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The Global Population Issue and the Work of Population Media Center

Paper Presented to the Conference on Overpopulation At the Regional Council of Piedmonte in Italy
January 2005, Updated December 2006
By William N. Ryerson
President
Population Media Center
Web site: www.populationmedia.org

The Population Situation
The news media in recent years have been informing people in Europe and the United States that there is a birth dearth and a possibility of a coming decline in population numbers sometime in the next 50 to 300 years.  On November 23, 1997, the New York Times Magazine proclaimed: "The Population Explosion Is Over.”  The Wall Street Journal echoed this sentiment in a January 24, 2003 editorial, “Global Baby Bust,” citing more recent U.N. projections.  On August 29, 2004, the New York Times ran an editorial entitled, “Subtract Billions: Demographic ‘Bomb’ May Only Go ‘Pop!’”  Newsweek followed suit September 27th, 2004 with “Birth Dearth; Remember the Population Bomb?”  On January 26, 2005, the Times of India went so far as to declare, “Population No Longer a Worry in Poor Countries.”  On June 30, 2006, Science magazine published an article entitled, “The Baby Deficit,” with a second piece called, “The Bomb that Wasn’t.”  On July 9, 2006, the Philadelphia Inquirer ran an article headlined, “Birthrate Decline will be our Global Peril.”  Similar articles continue to appear.

These articles miss the bigger – and more immediate picture – of what is happening worldwide.  In the next half century, conservative demographic projections show the world’s population growing by 3 billion people – a 50% increase.  This is the immediate issue at hand and the most important problem for world attention.

Even though the current rate of global population growth at 1.2% is lower than the peak rate of about 2% that occurred in the 1970s, the world’s population is still growing by 80 million people each year.  That’s the equivalent of adding a new United States every four years.

Exactly what is the long-term carrying capacity of our planet is debatable, and is a moving target, as technology changes.  However, Professor David Pimentel of Cornell University has estimated the globe's long-term carrying capacity at 2 billion and the U.S. at 200 million.  If he is right, the world is in an "overshoot," which will be followed by a die-off as critical resources run out.  The National Academy of Sciences and the Royal Society of London have jointly issued a proclamation that we must stabilize population worldwide as soon as possible in order to avoid catastrophic environmental consequences.
 
The United States is third among countries in the total growth of its population every year, after India and China.  Despite near replacement level fertility, immigration is driving growth that could cause the U.S. population to grow to 1 billion by the end of this century.  U.S. population growth is a subject of great concern on two levels: global and domestic.  On the global level, growth in the number of U.S. residents, who consume and pollute at a rate roughly ten times the per capita rates in developing countries, leads to a greater environmental burden by the U.S. on the rest of the world.  Adding to the numbers of such mega-consumers is not in the world’s interest.

On a domestic level, U.S. population growth is leading to loss of open space, added air pollution, water depletion, increased dependence on foreign oil, and a lowering in the quality of life.  In 1973, the U.S. had to import 38% of its oil.  The figure now is 55%.  Because of population growth, the projection is that by 2025, the U.S. will be dependent on foreign oil for 78% of its supply needs.  The Census Department projects a 50% increase in U.S. population in the next 46 years, growing from 290 million now to 420 million in 2050.
 
The assertion that rapid rates of population growth somehow stimulate economic growth has been made by economists for a long time but achieved prominence during the Reagan Administration in the U.S.  As advocated by Julian Simon, Malcolm Forbes Jr. (in an editorial in Forbes magazine) and others, the contention is that rapid rates of population growth stimulate consumerism and that the added demand fuels economic growth.

The opposite may well be true.  As explained by Ansley Coale of Princeton University, there is a direct relationship between rapid rates of population growth and declining economic conditions in underdeveloped countries.  The economies of many developing countries, such as those in Africa and Latin America, are being crippled by the fact that a high percentage of personal and national income is spent on the immediate consumption needs of food, housing and clothing--because there are too many children dependent on each working adult--leaving little income at the personal or national level available to form investment capital.  Lack of investment capital depresses growth of productivity of industry and leads to high unemployment (which is exacerbated by rapid growth in the numbers seeking employment).  Lack of capital also contributes to a country's inability to invest in education, government, infrastructure, environmental needs and other areas that can contribute to the long-term productivity of the economy and living standards of the people.

In the 20th century, no nation has made much progress in the transition from "developing" to "developed" until it first brought its population growth under control.  For example, in Japan, Korea, Taiwan, Hong Kong, Singapore, the Bahamas and Barbados, rapid economic development, as measured in gross national product per capita, occurred only after each country had achieved a rate of natural increase of its population below 1.5% per year and an average number of children per woman of 2.3 or less.  Herman Daly, former Senior Economist at the World Bank, believes that similar criteria probably hold for other countries.  Simply put, if the assertions by Simon and Forbes were true, the slow growing countries of Europe and North America would have weak economies, while the economies of sub-Saharan Africa and the high-population-growth countries of Asia and Latin America would be robust.  China is a good modern-day example of how demographic change to low fertility rates has stimulated the manufacturing sector and enhanced economic growth.

The real measure of economic welfare is not gross national product or national income, but the median income on a per capita basis.  Stimulating gross national product by having more and more people buying fewer and fewer necessities does not enhance economic welfare.  It may be true that a few people profit from population growth, but the mass of the people do not.

Worldwide, according to a comprehensive report by American author Bruce Sundquist, developing nations now require about $1 trillion per year in new infrastructure development just to accommodate their population growth – a figure that is very far from being met and is effectively impossible for these countries to generate.  This explains why developed-world humanitarian aid and loans to developing nations of $56 billion per year have been ineffective in improving their infrastructure and why the infrastructure of the developing world is sagging under the demands of the equivalent of a new Los Angeles County in additional population numbers (9.5 million) every six weeks. 

