Family Planning Made Entertaining

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Happy Halloween! I want to tell you a scary story. A decade ago, the planet had six billion people. Today, according to the United Nations, we have seven billion. The UN has chosen Halloween as the symbolic day when the seventh billion person will come screaming into existence. Not scared yet? Maybe these words from environmental researcher Jonathan Foley will do the trick:

Right now about one billion people suffer from chronic hunger. The world’s farmers grow enough food to feed them, but it is not properly distributed and, even if it were, many cannot afford it, because prices are escalating. But another challenge looms.

By 2050 the world’s population will increase by two billion or three billion, which will likely double the demand for food, according to several studies. Demand will also rise because many more people will have higher incomes, which means they will eat more, especially meat. Increasing use of cropland for biofuels will put additional demands on our farms. So even if we solve today’s problems of poverty and access—a daunting task—we will also have to produce twice as much to guarantee adequate supply worldwide.

Foley has some really smart ideas about how to feed that many people without wrecking the planet, and he lays them out in the November issue of Scientific American. But I’d like to propose a different plan: let’s have fewer babies. And then we won’t have to produce so much food.

According to USAID, 215 million women around the world don’t want to have children but aren’t using modern forms of contraception. In some cases, their religion forbids it. In other cases, they don’t have access. Sometimes, the problem is cultural. Family planning simply isn’t done. The women are scared. The men oppose it.

The Population Media Center (PMC) is trying to address this problem in a unique way: soap operas. The staff creates serial melodramas for TV or radio that contain messages about family planning, HIV, and gender equality. The idea is that viewers or listeners will identify with the characters and come to see them as role models. And when a role model decides to start using condoms, the viewer will have an easier time accepting that behavior even if the practice goes against cultural norms.

In the radio serial Ruwan Dare (Midnight Rain), which aired in Nigeria in 2007 and 2008, one main character, Azumi gets pregnant while breastfeeding her four-month-old son. While pregnant, she falls ill and nearly dies. A health worker tells Azumi that she needs time to recover before she has another baby. So Azumi and her husband, Lawai start using the rhythm method. But their sex life suffers. So on the advice of their local cleric, they switch to a modern method (the plot summary on PMC’s web site doesn’t say which one). But Azumi doesn’t regain her strength, so Lawai takes another wife, who gives him three children. Azumi’s parents hear about the other wife’s fecundity and pressure Azumi into abandoning the birth control. Once again, Azumi gets pregnant and ends up hospitalized. Lawai’s other wife has a fourth child and dies during childbirth. But the ending is happy — sort of. Azumi ends up adopting the other wife’s children and she “treats them like her own.” These are situations that happen in Nigeria. Now compare that to the evil twin scenarios and baby switching that permeate American soaps. (Marlena on Days of Our Lives was once possessed by the Devil. I’m not kidding).

Before Ruwan Dare aired, women said they wanted, on average, 7.71 children. That number fell to 5.39 after the drama aired. And about two-thirds of new clients vising family planning clinics said they came because of the serial. The most extensive investigation of whether the strategy works comes from Tanzania, where a serial drama aired from 1993 to 1997. In regions where the program played, the number of new family planning adopters increased by 32% from June 1993 (the month before the show began) to December 1994. The percentage of married women who reported using a family planning method increased 27% in the first two years of the program. In a different region, where the program had not been broadcast, the researchers saw no change.

I like this idea, but I also find it a bit unsettling. PMC has a very clear mission. But do the viewers know that? Should they? William Ryerson, PMC’s founder, sees it this way, “Unlike brainwashing, PMC’s approach is to show a range of options, to broaden rather than to narrow the perspective of the viewing audience with regard to the choices available to them. For each of the options, the programs show realistic consequences.”

Perhaps I’m too squeamish. Really this not so different from the time my favorite soap character (Melanie from Days of Our Lives — she’s so spunky) commented on the deliciousness of Hershey’s chocolate while trying to decide whether she belongs with Nathan or Phillip (Nathan, clearly). In fact, it’s better. PMC is selling family planning, not Coke or Doritos. And that’s something the world desperately needs.

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Image credit: ausnahmezustand on flickr

Also, I had to share this hilarious example of how NOT to do product placement from Days of Our Lives.

Categorized in: Cassandra, Commentary, Health/Medicine

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