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ABSTRACT
EFFECTIVENESS OF COM’UNICATION STRATEGY FOR
DIFFUSION OF FAMILY PLANNING IN WEST PAKISTAN

by Wiqar Husain Zaidi

Population problems of the world in general, and of the develop-
ing countries in particular, have aroused universal interest during the
past decade. There is a recognition of the need fOr curbing the rate
of population growth, to which end Pakistan launched a massive family
planning program in 1965. The assunption.has been that a sound com—
munication program is an essential ingredient fOr widespread acceptance
of birth control practices. .A study was conducted in 1967 by the
National Research Institute of Family Planning at Karachi to assess the
success of the strategies of the program.

In recognition of the significance and utility of the framework
employed in studying the difosion of innovations, the present study
seeks to explore the applicability of the model fOr pOpularizing family
planning in the diverse cultural conditions of Pakistan.~

.A stratified random sample of 487 married males from six dis-
tricts of west Pakistan was interviewed on a Sohedule which included
items on demographic Characteristics of the respondents, their commun—
ication behavior, their exposure to family planning messages over
several channels, their knowledge of information sources, and their
awareness and aoption of family planning practices. Statistical treat-
ment of the data included calculation of means and standard deviations,

percentages, and product—moment correlation. Five communication indices

 

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Wiqar Husain Zaidi
were constructed to derive composite scores on specific dimensions of
behavior.

The respondents, three—fourths of Whom.were rural residents of
areas, showed a very high level of awareness of family planning pro—

, gram. Ninety—four percent had heard about it, seventy-five percent
were aware of the fUnctionaries, and twenty—five percent were prac—
ticing birth control at the time of interview.

Urban residence, respondent's education, and wife's education
were associated with exposure to mass media of communication, as well
as exposure and favorable reactions to the messages of'family planning.
Age, parity, and occupation.were correlated negatively or insignificantly
with the indices of knowledge, attitude, and action.

Early awareness was related to education and.membership in
formal organizations. Urbanity, education of wife, and supplementary
sources of income were correlated with early consideration and early
start of the practice. Adopters, as a group, had high parity compared
to non-adopters.

About one—third of the practitioners claimed to have been sought
after for advice, whereas half that number sought advice. Both groups
were similar in Characteristics, none of which were significantly
correlated with opinion leadership.

More than three—fOurths of the respondents had seen a poster,
and sixty percent attended a mass meeting on the subject. Between one-
fourth and one-third of the sample reported exposure to family plan-
ning messages through pamphlets, radio, newspapers, cinema advertise-

ments, and family planning workers. Mbst of the people either’approved

Wiqar Ensain Zaidi
of the messages or remained neutral.

.Action following exposure to messages was mostly expression of
interest in innovation and visiting fUnctionaries fbr additional in-
formation. Most influential were newspapers, and least influential
were cinema slides and posters. Selection of specific contraceptives
was related to the characteristics of the individuals.

It seems that the diffusion framework is applicable in broad
outline to family planning. But the nature of the innovation and the
strategies of the program signify the need fOr modification. The stra-
tegies of the program succeeded in early stages but need reorientation

for later stages of diffusion.

EFFECTIVENESS OF COMMUNICATION STRAIBSY,
FOR DIFFUSION OF FAMILY PLANNING

IN WEST PAKISTAN

By

Wiqar Husain Zaidi

A.THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Sociology

1968

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Accepted by the faculty of the Department of Sociology, College
of Social Science, MiChigan State University, in partial fulfillment

of the requirements fOr a Master of Arts degree.
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all
Director of Thesis

.ACKNOWLEDGMENTS

A.thesis based on field research is a product of several in-
dividuals and organizations. The present work is no exception. To
mention the most significant contributors, the author expresses his
sincere thanks and deep sense of gratitude to:

Dr. Hideya Kumata, Director of the International Communica-
tion Institute and chairman.of'the thesis guidance committee; Dr.
Everett Rogers, Professor of Communication; and Dr. Frederick waisanen,
Professor Sociology and Communication, for providing inspiration, en-
couragement, support, and helpful suggestions in developing this thesis.

The Department of Sociology and the Department of Communication
of Michigan State University for making available to the author facil—
ities fbr analysis of the data and the writing of the report. Mrs.
Anita Immele, and Mr. Edward Davis deserve special mention fOr their
help in programming and editing, respectively.