The correlation between external debt of developing countries and population growth rate is strong.  Of the 41 countries designated as “heavily indebted poor countries” by the World Bank, 39 fall into the category of high-fertility nations, where women, on average, bear four or more children.  Similarly, the 48 countries identified by the U.N. as “least developed” are expected to triple their population by 2050.  As a whole, the developing world is struggling to make payments of $270 billion per year on its $2.5 trillion external debt – a debt that is increasing by another $1 trillion every decade.
 
Many articles about the so-called “birth-dearth” ignore the question of whether the world’s ecosystem can support 9 billion people.  Many people are not aware that world population growth continues at a rate of 80 million persons per year globally.  Nor do they perceive the impact of such growth on the global environment, including threats to ocean fisheries, wilderness areas, biodiversity, energy supplies, fresh water supplies, and forests, along with the poverty, ill health and human suffering that result from unplanned childbearing.  Population growth also has disastrous effects on soil erosion, increased flooding, overgrazing of grasslands, salination of soil through irrigation, exhaustion of underground aquifers (used for irrigation), destruction of coral reefs, siltation of dam backwaters, and species extinction.  In addition, many of the world’s fisheries face collapse – in large part, because the world’s fishing fleet has a fishing capacity twice that of the sustainable yield of the world’s wild fisheries, as Sundquist points out in his report.

The capital shortages caused by population growth make it increasingly difficult for developing countries to keep pace with the growing need for schools.  One of the main reasons for the intelligence community’s pessimistic forecast for the growth of terrorism in the Middle East is the region’s weak educational system – a capital cost associated with population growth.  This produces generations lacking in the technical and problem-solving skills required for economic growth.

On top of this, Sundquist notes, massive rural to urban migration in developing countries is making the situation in large urban centers increasingly desperate, with growing slums that lack basic sanitation and water.  In fact, it is likely that this migration will greatly increase in future years.  As agricultural systems become more capital-intensive, huge numbers of people in rural areas will become unemployed.  Given higher rates of population growth in rural areas, projections of rural to urban migration over the next 30 years are startling.  During that time, as many as four billion people may migrate from rural areas of developing countries either to join the one billion living in urban slums or emigrating to developed nations.  This is a formula for political, social and economic instability worldwide.

Data from demographic surveys worldwide make it clear that non-use of family planning is not primarily the result of lack of access to contraceptive services.  Rather, the leading reasons people cite for not using family planning are the desire for more children, fear of side effects from contraceptives, perceived or actual male opposition, religious opposition, and the belief that one does not have the moral right to determine the number or spacing of childrenThese cultural and informational issues can only be addressed through communication strategies, such as those of Population Media Center (PMC), that change societal norms. 

As Sundquist points out, the cost in human suffering that results from unplanned and excessive childbearing is staggering:

·        600,000 women and girls die worldwide every year from pregnancy and childbirth – a figure equal to U.S. deaths in World War I, World War II, the Korean War and Vietnam combined.  Most of these women are in their teens and early twenties, forced by their societies into bearing children at a young age and far too frequently.

·        140,000 women bleed to death each year during childbirth.  Tragically, many die within reach of medical facilities because their relatives refuse to allow them to be treated by male doctors.

·        75,000 women die each year trying to end their pregnancies.  The U.N. estimates that worldwide, 50,000 women and girls try to induce abortions on themselves each day (18.3 million per year).  Many of those who survive face life-long, disabling pain. 

·        Approximately 100,000 women die each year from infection, and another 40,000 women die from the agony of prolonged labor.  And those are only the fatalities.  UNICEF’s statistics show that for every woman who dies, 30 survive with gruesome injuries and disabilities.  That’s more than 17 million women per year. 

Add to that the exhausting burden of repeated pregnancies and births, and you have a global picture of suffering on the part of women that demands global response.

What is infuriating is that these deaths and tragic injuries are almost entirely preventable.  Yet, the developed world as a whole has failed to come close to meeting the commitments made at the Cairo Population Conference for population assistance.  The developing world is so capital-starved due to its high population growth rate that allocating some portion of government budgets to reproductive health care is often extremely difficult.  Both developed and developing countries would need to triple their contributions to come close to what they committed to in Cairo.  The lives of billions of developing-world people are being rendered increasingly desperate by being denied access to family planning information and services that they want and need.

A cost-benefit analysis of different strategies for addressing population growth carried out by Sundquist shows that by far the most cost-effective and humane strategy is to provide information, motivation and clinical family planning services that will prevent this horrendous toll of human suffering and will provide a “demographic bonus” with regard to infrastructure demands on governments struggling to stay even with growing populations. 

It is, indeed, in the area of information and motivation that the greatest shortfall is occurring globally.  And yet the behavior-change communication strategies used by Population Media Center have been demonstrated to be by far the most cost-effective means of averting births.  At the same time, these strategies expand the options and rights of women and girls far beyond their current fate of early and repeated childbearing.

Meeting the entire need for family planning information and services of just $15.2 billion per year for several decades could reap a long-term benefit of over $1 trillion per year in reduced need for developing world infrastructure growth.

Population Media Center is using entertainment-education serialized dramas to help people understand the importance of responsible parenthood, rights of women, education of girls, and communication between husbands and wives about the future of their families.  PMC’s founding members have been leaders for decades in the population field and have created the highly effective genre of entertainment-education serial dramas.  PMC is implementing long-term behavior-change soap opera projects in a dozen countries and is actively planning projects in another eight. 

Evidence of the Effectiveness of Entertainment-Education
There is strong evidence that mass media strategies, particularly entertainment broadcast programs, have played a significant role in a number of countries in bringing about changes in reproductive behavior and in promoting adoption of other health measures.  Radio and television soap operas in Mexico, India, Kenya and Tanzania have been documented by independent research in their massive effects on audience attitudes and behavior with regard to HIV/AIDS avoidance and use of family planning.

