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Publications
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The
Royal Family of Jordan appeared on the "Happy
Family" calendar. |
"Together for a Happy Family" ran from March 1998 to March 2000 and was the first-ever national multimedia campaign in Jordan to involve men in family planning. The goal of the campaign was to enlist men's support in making informed decisions with their wives toward using family planning. The Jordanian National Population Committee (NPC), with technical assistance from the Johns Hopkins Bloomberg School of Public Health Center for Communication Program's Population Communication Services project in Baltimore, designed a campaign around the following five messages:
Husband opposition, religious prohibition, and health concerns markedly limited the use of modern family planning methods in Jordan before 1996. Researchers from Jordan and Baltimore conducted the first national survey on family planning knowledge, attitudes, and practices (KAP) in 1996. The survey identified that lack of knowledge about the Islamic stance on the use of specific methods and limited knowledge about the safety, reversibility, and effectiveness of modern methods were two major barriers. It also revealed that large families and a preference for male children were social norms that influenced men's opposition to family planning use.
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Triad
teams of religious leaders, physicians, and social workers
worked with community leaders.
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Results of the KAP survey guided message development and activities of the campaign. The project staff developed and pretested the logo (front page left) and the slogan "Together for a Happy Family," and used them to brand al campaign activities and materials.
Support from the royal family and religious and political leaders, enlisted before the inception of the campaign and throughout its implementation, helped create an environment conducive to behavior change. To show his support for the campaign, His Majesty King Abdullah agreed to have a photo of the royal family on the cover of the NPC's family planning calendar, which communicated the campaign's messages through its nationwide distribution. Under the auspices of Her Royal Highness Princess Basma, who endorsed and spearheaded the campaign, the Prime Minister and cabinet ministers appeared at major public events.
Jordanian religious leaders participated in observational tours and family planning training in Egypt to explore the proactive role they could play in the campaign. Islamic scholars wrote booklets informing readers that using family planning is consistent with the teachings of Islam. Religious leaders, the general public, mosque libraries, and Islamic centers were recipients of these booklets.
In an integrated approach, three main channels - the mass media, community mobilization, and a national contest - disseminated the campaign messages. Five TV and five radio spots aired during prime time and featured religious leaders espousing support for "Together for a Happy Family." Religious leaders discussed campaign themes during family programs on Jordanian TV and radio, responded to questions from the audience, and wrote newspaper articles in support of the campaign.
To mobilize local communities, project staff trained 40 "Triad Teams." A physician, religious leader, and social worker used a video, discussion guide, and brochures to conduct discussion sessions about campaign themes with community leaders. The community leaders further disseminated the campaign themes by discussing them with family, friends, and community members.
Through the four major daily Jordanian newspapers, the campaign launched a National Family Planning Contest, which emphasized the campaign messages. Grand prize offers spurred information seeking and dialogue within and among families to answer the multiple-choice quiz.
The NPC; the Ministries of Health, Social Development, and Islamic Affairs; Jordan Radio and TV; the Jordanian Association for Family Planning and Protection; and other non-governmental and private sector organizations closely cooperated on the campaign. Liaison officers represented their organizations in the campaign's steering committee, which met regularly. The officers actively participated in the campaign design workshop, collectively produced the campaign design document, and provided sustained monitoring, follow-up, and reporting on different activities.
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Jordanian
NPC logo.
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Project researchers along with staff from the Jordanian Department of Statistics compared the 1996 KAP survey to the 2001 Men's Involvement in Reproductive Health Survey (MIRHS) following the campaign. The comparison of these two surveys demonstrated that "Together for a Happy Family" markedly improved the knowledge and attitudes of Jordanian men and women regarding specific modern family planning methods. Indeed, in 2001 significantly higher proportions of men regarded modern family planning methods as safe, effective (Figure 1), and permitted by Islam (Figure 2). Accordingly, the proportions of those who cited the use of specific modern methods as forbidden by Islam and those who did not know the religious stance of specific methods decreased from 1996 to 2001.
The proportion among men who used a family planning method and discussed it with their wives significantly increased from 93 percent to 98 percent (p < .05) between 1996 and 2001. Among women, however, the difference was not significant. In 2001, the majority of men and women reported that they decided together on the number of children to have compared to about one-third of those who decided together in 1996. Similarly, nearly 80 percent of MIRHS respondents said avoiding unwanted pregnancies is a shared responsibility of both husbands and wives.
MIRHS respondents received a list of topics from which they ranked
issues discussed and actions taken as a result of exposure to the
campaign. Respondents ranked discussing issues with spouses and
sharing decision-making as the top actions taken, and included
treating sons and daughters equitably and starting to use a family
planning method as other actions taken.
Although the campaign did not directly promote smaller family size, it did promote the use of family planning to improve the quality of life for families. Results of comparing the data from the KAP and MIRHS show that the ideal family size declined from 4.3 in 1996 to 3.8 in 2001.
A positive response accompanied each message delivered in "Together for a Happy Family." The findings described above demonstrate that, even in a country with strong tradi-tional religious beliefs, a well-coordinated large-scale health communication campaign supported by political and religious leaders can increase knowledge, acceptance, and use of modern family planning methods.
To learn more about "Together for a Happy Family" contact:
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Alfred Yassa, MD, MPH |
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© 2005 The Johns Hopkins University. All rights reserved.