The Population Council of New York fOr financing the trip and
the pundhing and verification of the cards.

Dr. Gilbert Hardee, Population Council Adviser to the National
ResearCh Institute of Family Planning, Karachi, for his personal and
professional involvement and active collaboration at every stage of the
project.

The executives of the Pakistan.Fandly Planning Council, namely,

Mr. Enver.Adil, Commissioner; Col. S. A, Jaferey, Deputy Secretary;

iii

Dr. Nafis Sadik, Director of Planning and Training; and Dr. Batul
Turabi, Director of National Research Institute of Family Planning,
for their sponsorship, administrative endorsement, and autonomy to the
author for designing and executing the study.

The District Publicity—cuneExecutive Officers and the Family
Planning Officers of the sampled areas for facilitating data collec-
tion.

The respondents, the interviewers, and the coders for providing
the data.

My wife, Hameeda, daughter, Rubina, and son, Imtiaz, fer their
forbearance during my prolonged absence from home.

The help of each of these individuals has been far beyond the
call of duty. Their contributions are not confined to the present
thesis. Later reports on this study and the study of Organizers owe

a great deal to them.

iv

Chapter

I

II

III

IV

FINDINGS I:

TABLE OF CONTENTS

INTRODUCTION

Demographic Situation in Pakistan

Early Family Planning Programs

The New Scheme . . .
Administrative Organization
Communication.Aspect .
Contraceptives .

The Process of Diffusion
Stages of Adoption .
Categories of'Adopters .

THE THEORETICAL FRAMEWORK OF THE STUDY_

Characteristics of Innovativeness

Opinion Leadership
Specific Item
Channel

THE SAMPLE .

Background of the Study .
Sampling Procedure

InterView Schedule

Data Collection .
Characteristics of the Sample .
Media Exposure . . .

Exposure to Family Planning Communication .

Statistical Analysis .
Measures . .

ADOPTION OF INNOVATION

Characteristics of Respondent and Media

“Esposure

Q

CHARACTERISTICS OF RESPONDENTS AND

l2
l3
1”
1H
15
l7
18

22

22
23
2M
25
25
27
28
30
31

35

35

Chapter

Characteristics of Respondents and
Message Exposure . . . . . . . .
Characteristics of Respondents and
Knowledge of Information Sources .
Characteristics of Respondents and
Message Approval . . . . .
Characteristics of Respondents and
Message Discussion . . . . . .
Summary of Correlates of Communication
Indices . . . . . . . .
Correlates of Adoption of Family Planning
Characteristics of Early Awareness
Characteristics of Early Intention
Characteristics of Early AdOption .
Selection of Contraceptive for.Adoption

V FINDINGS II: RELATIVE EFFECTS OF CHANNELS . .

Relative Exposure to Messages over Channels .

Media Overlap . . . . . . .

Relative Approval of Messages Through
Channels . . . . . . . . . . .

Relative Persuasive Effect of Messages
Through Channels . . . . . . . .

Opinion LeaderShip . . . . . . . .

Followership . . . . .

Advice Sources . . . . . . . . .

VI SUMMARY AND CONCLUSIONS . . . . . . . .

Eiunmary . . . . . . . .
limitations of. the Study . . . . . .
Recommendations for Action . . . . .
Needed Future Research . . . . . . .
Conclusions . . . . . . . . . .
BIBLIOGRAPHICAL REFERENCES . . . . . . . . .

Page

37
38
38
39

39
no
no
42
us
an

”9

H9
52

SH

55
58
59
61

62

62
66
67
69
71

7M

Table

10

11
12

13

M

LIST OF TABLES

Estimated expenditure on publicity ofiamily planning
(in thousands of rupees* over a 5-year period).

General Characteristics of the sample.
Communication behavior of the respondents.
Correlation between characteristics and indices.

Correlations between characteristics of respondents
and innovativeness.

Correlations between characteristics and adOption
behavior.

Correlation between respondent characteristics
and method used.

Relative exposure to family planning messages
through various channels.

Intercorrelation between message exposure from channels.

Opinion of family planning messages heard through
various media Channels.

.Action subsequent to exposure to message over channels.
COPPGLates of opinion leadership and followership.
Itemrtotal correlations of communication indices.

