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Last Published December 22, 2015 01:31 PM April 18, 2016 08:43 AM
Primary Outcomes (End Points) Primary outcomes: Total contraceptive prevalence rate (including modern methods and effective traditional methods such as withdrawal. To understand mechanisms we will also analyze impact separately by modern and effective traditional methods) Secondary outcomes include: A. attitudes towards contraception 1. Percentage of women intending to use contraception in the future 2. Percentage of women sexually active but who do not want to become pregnant 3. Percentage of women seeking family planning advice 4. Percentage of women discussing family planning with their partners 5. Index of attitudes towards contraception, appropriate age of marriage, and age of first birth 6. Index of partners perceptions of family planning (as described by women) B. Impact of use of contraception (these are important impact questions but we will have limited power to test for them so do not expect to find significant impacts). 7. Average time lapse between pregnancies 8. Number of unwanted pregnancies 9. (if accurate population level data on total births in communities become available) number of births per 1,000 women of reproductive age C. Knowledge about modern contraception 10. Percentage of women who know the price, source, advantages, and disadvantages of different contraceptive methods D. Potential knock on effects (third level of priority) 10. Attitudes and perceptions related to gender norms 12. Women's subjective health and well being (potential negative effects, as women might have to lie to their husbands when using contraception, which generates a sense of mistrust and tension) 13. Domestic violence and sexual harassment (potential negative effects, as violence might increase in the cases where women choose to use contraception when the husband doesn't approve it) Primary outcomes: 1. Contraceptive prevalence rate (including modern methods and effective traditional methods such as withdrawal. To understand mechanisms we will also analyze impact separately by modern and effective traditional methods) Secondary outcomes include: A. Usage of contraception and family planning 2. Percentage of women intending to use contraception in the future 3. Percentage of women seeking family planning advice 4. Percentage of women discussing family planning with their partners and others 5. Percentage of women who are fecund and sexually active who do not want to become pregnant but are not currently using contraception B. Impact of use of contraception (these are important impact questions but we will have limited power to test for them so do not expect to find significant impacts). 6. Average time lapse between pregnancies 7. Number of unwanted pregnancies 8. Number of births per 1,000 women of reproductive age (if accurate population level data on total births in communities become available) 9. Number of family planning products delivered throughout the study period (from administrative data, if available) C. Knowledge, attitudes, and perception of about contraception and family planning 10. Mean effects on survey questions relating to knowledge of contraceptive methods 11. Mean effects on survey questions relating to attitudes towards contraception 12. Mean effects on survey questions relating to knowledge of family planning 13. Mean effects on survey questions relating to attitudes towards family planning 14. Mean effects on survey questions relating to women’s perceptions of fertility and birth spacing 15. Mean effects on survey questions relating to partners’ perceptions of fertility and birth spacing (as reported by women) D. Potential knock on effects (third level of priority) 16. Mean effects on survey questions relating to perceptions on gender norms 17. Mean effects on survey questions relating to behavior reflecting women empowerment 18. Mean effects on survey questions relating to women's subjective health and well-being 19. Mean effects on survey questions relating to domestic violence and sexual harassment
Primary Outcomes (Explanation) -Measure of attitudes and perceptions related to family planning: a construct of different variables, including whether women think it is acceptable to talk about family planning in public (radio, TV, schools..); women's opinion on the ideal age of marriage, ideal gap between pregnancies, and ideal number of children to have. -Measure of attitudes and perceptions related to contraception: Whether women think it's embarrassing to buy or to get a contraceptive; whether women think it's embarrassing to buy or to get a contraceptive in front of other women from the village; whether women believe that some modern contraceptive methods could cause infertility or sickness; and whether it is justified for a woman to use contraceptive methods without her husband's knowledge. -Measure of attitudes and perceptions related to gender norms: how much women agree with certain statements regarding superiority of men, education for boys vs. girls, access to resources for men vs. women. 10. Mean effects on survey questions relating to knowledge of contraceptive methods • Variables include: knowledge of the existence, price, source, advantages, and disadvantages of different methods, including rejection of misconceptions such as contraception causing sterility or sickness 11. Mean effects on survey questions relating to attitudes towards contraception • Percentage of women who think that it is embarrassing to buy a contraceptive method • Percentage of women who think that using contraceptive methods is a sign of not trusting their partner 12. Mean effects on survey questions relating to knowledge of family planning • Percentage of women who know benefits of spacing births • Percentage of women who know benefits of delaying the age of marriage for young girls 13. Mean effects on survey questions relating to attitudes towards family planning • Percentage of women who think it is acceptable to talk about family planning in public (radio, schools, posters, etc.) • Percentage of women who think that a woman should be able to control the number of children she has during her lifetime 14. Mean effects on survey questions relating to women’s perceptions of fertility and birth spacing • Women’s perception on the ideal age at first birth (in standard deviation units from the control group) • Women’s perception on the ideal time lapse between first and second birth (in standard deviation units from the control group) • Women’s perception on the ideal number of children in total (in standard deviation units from the control group) 15. Mean effects on survey questions relating to partners’ perceptions of fertility and birth spacing (as reported by women) • Partners’ perception on the ideal time lapse between first and second birth (in standard deviation units from the control group) • Partners’ perception on the ideal number of children in total (in standard deviation units from the control group) 16. Mean effects on survey questions relating to perceptions on gender norms • Percentage of women who think that it is better to be a man than a woman • Percentage of women who think that boys should have better access to resources in education • Percentage of women who think that men must be more educated than their wives • Percentage of women who think that men should have better access to consumption of meat and imported products 17. Mean effects on survey questions relating to behavior reflecting women empowerment • Percentage of women working or participating in a productive activity • Percentage of women participating in decision-making when it comes to different household expenditures 18. Mean effects on survey questions relating to women's subjective health and well-being • Percentage of women satisfied with their lives • Percentage of women considering themselves healthy compared to other women in the village • Percentage of women considering themselves happy compared to other women in the village 19. Mean effects on survey questions relating to domestic violence and sexual harassment • Percentage of women whose husbands / husbands’ families get jealous when they walk to other men • Percentage of women whose husbands / husbands’ families don’t allow them to see their female friends • Percentage of women whose husbands / husbands’ families insist on knowing where they are in the village at any time of the day • Percentage of women whose husbands / husbands’ families ever threatened to harm them or their families • Percentage of women whose husbands / husbands’ families ever destroyed their personal objects • Percentage of women whose husbands / husbands’ families ever physically hurt them
Experimental Design (Public) The intervention will take place in 16 local radios available for the study, 8 of which will be randomly assigned to treatment. This number is limited by the number of radio stations that can be sampled without overlap in the broadcasting reach to allow for separation of treatment and control groups. These radio stations will also broadcast messages in local languages corresponding to the rural zones targeted. The possibility of leakages between treatment and control groups is therefore unlikely, as people living in rural areas speak different languages. Although the messages diffused will address both men and women to influence cognitive barriers to usage of contraception among couples, our study will only survey women at the age of reproduction (15-49 years old). We will survey an average of 20 villages per radio station cluster, and 25 women per village. -We will conduct a baseline survey to capture baseline levels of mCPR and other population characteristics. We will use these to stratify our sample prior to randomization. -We will be monitoring supply of contraceptive methods throughout the intervention in an attempt to disentangle demand and supply factors in changing the level of contraceptive uptake. The intervention will take place in 16 local radios available for the study, 8 of which will be randomly assigned to treatment. This number is limited by the number of radio stations that can be sampled without overlap in the broadcasting reach to allow for separation of treatment and control groups. These radio stations will also broadcast messages in local languages corresponding to the rural zones targeted. The possibility of leakages between treatment and control groups is therefore unlikely, as people living in rural areas speak different languages. Although the messages diffused will address both men and women to influence cognitive barriers to usage of contraception among couples, our study will only survey women at the age of reproduction (15-49 years old). Our total sample size will be around 8000 across more than 250 villages across in 16 radio station clusters. Women selection will be stratified on education and access to radio, while village selection will be stratified by average distance to a clinic. -We will conduct a baseline survey to capture baseline levels of mCPR and other population characteristics. We will use these to stratify our sample prior to randomization. -We will be monitoring supply of contraceptive methods throughout the intervention in an attempt to disentangle demand and supply factors in changing the level of contraceptive uptake.
Randomization Method In office by a computer following random assignment after stratification. We will be stratifying our samples on the region, village, and individual levels to guarantee a balance between treatment and control groups along certain key characteristics (baseline level of mCPR, education, number of children, age, distance to clinics, marital status, religion...) Stratified randomization of villages and women selection is done in office by a computer.
Planned Number of Observations We will survey 20 villages per cluster, and 25 women per village. Out total sample size is approximately 8000 women. We will survey 252 villages across the 16 clusters. Out total sample size is approximately 8000 women.
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