One of the advantages of using serial dramas, as opposed to documentaries or single-episode dramas, is that they allow time for the audience to form bonds with the characters and allow characters to evolve in their thinking and behavior with regard to various issues at a gradual and believable pace in response to problems that have been well illustrated in the story line.  Just as important, entertainment programs forge emotional ties to audience members that influence values and behaviors more forcefully than the purely cognitive information provided in documentaries.  As described in the social learning theory of Stanford University psychologist Albert Bandura, vicarious learning from others is a powerful teacher of attitudes and behavior.  Next to peer and parental role models, role models from the mass media are of particular importance in shaping cultural attitudes and behavior.

Serial melodramas using the methodology developed by Miguel Sabido of Mexico for promoting reproductive health have been remarkable in that they have attracted no serious opposition in any country.  This stems, in part, from the thorough research that has been done prior to the development of the programs to measure audience attitudes and norms with regard to these issues.  Characters for the serial dramas can then be developed that reflect the audience, so that the show is in harmony with the culture.  Through the gradual evolution of characters in response to problems that many in the audience also are facing, soap operas can show adoption of new, non-traditional behaviors in a way that generates no negative response from the audience.  Because of the bonds that have been formed by this stage between audience members and characters, and because of the commonality of problems between characters and the audience, audience members tend to accept these changes, even though they may challenge some cultural traditions.  Because they deal with issues that are as sensitive as sexual relationships and reproduction, it is especially important that such programs are designed not to build opposition or cause a backlash.

Mexico
In 1977, Miguel Sabido, then Vice-President of Televisa in Mexico, created the first soap opera to promote family planning, named Acompaname (“Accompany Me”).  As with an earlier serial he produced that dealt with the issue of literacy through the lives of illiterate characters, the program was designed to create characters who would evolve over time to become positive role models for the audience.  Acompaname showed in dramatic terms over the course of the nine-month series the personal benefits of planning one’s family, by focusing on the issue of family harmony.

The results of Acompaname, as reported by the Mexican government’s National Population Council (CONAPO), were:

1.      Phone calls to the CONAPO requesting family planning information increased from zero to an average of 500 a month.  Many people calling mentioned that they were encouraged to do so by the television soap opera.

2.      More than 2,000 women registered as voluntary workers in the national program of family planning.  This was an idea suggested in the television soap opera.

3.      Contraceptive sales increased 23% in one year, compared to a 7% increase the preceding year.

      4.   More than 560,000 women enrolled in family planning clinics, an increase of 33% (compared to a 1% decrease the previous year).

In Mexico, to date, there have been five additional family planning soap operas, all developed by Miguel Sabido.  They were Vamos Juntos (“We Go Together”), Caminemos (“Let’s Walk”), Nosotros las Mujeres (“We the Women”), Por Amor (“For Love”), and Los Hijos de Nadie (“Nobody’s Children”).

During the decade 1977 to 1986, when many of these Mexican soap operas were on the air, the country underwent a 34% decline in its population growth rate.  As a result, in May 1986, the United Nations Population Prize was presented to Mexico as the foremost population success story in the world.

Thomas Donnelly, then with USAID in Mexico, wrote, “Throughout Mexico, wherever one travels, when people are asked where they heard about family planning, or what made them decide to practice family planning, the response is universally attributed to one of the soap operas that Televisa has done. ... The Televisa family planning soap operas have made the single most powerful contribution to the Mexican population success story.”

India
Following a meeting David Poindexter, now Honorary Chair of Population Media Center, and Miguel Sabido held with Indira Gandhi, and a training program they organized for Doordarshan (Indian Television), the country began broadcasting India’s first social content soap opera, Hum Log (“We People”) in July 1984.  The program included promotion of family planning and elevation of the status of women through the words and actions of key characters.

Over 17 months of their broadcast, the episodes of Hum Log achieved ratings of 60 to 90%.  Research conducted by Professor Everett M. Rogers and Arvind Singhal, then of the Annenberg School of Communications of the University of Southern California, found through a sample survey that 70% of the viewers indicated they had learned from Hum Log that women should have equal opportunities, 68% had learned women should have the freedom to make their personal decisions in life, and 71% had learned that family size should be limited.  Among other things, the program stimulated over 400,000 people to write letters to the Indian Television Authority and to various characters in the program, stating their views on the issues being dealt with or asking for help and advice.

Following a second training for a team from India in December 1986 held in Mexico City, producer Roger Pereira of Bombay undertook the creation of a second television soap opera.  This program, Humraahi (“Come Along With Me”), went on the air in January 1992.  It dealt with the status of women, with particular attention to age of marriage, age of first pregnancy, gender bias in childbearing and child rearing, equal educational opportunity, and the right of women to choose their own husbands.  Within four months, Humraahi was the top-rated program on Indian television.  The estimated audience was 230 million viewers.  In the series, a servant girl dies in childbirth at age 15 after being forced into an arranged marriage at age 14 by her parents.  Following that key episode, the other characters lament what is happening to the young women of India and the tragedy of early marriage and pregnancy.  A Rockefeller Foundation-funded study developed by William Ryerson showed that viewers, contrasted with non-viewers, changed significantly in their attitudes regarding the ideal age of marriage and the acceptability of women in the work place -- two issues that were central to the story line.

