Changes in Ideational Profiles of Women of Reproductive Age in Urban Nigeria: The Role of Health Communication

Abstract

Reproductive health indicators in Nigeria remain among the poorest in the world. Modern contraceptive prevalence rate has remained practically at the same level since 2003. Whereas contraceptive use is higher in urban compared with rural areas, the majority of urban women are not using a modern contraceptive method. Low contraceptive use in the country results from unfavorable ideational variables, including knowledge, values, beliefs, and norms. Ideational segmentation allows program planners to identify groups that are homogenous with respect to ideational variables and which have similar informational and skills strengthening needs. In this study, we conducted latent class analyses with longitudinal data collected from a sample of women in 2010/2011 and 2014 to identify distinct ideational segments among women of reproductive age in six Nigerian cities at the two points in time. The analysis revealed three ideational segments at baseline: (a) Inefficacious, misinformed and unsupported, labeled “Disempowered,” 58.8%; (b) Efficacious, misinformed, and unsupported, labeled “Unsupported,” 31.8%; and (c) efficacious, supported but misinformed, labeled “Skeptics, 9.4%. These groups differ in terms of sociodemographic characteristics and contraceptive use and intention to use. At endline, four ideational segments were identified: (a) Inefficacious, misinformed and unsupported, labeled “Disempowered,” 28.9%; (b) Efficacious, supported but misinformed, labeled “Skeptics,” 28.5%; (c) Efficacious, informed but unsupported, labeled “Unsupported,” 27.0%; and (d) efficacious, informed and supported, labeled “Empowered,” 15.6%. Exposure to Nigerian Urban Reproductive Health Initiative communication interventions was one of the most significant predictors of improvements in ideational characteristics over time. Messages tailored to the informational needs of the various ideational segments and that address their worldview are needed to increase contraceptive use.

Keywords

contraceptive use ideation Nigeria segmentation urban

Get full access to this article

View all access options for this article.

References

Adebayo

S. B.

Gayawan

Ujuju

Ankomah

(2013). Modelling geographical variations and determinants of use of modern family planning methods among women of reproductive age in Nigeria. Journal of Biosocial Science, 45, 57-77.

Agha

Van Rossem

(2002). Impact of mass media campaigns on intentions to use the female condom in Tanzania. International Family Planning Perspectives, 28, 151-158.

Asekun-Olarinmoye

Adebimpe

Bamidele

Odu

Asekun-Olarinmoye

Ojofeitimi

(2013). Barriers to use of modern contraceptives among women in an inner city area of Osogbo metropolis, Osun state, Nigeria. International Journal of Women’s Health, 5, 647.

Babalola

John

Ajao

Speizer

(2015). Ideation and intention to use contraceptives in Kenya and Nigeria. Demographic Research, 33, 211-238.

Babalola

Kincaid

D. L.

(2009). New methods for estimating the impact of health communication programs. Communication Methods and Measures, 3, 61-83.

Babalola

Vonrasek

(2005). Communication, ideation and contraceptive use in Burkina Faso: An application of the propensity score matching method. Journal of Family Planning and Reproductive Health Care, 31, 207-212.

Bandura

(1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.

Bongaarts

Casterline

(2013). Fertility transition: Is sub-Saharan Africa different? Population and Development Review, 38(s1), 153-168.

Bongaarts

Cleland

Townsend

J. W.

Bertrand

J. T.

Gupta

M. D.

(2012). Family planning programs for the 21st century. New York, NY: Population Council.

10.

Bongaarts

Watkins

S. C.

(1996). Social interactions and contemporary fertility transitions. Population and Development Review, 22, 639-682.

11.

Cleland

J. G.

(1985). Marital fertility decline in developing countries: Theories and the evidence. In Cleland

Hobcraft

(Eds.), Reproductive change in developing countries: Insights from the World Fertility Survey (pp. 223-252). Oxford, England: Oxford University Press.

12.

Cleland

J. G.

Ndugwa

R. P.

Zulu

E. M.

(2011). Family planning in sub-Saharan Africa: Progress or stagnation? Bulletin of the World Health Organization, 89, 137-143.

13.

Cleland

J. G.

Wilson

(1987). Demand theories of the fertility transition: An iconoclastic view. Population Studies, 41, 5-30.

14.

Dervin

Foreman-Wernet

(2013). Sense-making methodology as an approach to understanding and designing for campaign audiences: A turn to communicating effectively. In Rice

R. E.

Atkin

C. K.

(Eds.), Public communication campaigns (4th ed., pp. 147-162). Thousand Oaks, CA: Sage.

15.

Ejembi

C. L.

Dahiru

Aliyu

A. A.

(2015). Contextual factors influencing modern contraceptive use in Nigeria. Rockville, MD: ICF International.

16.