Intercorrelations between the indices.

vii

Page

10
26
29

36

41

H5

H6

50

53

55
57
60
83

84

Chart

LIST OF CHARTS

Pakistan Family Planning Organizational Chart

viii

Page

Appendix
.A

LIST OF APPENDICES

INDEX CONSTRUCTION

INTERVIEW SCHEDULE (TRANSLATION)

Page
79

85

CHAPTER I

INTRODUCTION

The population problem.is universally considered as one of the
. gravest and most significant problems in the world today. As John D.
Rockefeller has observed:

Today no problem.is more urgently important to the

well-being of mankind than the limitation of popu—

lation growth . . . . In many parts of the world,

it obstructs much needed economic growth even as

it fosters social unrest and political instability.

(34, p. 2)
The world is plagued by an unprecedented growth of population as a
result of rapid decline in mortality rates through revolutionary de-
velopments in preventive and curative measures of diseases such as
small pox, Cholera, plague, tuberculosis, malaria, typhoid, and in—
fluenza. JThe development of antibiotics has caused a sudden drop in
the death rates. The drop in the death rates has been accompanied by
an increase in the birth rate, producing a fUrther acceleration of the
rate of natural increase.

g Whereas the population of the world took about 1,200 years to
double itself since the beginning of the Christian era, and another
H00 for the next doubling, under existing fertility conditions the
world population is expected to rise fron13,281 million in 1965 to
7,522 million at the turn of the century. Even under conservative pro-
jections, anticipating a fertility decline, the population may grow to

1

2
6,130 million by that time (H9). More people are living in the world
today than have lived in the entire history of mankind. There is
little ground for optinisnlunless a concerted effort is made to remedy
the unmitigated process of proliferation (10).

The demographic transition theorists, taking the western world
as a model, expect a downward trend in birth rates following a reduc-
tion in death rates accompanying industrialization, urbanization and
education, the general indicators of modernization (#6). There is
evidence of such occurrence in the Far East (6, 17). The hope is,
however, that this will occur soon enough to avert calamity. Despite
improvements in scientific agriculture, large areas of the world are
faced with nearbfamine conditions alleviated only through huge imports
of foodstuffs from advanced and generous countries of the world, mainly
the U.S.A,

1'The population problem.should not be perceived in the context of
fOOd shortages alone. An added concern is the rising expectations of
the youth in the "have-not" countries of the world, which has produced
rising frustrations, political unrest, and social upheaval (26).

Against this background, the developed countries of the world
are offering liberal economic assistance to the less developed areas.
And, notwithstanding national philosophies to the contrary, programs
of birth control have been included in the sphere of technical assis-
tance. Not only are national governments launching massive programs
(6), but international organizations--the United Nations and its sub-
sidiaries (ECAFE, UNESCO, WHO, UNICEF) (48), and_agencies suCh as SIDA

(Sweden), AID (U.S.A,), Ford Foundation, and Rockefeller Foundation,

3
to name a few most significant——have extended their support to family
planning programs in the world.

The Population Council of New York is dedicated to family plan-
ning and allocates large sums of money fOr developing better contra-
ceptives and for providing technical assistance around the globe (33).
The effort and enthusiasm.of the chairman of the board of trustees,
John D. Rockefeller 3rd, culminated in the signing of the Declaration
on Population by thirty heads of states (47).

In their declaration, the heads of states enumerated their con-
victions concerning the importance of the population problem for
national planning of economic goals and for the achievement of lasting
peace, their belief in the right of parents to plan the size of their
families, and the view that the enrichment of human life is the objec-
tive of family planning (47). The UN Genera1.Assembly unanimously
adopted a resolution on 17 December, 1966, requesting the Secretary
General to implement the'work program recommended by the Population
Commission and endorsed by the Economic and Social Council (#8).

More and more governments are joining the community of nations
with.more or less official programs that bring family planning informa-
tion, services, and supplies to mass populations. Pakistan is not only
a signatory to the declaration on population but had earlier launched,
in July '65, an intensive and.massive government-sponsored program.of

family planning, probably the largest in the world.