Kenya
David Poindexter began working in Kenya in 1983 with the government-run Voice of Kenya, which later became the Kenya Broadcasting Corporation (KBC).  After training Kenyan television and radio personnel in Mexico with the help of Miguel Sabido, he helped in the development of two programs:  a television series, Tushauriane (“Let’s Talk About It”); and a radio series, Ushikwapo Shikamana (“If Assisted, Assist Yourself”).  Both programs went on the air in 1987.  The programs were aimed at opening the minds of men to allowing their wives to seek family planning.  The programs also effectively linked family size with land inheritance and the resulting ability or inability of children to support their parents in their old age.  Both programs were the most popular programs in their respective media ever produced by the Voice of Kenya.

By the time the two series had ended, contraceptive use in Kenya had increased 58% and desired family size had fallen from 6.3 to 4.4 children per woman.  While many factors undoubtedly contributed to these changes, a study conducted by the University of Nairobi’s School of Journalism at rural health centers gave evidence of women coming in for family planning saying that the radio program had caused their husbands to allow them to come for family planning.

Tanzania
The most extensive evaluation of the effects of a social content serial drama occurred from 1993 to 1997 in Tanzania.  There, Radio Tanzania broadcast a serial melodrama that attracted 58% of the population (age 15 to 45) in areas of the broadcast.  By design, in one region of the country, the area surrounding the city of Dodoma, a music program was heard instead of the soap opera during the first two years of the project (1993-95).  Then, from 1995-97, the soap opera was broadcast in the Dodoma comparison area.

Independent research by the University of New Mexico and the Population Family Life Education Programme of the Government of Tanzania measured the effects caused by the program with regard to such issues as AIDS prevention behavior, ideal age of marriage for women, and use of family planning.  While the population of the Dodoma comparison area was more urban than the rest of the country, a multiple regression analysis eliminated the influence such differences might have accounted for.  Nationwide random sample surveys of 2750 people were conducted before, during and after the broadcast of the program. Data was also collected from the AIDS Control Programme of the government, the Ministry of Health, and the Demographic and Health Survey, all of which reinforced the finding of significant impacts on attitudes and behavior.

Among the findings were a significant increase in the percentage of the population who perceive that they may be at risk of HIV infection; an increase in people’s belief that they can take effective action to prevent HIV/AIDS; an increase in interpersonal communication about HIV/AIDS; an increase in the belief that individuals, rather than their deity or fate, can determine how many children they will have; an increase in the belief that children in small families have better lives than children in large families; and an increase in the percentage of respondents who approve of family planning.

The study also provided evidence that the Tanzanian radio serial stimulated important behavioral changes.  Over half the population of the areas where the serial was broadcast identified themselves as listeners, with more men than women in the audience.  One of the key characters in the soap opera was a truck driver with many girl friends along the truck route.  In the program he contracts AIDS.  Of the listeners surveyed, 82% said the program had caused them to change their own behavior to avoid HIV infection, through limiting the number of sexual partners and through condom use.  Independent data from the AIDS Control Programme of the government of Tanzania showed a 153% increase in condom distribution in the broadcast areas during the first year of the soap opera, while condom distribution in the Dodoma non-broadcast area increased only 16% in the same time period. 

The program was also effective in promoting family planning.  There was a strong positive relationship between listenership levels by district and the change in the percentage of men and women who were currently using any family planning method.  The research also showed an increase in the percentage of Tanzanians in the areas of the broadcast who discussed family planning with their spouses.  The program also had a significant effect in raising the ideal age of marriage for women and the ideal age of first birth for women. 

In regions where the show was broadcast, the percentage of married women who were currently using a family planning method increased 10 percentage points in the first two years of the program, while that percentage stayed flat in the Dodoma area during the time the program was not broadcast there.  Then, when the program was broadcast in Dodoma, the contraceptive prevalence rate there increased 16 percentage points.  In regions where the program was broadcast, the average number of new family planning adopters per clinic, in a sample of 21 clinics, increased by 32% from June 1993 (the month before the show began airing) to December 1994.  Over the same period, the average number of new adopters at clinics in the Dodoma area remained essentially flat. 

Independent data from Ministry of Health clinics showed that 41% of new adopters of family planning methods were influenced by the soap opera to seek family planning.  This included 25% who cited the soap opera by name when asked why they had come to the clinic, and another 16% who cited “something on the radio” and then identified the soap opera when shown a list of programs currently on the air.  Another family planning serial drama using a different methodology that was broadcast nationwide by Radio Tanzania at the same time was cited by just 11% of new family planning adopters at the same Ministry of Health clinics. These data point to the importance of the methodology used in the design of the serial drama.

Counting all of the costs of the radio serial, the cost per new adopter of family planning was under 80 cents (U.S.).  The cost per person who changed behavior to avoid HIV/AIDS was 8 cents (U.S.).

Because entertainment programming (radio or television, depending on the coverage of each medium in any country) attracts the largest audiences, it is particularly important to utilize entertainment media for disseminating information about reproductive health issues.

The Work of Population Media Center
Population Media Center works to develop comprehensive media campaigns in the countries where it is carrying out projects.  Because of the strong evidence of their effectiveness, social-content serial dramas are, in most instances, a centerpiece of the strategy in any country.  The strategy uses the best of what has been done in the past, and builds on it in each country with intensive coverage of issues related to sexual risk behavior.  In this way, PMC intends to contribute to rapid change in the health-related behavior of people worldwide.

PMC provides people with entertainment and information to help them make informed decisions without telling them what to do.  PMC’s approach emphasizes non-coercive, informed decision-making, tailored in each case to local needs and circumstances.  Programs are designed to promote human health and dignity by providing education and examples of various alternatives and their consequences.