Hine

D. W.

Reser

J. P.

Morrison

Phillips

W. J.

Nunn

Cooksey

(2014). Audience segmentation and climate change communication: Conceptual and methodological considerations. Wiley Interdisciplinary Reviews: Climate Change, 5, 441-459.

17.

Hutchinson

P. L.

Meekers

(2012). Estimating causal effects from family planning health communication campaigns using panel data: The “your health, your wealth” campaign in Egypt. PLoS One, 7, e46138. doi:10.1371/journal.pone.0046138

18.

Kannan

V. D.

Veazie

P. J.

(2015). Who avoids going to the doctor and why? Audience segmentation analysis for application of message development. Health Communication, 30, 635-645.

19.

Kincaid

D. L.

(2000a). Mass media, ideation, and behavior: A longitudinal analysis of contraceptive change in the Philippines. Communication Research, 27, 723-763.

20.

Kincaid

D. L.

(2000b). Social networks, ideation, and contraceptive behavior in Bangladesh: A longitudinal analysis. Social Science & Medicine, 50, 215-231.

21.

Kirk

(1996). Demographic transition theory. Population Studies, 50, 361-387.

22.

Krenn

Cobb

Babalola

Odeku

Kusemiju

(2014). Using behavior change communication to lead a comprehensive family planning program: The Nigerian Urban Reproductive Health Initiative. Global Health: Science and Practice, 2, 427-443.

23.

Lesthaeghe

(1983). A century of demographic and cultural change in Western Europe: An exploration of underlying dimensions. Population and Development Review, 9, 411-435.

24.

Lesthaeghe

(2010). The unfolding story of the second demographic transition. Population and Development Review, 36, 211-251.

25.

Lesthaeghe

Neels

(2002). From the first to the second demographic transition: An interpretation of the spatial continuity of demographic innovation in France, Belgium and Switzerland. European Journal of Population/Revue Européenne de Démographie, 18, 325-360.

26.

Lesthaeghe

Surkyn

(1988). Cultural dynamics and economic theories of fertility change. Population and Development Review, 14, 1-45.

27.

Mendell

N. R.

Rubin

D. B.

(2001). Testing the number of components in a normal mixture. Biometrika, 88, 767-778.

28.

Loganathan

Kreuter

(2014). Audience segmentation: Identifying key stakeholders for mental health literacy interventions in India. Journal of Public Mental Health, 13, 159-170.

29.

Madanat

Arredondo

Ayala

(2015). Introduction to health promotion & behavioral science in public health. Boston, MA: Cengage Learning.

30.

Maibach

E. W.

Maxfield

Ladin

Slater

(1996). Translating health psychology into effective health communication the American health styles audience segmentation project. Journal of Health Psychology, 1, 261-277.

31.

Muthen

(2012). Mplus: Statistical analysis with latent variables (Version 7). Los Angeles, CA: Muthén & Muthén.

32.

National Population Commission & ICF International. (2014). Nigeria Demographic and Health Survey 2013. Abuja, Nigeria/Rockville, MD: Authors.

33.

Okigbo

C. C.

Speizer

I. S.

Corroon

Gueye

(2015). Exposure to family planning messages and modern contraceptive use among men in urban Kenya, Nigeria, and Senegal: A cross-sectional study. Reproductive Health, 12(1), Article no. 63.

34.

OlaOlorun

F. M.

Hindin

M. J.

(2014). Having a say matters: Influence of decision-making power on contraceptive use among Nigerian women ages 35–49 years. PloS One, 9(6), e98702.

35.

Slater

M. D.

(1996). Theory and method in health audience segmentation. Journal of Health Communication, 1, 267-284.

36.

Smith

R. A.

Findeis

J. L.

(2013). Exploring audience segmentation: Investigating adopter categories to diffuse an innovation to prevent famine in rural Mozambique. Journal of Health Communication, 18, 6-19.

37.

Storey

Boulay

Karki

Heckert

Karmacha

D. M.

(1999). Impact of the integrated radio communication project in Nepa, 1994-1997l. Journal of Health Communication, 4, 271-294.

38.

Strickland

J. R.

Smock

Casey

Poor

Kreuter

Evanoff

B. A.

(2015). Development of targeted messages to promote smoking cessation among construction trade workers. Health Education Research, 30, 107-120.

39.

Van de Kaa

D. J.

(1996). Anchored narratives: The story and findings of half a century of research into the determinants of fertility. Population Studies, 50, 389-432.

40.

Van de Kaa

D. J.

(2002). The idea of a second demographic transition in industrialized countries. Birth, 35, 45.

41.

Williams

Ibisomi

Sartorius

Kahn

Collinson

Tollman

Garenne

(2013). Convergence in fertility of South Africans and Mozambicans in rural South Africa, 1993–2009. Global Health Action, 6(1), Article no. 19236.