Development of behavioural change communication strategies to promote the use of intrauterine contraceptive device in Addis Ababa, Ethiopia
Tewodros Alemayehu Abebe
Intrauterine contraceptive devices (IUCDs) are one of the long-acting contraceptive methods
that provide protection from pregnancy for duration up to 12 years. IUCD is the most efficient,
cost-effective, and extensively used contraceptive technique in the world, yet it is rarely
utilized in Ethiopia.
The purpose of this study was to develop social and behavioural change communication
strategies (SBCC) to improve the utilization of IUCD in Addis Ababa, Ethiopia, through
understanding intention and its determinants.
The research was conducted in Addis Ababa among users of family planning methods in
health facilities using complex mixed research approaches. Reasoned Action Approach was
used as the study’s theoretical framework and the research was completed in three
consequetive phases. In the first phase, qualitative data from users of a short and long-acting
method of family planning was obtained, and the findings were utilized to help construct a
questionnaire that was employed in the second phase of the study. Correlational quantitative
cross-sectional approach was used in the second phase to collect data from representative
samples of users of short-acting contraceptive methods in health facilities. Using the findings
from the second phase, the SBCC model and communication strategy for IUCD promotion
in Addis Ababa was developed in the third phase.
Only 8.4% of short-acting contraceptive have intention to use IUCD in the coming year.
Unfavourable attitudes and a negative perceived social norm on the use of IUCD were the
main drivers of poor intention. The specific underlying beliefs responsible for the observed
low intention and its direct determinants were presence of fear and shyness related to the
procedure of IUCD insertion, believing that IUCD is not allowed for them, perception that
IUCD causes infertility, need for approval from husband, preference to do as their close
friends and neighbours, and preference to hear experience from other IUCD users.
SBCC model and communication strategy were designed to address the identified
underlying beliefs, to result in a positive attitude, supporting social norm, and enhanced
intention toward the usage of IUCD, which will ultimately improve uitiliztion of IUCD and
family planning method mix in Addis Ababa.
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