In its first eight years, Population Media Center (PMC) has initiated projects in Brazil, Burkina Faso, Côte d’Ivoire, Ethiopia, Jamaica, Mexico, Mali, Niger, Nigeria, the Philippines, Rwanda, Senegal, Sudan, the United States and Vietnam.  PMC has new projects in development in Botswana, China, Honduras, Kenya, Madagascar, Mozambique and Tanzania.  It has continuation projects in development in Burkina Faso, Côte d’Ivoire, Mali and the Philippines.  Here are some examples of that work:

AFRICA

Ethiopia
Population Media Center has received funding from Save the Children-Norway (with funds from the Norwegian government) for a four-year social-content radio serial drama project in Ethiopia.  The project also involves production of a radio talk show for youth with phone ins from listeners; production of various print materials on reproductive health; and capacity building programs for journalists, playwrights, religious leaders, women leaders, youth associations, and reproductive health professionals.  In addition, the project includes specialized activities for Ethiopia’s Afar and Somali Regions.  The project includes extensive monitoring and evaluation.

This project follows a string of previous projects by PMC in Ethiopia.  In 2004, PMC completed a project that included radio serial dramas in the major languages, Amharic (257 episodes) and Oromiffa (140 episodes).  Formative research was completed in 2001, and broadcast of the radio serial dramas in the two languages began in June 2002.  The programs addressed issues of reproductive health and women’s status, including HIV/AIDS, family planning, marriage by abduction, education of daughters, spousal communication and related issues.  As of November 2004, 63% of new clients seeking reproductive health services at 48 service centers in Ethiopia reported that they were listening to one of the PMC serial dramas.  In fact, 26% of new clients named one of PMC’s programs by name as the primary motivating factor for seeking services. 

Of new clients who cited radio programs as a motivation for seeking services, 96% said that they were motivated by one of PMC’s programs.  About half the population reported being regular listeners.

In just two and a half years of nationwide broadcasting, the following changes were recorded:
·        Listeners were 5 times more likely than non-listeners to know 3 or more family planning methods.
·        Among married women in the Amhara region who were listeners, there was a 55 percentage point increase in those who had ever used family planning methods, while among non-listeners, the change was only 24 percentage points.  A similar increase occurred among male listeners in the Amhara region.
·        Male listeners sought HIV tests at four times the rate of non-listeners, and female listeners sought tests at three times the rate of non-listeners.
·        The fertility rate in Amhara (the most populous region) fell from 5.4 to 4.3 children per woman.
·        Demand for contraceptives increased 157%.
·        Spousal communication about family planning issues among married women climbed from 33% to 68%.
·        The 2005 Demographic and Health Survey found independently that, since 2000, contraceptive prevalence in Ethiopia had increased 133 percent.
·        There was a 50% increase in communication between mothers and their children about sexuality issues.
·        There was a 52 percentage point increase among men and a 21 percentage point increase among women in recognizing the importance of girls’ education.
·        There was a 35 percentage point increase among men and a 13 percentage point increase among women in the belief that women are fit to hold public office.

A multiple regression analysis was done to eliminate any effects that such factors as income, educational level, age, marital status, ideal number of children, urban or rural place of residence, ethnic group or language may have had on family planning use or HIV testing, and the results continued to show highly significant effects of the serial drama.
The outpouring of emotion in Ethiopia, in response to PMC’s programs, has been overwhelming.  From all over the country – and even beyond the borders of Ethiopia – 15,000 letters have poured in to PMC’s office in Addis Ababa.  Ethiopia’s news media have run almost a hundred stories on the soap opera phenomenon PMC has created.
PMC’s first serial drama project in Ethiopia was supported by the David and Lucile Packard Foundation, the HIV/AIDS Prevention and Control Office of the Government of Ethiopia (HAPCO), the Hughes Memorial Foundation, the Flora L. Thornton Foundation, CARE-Ethiopia, Save the Children-U.S., the UN Population Fund, and 35 individual contributors.  The partnership with Save the Children involved production and distribution of a third serial drama on audiocassettes for play by truck drivers and other high-risk groups.  The support from Save the Children allowed production and distribution of 24 episodes of this program, plus the writing of another 28 episodes.  The evaluation of the cassette-based drama showed major changes in self-reported behavior by those who listened to the program.  HAPCO awarded PMC additional funds to complete production of the remaining episodes and to distribute them to high-risk populations via cassette, as well as to broadcast them on Radio Ethiopia.  The broadcast of this program, Maleda (“Dawn”), started in May 2005 and was completed in September 2006.

PMC also received support from the Packard Foundation for two additional projects in Ethiopia designed to involve the creative community in addressing population and reproductive health issues.  These projects included creating traveling stage plays to address reproductive health issues; developing two video documentaries on population and HIV/AIDS issues in Ethiopia; holding contests for the best short stories and poems that address reproductive health issues; and conducting training of journalists in covering reproductive health issues.  As part of this work, PMC-Ethiopia published a collection of national prize-winning short stories and poems focusing on HIV/AIDS and related social issues in 2003 under the title Yehiwot Tebitawoch (“Drops of Life”).  The creative pieces were selected from among 146 short stories and 176 poems submitted in response to a national competition for the best poems and short stories that address reproductive health and HIV/AIDS issues.  10,000 copies of this book were published and distributed throughout Ethiopia.  A second volume of short stories was published in 2004 as a result of a second nationwide competition.  The book, Kinfam Hilmoch (“Winged Dreams”), was also widely distributed. A third book, Wenzoch Eskimolu (“Waiting for the Rivers to Rise”), was published and distributed in 2006.  PMC also produced a full-length stage play entitled Yesak Jember (“Laughter at Dusk”), focusing on HIV/AIDS prevention. The stage play was launched in September 2003, and was attended by the former President of Ethiopia, Dr. Negasso Gidada.  The play was staged in the capital for five months, followed by performances in 14 other cities around Ethiopia. The script was then given to local drama groups for adaptation.  PMC received additional support from the Packard Foundation for additional training of journalists in covering reproductive health issues, and that project was completed in 2006.

