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Title The power of womens and mens Social Networks to catalyse normative and behavioural change: evaluation of an intervention addressing Unmet need for Family Planning in Benin.
Full text https://escholarship.org/uc/item/4230b1hd; https://escholarship.org/content/qt4230b1hd/qt4230b1hd.pdf
Date 2022
Author(s) Kim, Theresa; Igras, Susan; Barker, Kathryn; Diakité, Mariam; Lundgren, Rebecka
Abstract BACKGROUND: In Benin, despite good knowledge and availability, modern contraceptive prevalence remains relatively low, and the unmet need for family planning is relatively high. This is partly due to insufficient attention to socio-normative barriers that influence need and method use. Applying social network theory, Tékponon Jikuagou (TJ) aims to reduce socio-normative barriers preventing modern contraceptive use in rural Benin. After community identification, TJ trains influential network actors who encourage critical dialogue about unmet need, family planning, gender, and other social norms within their networks, complemented by radio and services linkages. This paper evaluates TJs effectiveness and how intervention components affect intermediate and primary FP outcomes. METHODS: We report findings from pre/post-intervention cross-sectional research with a comparison group conducted at baseline with 1,043 women and 1,030 men, and 14 months later at endline with 1,046 women and 1,045 men. Using sex-stratified models, we assessed balance across intervention and comparison groups on background characteristics using Pearsons chi-square tests of independence; performed bivariate tests of independence to assess differences between baseline to endline on intermediate outcomes and primary FP outcomes; used logistic regression to examine the effect of intervention components on intermediate and primary FP outcomes. RESULTS: Statistically significant improvements in primary outcomes: womens intentions to use modern contraception, achieve met need, and reduce perceived met need. The fourth primary outcome, actual use, showed substantial gains, although not statistically significant. Mens achievement of met FP need and reduced perceived met need were also statistically significant. Assessing intermediate outcomes at individual, couple, normative-network levels, TJ led to statistically significant increases in couple and network communication on fertility desires and family planning use and self-efficacy and confidence to access services. Both women and men showed significant shifts in the acceptability of discussing FP in public. Results for other indicators of norms change were inconsistent. CONCLUSIONS: An easy-to-implement, short-duration, gender-equitable social network intervention with a limited set of network actors, TJ effectively decreases social and normative barriers preventing women and men from seeking and using FP services. Results support the broader use of innovative social and behaviour change strategies that diffuse family planning ideas through social networks, diminish normative and communication barriers, and catalyse modern family planning use.
Subject(s) Benin; Family planning; Gender norms; male reproductive health; Sexual and reproductive health and gender; Social determinants of reproductive health; Unmet need for family planning; West Africa; Benin; Contraception; Contraception Behavior; Contraceptive Agents; Cross-Sectional Studies; Family Planning Services; Female; Humans; Male; Social Networking
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source BMC Public Health, vol 22, iss 1
Rights public
Identifier qt4230b1hd; info:doi/10.1186/s12889-022-12681-4
Repository Berkeley - University of California
Added to C-A: 2024-09-16;09:29:48