Demographic Situation in Pakistan

The high priority assigned by the government of Pakistan to
curbing population growth should be viewed in the light of the country's
_ geographic and demographic characteristics and its problems of social
and economic development. In 1966, the president of Pakistan, Field
Marshall Mohammad.Ayub Khan, expressed his concern in the following

worlds:

The rapid growth of population creates frightening

prospects fOr those looking into the future . . . our

planning, our sacrifices, and our hard.work for the

progress of the country would be neutralized by the

rapid growth of population. If nothing is done to

Check the rate of growth, I shudder to think of what

will happen after a few decades . . . . The coming

' generation would not forgive us for landing them in

suCh a mess. (2)

The enumerated population of the areas now comprising Pakistan
rose from.46 million in 1901 to 76 million in 1951, an increase of 30
million (65 per cent) over a period of 50 years, a little over 1 per
cent per annum. The 1961 census recoreded 94 million, an addition of
18 million (24 per cent) over a decade (30). In View of probable under—
enumeration, the Planning Commission of Pakistan estimated the 1961
population at about 102 million, with an estimated growth of 115 million
by 1965 (32).

The population figures are further confounded in the absence of
even a crudely acceptable registration of vital events. In 1962, a
Population Growth Estimation Project (PGE) was established to derive,
from.a national sample, the estimates of vital rates using simultaneous

registration and quarterly surveys. By using the Chandra-Deming formula

for adjusting unreported events, the Crude Birth Rate (CBR) for 1963 was

5
estimated.at 54 and the Crude Death Rate (CDR) 19, indicating a 3.5 per
cent Rate of Natural Growth (NGR) annually. The Family Planning Pro-
gramu framed befOre this report, is based on a CBR of 50, CDR of 20
and NGR of 3 per cent (31).

The U.S. Bureau of Census constructed a population projection
for Pakistan under various realistic assumptions. If the Family Plan-
ning Program succeeds in aChieving its target of a 20 per cent decline
in birth rate during the five—year period, the population may be limited
to 210 million in 1985; if the program fails, it may increase to 240
million. The Family Planning Program may thus effect a reduction of 30
million in 20 years (50).

Demographic Characteristics of the country lend greater urgency
to the programn The country has about 45 per cent of its population
under 15 years of age (30), only 19 per cent of the population over
five years of age was literate in 1961 (1), and the rural population
constituted 85 per cent of the total population, even though the urban
population increased by 52 per cent during the decade (2).

SuCh conditions impose a heavy burden on national resources fOr
economic growth, since the country has to earmark greater sums of money
for improvement of health, education, social welfare, urban development
and resettlement, and public works (58). The most pressing argument
for population control fOr the policy makers is the chronic shortage
of food, the country being an importer of grains worth about 200
million dollars annually. Hence a.very high priority has been given
‘to the Family Planning Program, the cause being championed by the

president himself (2).

Early Family Planning Programs

 

The earliest record of organized effort in family planning dates
back to 1953 when the Family Planning Association was formed with a
modest grant fromlthe government. Later, several branches were estab-
lished with the provision for clinical activities supported by educa-
tion and publicity on a limited scale. During the first Five-Year Plan
(1955-60), a small sum.of $100,000 was allocated for family planning
through grants to voluntary agencies and to the Village AID (come
munity development) organization (2).

Substantive steps were taken by the government after the Revolu-
tionary Regime (initially Martial.law'Administration) assumed power.
Eight million dollars were allocated to family planning as a component
of general health services under the second Five-Year Plan (1960-65)
for training motivational personnel, for providing teChnical services
and contraceptive supplies through.hospital and dispensaries, and for
promotion of researCh projects.

The program failed to achieve its target, even in terms of ex-
penditure. It led, however, to the establishment of researCh and ad—
ministrative units and some pilot projects, and provided researCh
_ findings that could lay the guidelines in formulating the new scheme to

be launChed as a part of the third plan (31).

The New Scheme

 

The new sCheme incorporated provisions WhiCh could remedy the

shortcomings of the previous sChemes. Stress was laid on the motivational

and communication aspects particularly.

7

Administrative Organization: .A salient feature of the scheme

 

is the establishment of an autonomous organization for flexibility and
quick decisions not permissible under rigid government regulations;
yet the organization retained the basic character of governmental
activities.