In 2005 and 2006, PMC received support from UNICEF, HAPCO and the Flora L. Thornton Foundation to develop and broadcast a youth-focused radio serialized melodrama to motivate young people to adopt positive behaviors regarding HIV/AIDS, reproductive health and related social issues.  The program, Menta Menged (“Crossroads”), began broadcasting on Radio Ethiopia in March 2005. 

This same project involves production of a talk radio program aimed at youth.  The program, Alegnta (“Security”), has been on the air since October 2005, with phone ins from audience members and youth-led panel discussions with experts.  The Alegnta project also involves production of print materials for youth on reproductive and sexual health issues.  A total of five booklets have been published and distributed in 32,000 copies each, along with four leaflets distributed in 40,000 copies each.

Kenya
PMC is working to develop a Sabido-style radio serial for broadcast in Kenya.  The program will be produced by Tom Kazungu, who was the first person in Africa and the first radio producer trained by Miguel Sabido.

Madagascar
PMC is working to develop a radio serial drama in Madagascar to promote family planning and small family norms, as well as conservation of the unique wildlife habitat of the country.  The project will be carried out in partnership with the Dodwell Trust, which has experience with Sabido-style radio programming and has an office in Madagascar.  Support for the exploratory work of developing the project is being provided by the Flora L. Thornton Foundation.  An exploratory visit to Madagascar occurred in May-June 2006.

Mali, Ivory Coast and Burkina Faso
In West Africa, PMC produced a radio serial drama to address issues of child slavery and the link between this problem and poverty-inducing factors, such as unwanted pregnancy and HIV/AIDS.  PMC established an office in Bamako, Mali to oversee the project.  Formative research was completed, and training was conducted for the producer and writers in June 2004.  The radio serial drama went on the air in November 2004 and was completed in October 2005.  The program, Cesiri Tono (“Fruits of Perseverance") was done in partnership with First Voice International, which distributed the program via WorldSpace satellite to 169 community radio stations.  These stations then broadcast the program throughout Mali, Ivory Coast and Burkina Faso.  PMC received a grant from USAID to support this work.  The Ashoka Foundation awarded PMC the Changemakers Innovation Award (one of three worldwide) in their global competition for the most creative programs designed to prevent human trafficking.

A random-sample, household evaluation survey was conducted in Mali, Burkina Faso, and Ivory Coast in December 2005 to determine the impact listening to Cesiri Tono had on awareness of and attitudes towards child trafficking and exploitation and its underlying causes in the three countries.  The survey data indicated that the program produced the following results:
MALI
         22.4% of respondents listened to the drama, which translates to approximately 3.1 million Malians.
         Listeners in Mali were half as likely as non-listeners to prioritize educating boys over girls (11% vs. 22%).
         31% of listeners in Mali had discussed exploitative child labor during the period of the program, compared to 17% of non-listeners during the same period.

         The belief that it is acceptable for women to work outside of the home was 53% higher among listeners than it had been at baseline.

BURKINA FASO
         In Burkina Faso, 23% of listeners had taken action against exploitative child labor, compared to 9% of non-listeners in Burkina Faso.
         96% of listeners in Burkina Faso could identify at least one place that provides family planning/reproductive health services, compared to 80% of non-listeners.

IVORY COAST
         43% of listeners in Ivory Coast had discussed children’s rights in the 12 months before the end of the program, while only 25% of non-listeners had discussed children’s rights in the same period.

         32% of listeners in Ivory Coast knew at least three factors that can lead to child trafficking, compared to 14% of non-listeners.

ALL THREE COUNTRIES

         Listeners in all three countries were substantially more aware of child trafficking than non-listeners.

         Listeners to Cesiri Tono were over five times more likely to have heard of the phenomenon of exploitative child labor than non-listeners.

Mozambique
PMC has been invited to be the communications partner of the Inter Religious Campaign against Malaria in Mozambique (IRCMM).  As part of the process of developing a communications strategy, a PMC delegation visited Mozambique in June 2006.  PMC anticipates that the communications initiative will include a variety of issues in addition to malaria prevention, including elevation of women’s status and promotion of reproductive health.

Niger

In March 2005, PMC received USAID funding to implement a two-year radio serial drama project in Niger to address similar issues to those addressed in Mali, Ivory Coast and Burkina Faso.  A Country Representative was brought on board, formative research was completed, and an in-depth workshop was held to train the producer and scriptwriters.  The program, entitled Gobe da Haske (Tomorrow will be a Brighter Day) went on the air on February 12, 2006.  It is being distributed by First Voice International via WorldSpace satellite to community radio stations in Niger.

Nigeria
PMC is carrying out a radio serial drama project in Nigeria in collaboration with the Rotarian Action Group on Population and Development (RFPD) and with a Nigerian organization, Multi-Sector Projects.  The project involves a 70-episode program in northern Nigeria aimed at improving maternal health and preventing obstetric fistula through delaying marriage and the onset of childbearing until adulthood.  In addition to Rotary support, the project is funded by the Conservation, Food and Health Foundation and the David and Lucile Packard Foundation.  The radio serial Gugar Goge (“Tell Me Straight”) serving Kano and Kaduna states went on the air in early June 2006.  By mid-September, 47 percent of new reproductive health clients indicated they were listening to the program.  The program was cited by 33 percent of new family planning clients and 54 percent of fistula patients as the primary reason for seeking medical services.

PMC is planning a new serial drama project for northern Nigeria to be started in 2007, with continuing support from the Conservation, Food and Health Foundation and the David and Lucile Packard Foundation and new support from an individual contributor.  In addition, PMC is planning a multi-language radio serial drama designed to deal with HIV/AIDS prevention, family planning promotion and elevation of women’s status nationwide.

