Impact of family planning messages on modern contraceptive use: an observational study of women of reproductive age in Zambia 2007–2018
4 affiliations
- 1Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
- 2University of KwaZulu-Natal, Durban, South Africa
- 3Department of Economics, University of Zambia, Lusaka, Zambia
- 4Department of Women and Children’s Health, Karolinska Institutet, Stockholm, Sweden
Abstract
Introduction: Reducing unintended pregnancies in low-income and middle-income countries requires enhancing the use of modern contraceptives. Country level evidence on the role of the media and counselling in this process is scanty. The aim of the study is to estimate the impact of family planning messages received through mass media and counselling by health workers on modern contraceptive use among women of reproductive age in Zambia over the study period of 2007 to 2018.
Methods: We analysed three rounds of Zambia Demographic and Health Survey data (2007, 2013/14, 2018). We used different modelling approaches, including logistic regressions, probability weighting and propensity score matching to determine the average treatment effects (ATE) of media messages and counselling by health workers. ATE were also estimated by year. Post-estimation and robustness checks were conducted using overlap plots and bootstrapping.
Findings: Across all surveys, a total of 19 958 women of reproductive age (15–49 years) were identified for inclusion in the study. The magnitude of impact of family planning messages varied by mode of delivery of the messages. Receiving family planning messages through a combination of health worker counselling and mass media had the most significant positive impact on contraceptive use (ATE 17.06%) followed by counselling (ATE 14.55%) and mass media messages only (ATE 3.37%). The impact of the different modes of delivery of family planning varied by year, showing a decreasing trend.
Conclusion: The mode of delivery influences the impact of family planning messages on modern contraceptive use among women. Family planning counselling and combined approaches outperform mass media messages only. A declining impact over time raises concerns and highlights the need for further investigation into delivery effectiveness.
Related
- Association between interspousal communication on family planning and contraceptive use: a cross-sectional study in Temeke municipality, Tanzania.
- Predictors of modern contraceptive use among reproductive-aged women (15-49 years) in Mozambique: Evidence from Mozambique Demographic and Health Survey.
- Predicting Contraceptive Discontinuation in Nigeria: A Machine Learning Analysis of Family-Planning Method Adherence Using NDHS 2023-24 Calendar Data
- Impact of contraceptive initiation on the cervicovaginal mucosa: results from the UMPALA multicentre, partially randomized patient-preference interventional trial
- High prevalence of adverse drug reactions among oral contraceptive pill users in Western India: a prospective observational study
BibTeX
@article{kazibwe2026impact,
title = {{Impact of family planning messages on modern contraceptive use: an observational study of women of reproductive age in Zambia 2007–2018}},
author = {Joseph Kazibwe and Jesper Sundewall and Felix Masiye and Mia Kolak and Marie Klingberg-Allvin and Bjorn Ekman},
journal = {BMJ Global Health},
year = {2026},
month = oct,
doi = {10.1136/bmjgh-2026-024080},
url = {https://doi.org/10.1136/bmjgh-2026-024080},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of family planning messages on modern contraceptive use: an observational study of women of reproductive age in Zambia 2007–2018
AU - Joseph Kazibwe
AU - Jesper Sundewall
AU - Felix Masiye
AU - Mia Kolak
AU - Marie Klingberg-Allvin
AU - Bjorn Ekman
PY - 2026
DA - 2026/10/30
JO - BMJ Global Health
DO - 10.1136/bmjgh-2026-024080
UR - https://doi.org/10.1136/bmjgh-2026-024080
AB - Introduction: Reducing unintended pregnancies in low-income and middle-income countries requires enhancing the use of modern contraceptives. Country level evidence on the role of the media and counselling in this process is scanty. The aim of the study is to estimate the impact of family planning messages received through mass media and counselling by health workers on modern contraceptive use among women of reproductive age in Zambia over the study period of 2007 to 2018. Methods: We analysed three rounds of Zambia Demographic and Health Survey data (2007, 2013/14, 2018). We used different modelling approaches, including logistic regressions, probability weighting and propensity score matching to determine the average treatment effects (ATE) of media messages and counselling by health workers. ATE were also estimated by year. Post-estimation and robustness checks were conducted using overlap plots and bootstrapping. Findings: Across all surveys, a total of 19 958 women of reproductive age (15–49 years) were identified for inclusion in the study. The magnitude of impact of family planning messages varied by mode of delivery of the messages. Receiving family planning messages through a combination of health worker counselling and mass media had the most significant positive impact on contraceptive use (ATE 17.06%) followed by counselling (ATE 14.55%) and mass media messages only (ATE 3.37%). The impact of the different modes of delivery of family planning varied by year, showing a decreasing trend. Conclusion: The mode of delivery influences the impact of family planning messages on modern contraceptive use among women. Family planning counselling and combined approaches outperform mass media messages only. A declining impact over time raises concerns and highlights the need for further investigation into delivery effectiveness.
SN - 2059-7908
ER -