Policy decisions come from the Central Family Planning Council
(Chart 1), Chaired by the Minister of Health, with membership composed
of the top executives of allied departments, the executive authority
vested in the Family Planning Commissioner Who is the secretary of the
council and of the family planning division. Besides units for co-
ordination, planning and training, evaluation and administrative super—
vision, the council has attaChed to it the National Research Institute
of Family Planning (NRIFP) at Karachi, responsible fOr conducting re—
search on medical, communication, demographic, and social psychological
aspects of the program with a View to making modifications in the
scheme when necessary.

The execution of the program is primarily the responsibility of
the Provincial Family Planning Boards constituted on the lines of the
Council. The program.is operated by District Family Planning Boards
where the administrative head of the district, the Deputy Commissioner,
is the Chairman, and the Publicity—cumrExecutive Officer (DPCEO) is
the secretary.

Family Planning Officers, one fOr eaCh 30,000 people are ap—
pointed to organize the motivational program in their areas under the
direction of the DPCEO. He supervises the work of the grass roots

level workers, gives them.training,.makes arrangement for supplies and

ADMINISTRATIVE AUTHORITY _

Family Planning
Commissioner
(Secretary,
F. P. Wing)

Administrator
Framily Planning
(Secretary)

 

V
Deputy Commissioner
(Chairman)
District Publicity—
cumeExecutive
Officer
(Secretary)

v
Family Planning Officer

Union Coincil Secretary

 

 

8

GOVERNING BODY _

 

 

Central
Family Planning
Council

 

 

 

 

Provincial
Family Planning
Board

 

 

V

 

 

District
Family Planning
Board

 

 

 

 

Tehsil Council

 

 

v

 

 

Union Council

 

 

V
Family Planning Organizgrs (Dais) Village

 

TECHNICAL

Central Health
Minister
(Chairman)

Director General
of Health
(Member)

Provincial Health
Minister
(Chairman)

Provincial Health
Secretary
(Vice-Chairman)

District Health
Officer
(rural)

District Civil
Surgeon
(urban)
(Members)

Family Planning
Doctors

Source: Adapted from FAMILY PLANNING SCHEME FOR PAKISTAN DURING

THE THIRD FIVEeYEAR PLAN (1965-70) PERIOD)
Govt. of Pakistan, 1965.

Chart 1. Pakistan Family Planning Organizational Chart

9

services, and maintains records. He is expected to enlist the support
of the organized groups. A.functionary of the local government, the
Union Council Secretary, is expected to establish.contact with local
pressure groups and opinion leaders. The most striking feature of the
program.is the employment of Family Planning Organizers, mostly the
Village midwives (Dais) , who carry the greatest burden for informing
and.motivating village women through home visits and provide feedback
to the programu One organizer is appointed for each one or two thou-
sand persons. Besides the above mentioned functionaries, thousands of
distribution agents have been appointed on a commission basis for the

sale of contraceptives.

Ctmmmnication Aspect: The role of communication in the success

 

of the programlhas been recognized through the hiring of motivational
personnel, through pre-service training and refresher courses, and
through laying specific guidelines for field workers (31). The phi-
losophy behind the communication strategy is the.use of a.multi-channel
approaCh. The sCheme enunciates that the methodology employed will be:

1. motivation through individual contact

2. motivation by group discussions at the village level

3. motivation by mass media of publicity

4. motivation by monetary incentives

5. motivation by bringing supplies and services to the

doorsteps of the people. (31)
Techniques and principles have been listed in the scheme.

Table 1 shows the itemized provisions for'publicity materials to be

10

Table 1. Estimated expenditure on publicity of family planning
(in thousands of'rupees* over a 5—year period). '

 

 

 

Type of Expenditure East Pakistan West Pakistan Total
Billboards 1,105.0 1,285.0 2,390.0
Pamphlets 1,090.0 1,285.0 2,375.0
Flash Cards for Dais 1,215.0 810.0 2,025.0
Bus Panels 810.0 810.0 1,620.0
Posters 730.0 740.0 1,470.0
Press Publicity 720.0 740.0 1,460.0
Films 405.0 405.0 810.0
MatCh Box Advertisement 36.3 36.3 72.6
Cinema Slides 24.2 24.2 48.4

Total 6,135.5 6,135.5 12,271.0

Salary to Dais
(Family Planning
Organizers) 21,870 14,580 36,450

 

Source: EAMILY PLANNING SCHEME FOR PAKISTAN DURING THE THIRD FIVE-
YEAR PLAN (1965—70), Govt. of Pakistan, Ministry of Health
and Social Welfare, Rawalpindi, 1965.