Rwanda
PMC has received funding from the United Nations Population Fund, the Flora L. Thornton Foundation, the Mulago Foundation and Texas A&M University to develop a radio serial drama project in Rwanda addressing a combination of issues, including reproductive health, prevention of HIV/AIDS, preservation of wildlife habitat, preservation of natural resources, land conservation, and promotion of civil harmony.

Senegal
PMC is developing a nationwide radio serial drama project in Senegal.  In October 2006, two PMC staff visited Dakar at the invitation of the UCLA School of Public Health.  As a result of the visit, PMC has received indication that it will receive funding in 2007 for a two-year project to promote family planning use and adoption of other reproductive health behaviors.

Sudan
In August 2006, PMC completed a radio serial drama project dealing with reproductive health issues and elevation of the status of women and girls.  PMC conducted formative and baseline research during the second half of 2003, and conducted a training workshop for the producer and writers in February 2004.  The results of the formative research were presented during this training workshop, to provide a basis for development of the storyline, characters and scripts.  Broadcast of the program, Ashreat Al Amal (“Sails of Hope”), began in November 2004 over Radio Omdurman, with free air time provided by the government's Ministry of Information and Communication.  The program was completed in June 2006, and evaluation research was conducted in July 2006 by a team from Ohio University led by communications scholar Professor Arvind Singhal.  Support for the work in Sudan was provided by the David and Lucile Packard Foundation.
Highlights of the results of the project in Sudan include the following:

  • Monitoring data showed that among the targeted group (women of reproductive age) there was high listenership.  Data gathered from clinic clients in 2005 indicated that between 29% and 39% of clinic clients listened to Ashreat al Amal.
  • Attitudes toward female circumcision:  There was a consistent increase over the project period in the percentage of the population who believe that female circumcision should be eradicated (from 28.6% to 65.4%).  The qualitative evaluation found that after the broadcast of Ashreat al Amal, listeners overwhelmingly supported eradicating the practice of female circumcision.
  • There was an increase in the percentage of listeners who discussed HIV/AIDS with partners:  Respondents to the impact evaluation were over 2 ½ times more likely to have discussed HIV/AIDS with their partners after the program than respondents at the baseline. 

LATIN AMERICA AND THE CARIBBEAN

Brazil
In Brazil, PMC is working in partnership with Comunicarte, a non-governmental organization in Rio de Janeiro, to assist TV Globo to incorporate social and health issues in its entertainment programs.  The staff of this project meets regularly with the writers of the prime-time soap operas on TV Globo to suggest themes and storylines related to reproductive health.  In 2005, the project was successful in getting TV Globo to integrate 1,551 scenes dealing with reproductive health, small family size, gender relations and related social and health issues. During the first half of 2006, another 491 scenes addressed social and health issues.  These programs are broadcast nationwide in Brazil and exported to dozens of countries worldwide, dubbed into various languages.  The project is supported by the Hughes Memorial Foundation, the Mulago Foundation and the Weeden Foundation.

Jamaica
In partnership with University Research Corporation (URC), PMC has received funding from USAID to implement the behavior change communication component of a five-year, multi-faceted adolescent reproductive health project.  As its part of this project, PMC is producing a 312-episode radio serial drama aimed at prevention of adolescent pregnancies, prevention of HIV infection, reduction of violence and prevention of drug abuse.  A team of writers was chosen, and a training workshop was conducted in March 2006.  The program, Outta Road (“What’s Happening out in the Streets”), began broadcasting in September 2006.

Mexico
In Mexico, youth are creating radio serials dealing with adolescent sexuality.  PMC is working with the Adolescent Orientation Center (CORA) of Mexico to produce a series of radio mini-serials mixed with talk shows in the five states of Mexico with the highest fertility rates. These programs have been developed by young people and are aimed at youth audiences.  PMC tested the model for the radio programs in Puebla State and then developed a manual for the methodology.  PMC and CORA have expanded the use of the methodology to other states, including Hidalgo, Tlaxcala, and, most recently, Michoacan.  In addition to the radio programs, the project includes intensive training of health care providers and youth service agency staff in how to effectively deal with adolescent sexuality issues.  Support for the work in Mexico has been provided by the Bergstrom Foundation, the Compton Foundation, the Jewish Communal Fund, Path, Interact Worldwide, an individual donor and the participating state governments.

ASIA

Philippines
In 2005, PMC produced and broadcast a radio soap opera in the Philippines.  The radio serial drama was supported by UNFPA for broadcast nationwide on affiliate stations of the Manila Broadcasting Corporation.  A literature review was completed in May 2005, and training of PMC’s scriptwriters was conducted in June 2005.  The program, named Sa Pagsikat ng Araw (“The Hope After the Dawn”), was broadcast five days a week between July 18 and December 30, 2005.  In total, 120 episodes were broadcast.  A participatory evaluation of the impact of the program was conducted by a team from Ohio University (led by Dr. Arvind Singhal) in December 2005, and the findings indicated profound effects of the program on the lives of listeners.

In addition, in 2005, PMC conducted a training workshop for members of the AIDS Society of the Philippines and for scriptwriters brought together by them, as well as a seminar for the International Rice Research Institute on the use of entertainment-education for the farming community.

Previously, in 2001, PMC held a "Soap Summit" for producers and writers of the 29 television soap operas and dozens of radio soap operas on the air in the Philippines.  A one‑day meeting, co‑sponsored by three committees of the Philippine Congress and held in the largest hearing room of the Congress, attracted 300 participants from the broadcasting industry, various government ministries, communication scholars, advertisers, members of Congress, NGOS, and other agencies.  In addition, a half‑day seminar by Miguel Sabido on the design of entertainment‑education serial dramas, held at the National Library, attracted 150 broadcast professionals and was followed by dinner hosted by President Gloria Macapagal‑Arroyo at Malacanang Palace.

