~3~:193-211.
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From page 239... ...
Rodriguez 1995 The mass media and family planning in Kenya. International Family Planning Perspectives 21:1, 26-31, 36.
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