In November 2003, PMC led a session focused on the role of female scriptwriters in elevating the status of women and in bringing about social change worldwide at the Women Playwrights International conference in Manila.  In addition, in 2003, PMC conducted a training workshop for members of the AIDS Society of the Philippines.

Vietnam

At the invitation of UNFPA-Hanoi, PMC is developing a serial drama project to promote reproductive health and avoidance of HIV/AIDS in Vietnam.  Two exploratory visits were made to Vietnam in 2005.  The project will start in 2007, with support from the Danish government via UNFPA-Hanoi.

NORTH AMERICA

United States
In 2004 and 2005, PMC conducted nationwide contests, which awarded prizes for the best published cartoons dealing with population-related issues.  In 2004, the first year of the contest, 188 published cartoons were submitted.  In the 2005 contest, 156 entries were submitted.  The National Cartoonists Society and the Association of American Editorial Cartoonists publicized both contests to their members.

Judges in the 2004 contest included former Colorado Governor Richard Lamm, retired United Media Chairman Robert Metz, Yale University Professor Robert Wyman, Planned Parenthood Federation's Vice President for International Programs Allie Stickney, and cartoonists Edward Koren and Signe Wilkinson.  The 2005 panel of judges included cartoonists Greg Evans (Luann), Rick Kirkman (Baby Blues), Rick Stromoski (Soup to Nutz) and population experts John Seager (President of Population Connection) and Nancy Yinger (Director of International Programs for the Population Reference Bureau).  The awards event for the 2005 contest was held in the Senate Environment Hearing Room in the Dirksen Building in Washington, DC.  Vermont Senator Jim Jeffords spoke at the event. 

Many of the 2004 finalists can be viewed on the world's largest editorial cartoon website at www.cagle.com/news/NationalPopulation/1.asp.  This website has also run a series of editorials on population issues, including two by PMC President William Ryerson and an editorial he sought from Dr. Thoraya Obaid, Executive Director of the United Nations Population Fund on World Population Day (July 11, 2005), plus columns by former Colorado Governor Richard Lamm; Lindsey Grant, former U.S. Assistant Secretary of State for Population and Environment; and attorney John Rohe.  These columns have been distributed by the Cagle Syndication Service to 800 subscribing U.S. newspapers, many of which have published them for their readers.  To view these columns, visit www.caglecartoons.com and click on Expert Columnists.

PMC is expanding its work in the U.S. beyond the print media.  In 2006, PMC engaged Sonny Fox, former Chairman of the Board of the National Academy of Television Arts and Sciences, to represent the organization on the West Coast and to work with the entertainment industry to engage them in positive treatment of population and reproductive health issues.  Among the plans for this work, PMC is planning a public health summit to bring together entertainment industry leaders and public health professionals for the purpose of creating an ongoing mechanism for regular and speedy input by the public health community into entertainment programs on reproductive health and other health concerns, to be held in May 2007 in partnership with the Emory School of Public Health.  PMC is also planning a series of briefings to be hosted by the Hollywood Screenwriters’ Guild to give them information and storyline concepts for population issues in entertainment programming.

PMC is involved in development of a serialized radio drama for urban youth, to be done in partnership with Clear Channel Communications’ syndication division.  In addition, PMC is working with Miguel Sabido, creator of the social-content telenovela methodology that PMC uses in developing countries, to develop a web novela for Hispanic youth addressing teenage pregnancy and related issues.

PMC is developing a number of other initiatives to reach the American public with information and motivational communications on population and reproductive health issues.  Among these is distribution of frequent news articles and editorials about population issues to a global list of population-concerned individuals and institutions.  This email service has generated a flood of letters reacting to both negative and positive statements by political leaders, the news media, environmental leaders and others.

INTER-REGIONAL

Inter-Regional Training
In 2003, PMC implemented a project for the U.N. Population Fund (UNFPA) on a region-wide basis in Africa and Asia to assist local FM and community radio stations in addressing HIV/AIDS and reproductive health issues through entertainment-education.  The project included training workshops in the use of entertainment-education techniques for community radio producers and representatives from selected NGOs.  Under this project, personnel from radio stations and NGOs in eight African countries received training at a workshop in Johannesburg in March 2003.  They were Angola, Guinea Bissau, Mali, Mozambique, Namibia, Niger, Nigeria and South Africa.  Six Asian countries participated in a similar workshop in Manila in May 2003.  They were Cambodia, Mongolia, Nepal, Papua New Guinea, Philippines and Vietnam.  As part of the project, PMC produced a report of a needs assessment, Strengthening Partnerships among Local FM Radio Networks and Reproductive Health Agencies on HIV/AIDS, which can be found at www.unfpa.org/upload/lib_pub_file/486_filename_157_filename_commmunityradio.pdfIn follow up to the workshops, PMC has developed long-running social-content serial drama projects with several of the participants.

Training Guide & Best Practices Manual
In 2004, UNFPA asked PMC to develop a training guide with detailed information on the application of the serial drama methodology to address such issues as the way in which gender discrimination impacts women’s vulnerability to HIV/AIDS.  The training guide was published in 2005. A PDF of the Training Guide is available on the PMC website at www.populationmedia.org.  In 2005, UNFPA asked PMC to develop a best practices manual with examples of excellent social change communication programs worldwide.  That publication will be available in 2007.  An article on PMC’s work appears on the UNFPA website at www.unfpa.org/news/news.cfm?ID=761&Language=1.

For more information, contact:

            Population Media Center

PO Box 547

Shelburne, Vermont 05482 USA
            Telephone:  802-985-8156      Fax: 802-985-8119
            Email: pmc@populationmedia.org        Web site: www.populationmedia.org
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