*A rupee is officially equivalent to 21 cents.

used during the five—year period.

Contraceptives: Berelson (7) considers contraceptives as one of

 

the three ingredients determining the success of the program of family
planning, the other two being administrative efficiency and communication.

In Pakistan, a "cafeteria" system is followed, where a client is guided

11
in selecting the contraceptive teChnique best suited to his needs.
Clinical contraceptives--Intra-uterine Contraceptive Devices (IUD),
mainly the Lippes Loop, tubeligation (female sterilization), and vasec-
tomy (male sterilization)-—are offered free of cost. Additional incen—
tives fOr acceptance of clinical contraceptives include small payments
for sterlization, post—service medical care, follow—up visits, and free
medicines.

If the couple do not desire any of the clinical methods, they
are supplied, at a nominal price, conventional contraceptives--condoms,
f0am.tab1ets, liqui' foamu diaphragm, and jelly. In View of the high
cost, the 1aCk of adequate researCh information on acceptance and con—
tinued use, and the scarcity of qualified doctors to supervise hormone
therapy, oral pills are not promoted in the programn To those who can

afford them, pills of several brands are available in urban areas.

CHAPTER II

THE THEORETICAL FRAMEWORK OF THE STUDY.

This study uses the conceptual framework first established in
the study of the diffusion of innovations in rural sociology in the
U.S.Am The theory has been extended to the process of modernization

in traditional and transitional societies (52).

The Process of Diffusion

 

Diffusion research has recently made an attempt to develop
"middle range" analyses between "raw empiricism" and "grand theory"
(40). This approaCh essentially consists of accumulating and synthe—
sizing a series of middle range generalizations from.empirical findings
on the diffusion of innovations. According to DeFleur (11) the studies
of diffusions of innovations, including the part played by mass come
munication, promise to provide an empirical and quantitative basis for
developing more rigorous approaches to theories of social Change.

‘f An "innovation," according to Rogers (35), is an idea perceived
as new. "Diffusion" is the process by whiCh innovations are communica-
ted by certain Channels to the members of a social system, Katz (19)
characterized the process of diffusion as (1) acceptance (2) over time
(3) of a specific items—an idea or practice (4) by individuals or
_groups or other adopting units (5) linked to specific Channels of come
munication (6) to a social structure, and (7) to a given system of

12

13

values or culture.

Stages of Adoption

 

In the acceptance of a new idea, invention, or practice, an
individual undergoes specified stages of decision making. Several re-
searChers (5) empirically confirmed the existence of identifiable stages
though they differed in the number and sequence. In agricultural prac-
tices they have been identified (27, 35) as (1) awareness (2) interest
(3) evaluation (4) trial and (5) adoption. Wilkening (55) accepts only
three stages, awareness, decision-making, and adoption. In family plan-
ning practice, Bogue proposed fOur stages: (1) awareness and interest;
(2) information gathering, evaluation and decision to try; (3) imple—
mentation; and (4) adoption and continued use. Realizing the weaknesses
of early conceptualizations of the sequence of stages, Rogers and
Shoemaker (40) suggested a set of f0ur functions or sub—processes to
the innovation decision. They name them as (1) knowledge; (2) persuasion;
(3)_decision and (4) confirmation.

Studies have been conducted, in recent years, to investigate come
munication strategies successful at various stages of the decision
process for the adopting unit as well as the community. Ingafimore
modernized system, innovations find quicker acceptance by the individ—

uals than in those systems where the community is more traditional (40).

 

Whereas a.program of infOrmation (knowledge) could be sufficient in the
early stages of the introduction to create awareness of and interest in

the innovation, persuasive communication is necessary during decision

and.implementation. Dubey (l2) fOund confirmation of the relevance of

14
stages in the adoption of IUD and also found corroborative evidence of

crmmunication variability at different stages.

Categories of.Adopters

 

The consideration of time is central in the diffusion process.
Not only do psychological processes involved in the passage from one
stage to another by the adopting unit involve an element of time, but
time is also relevant in terms of the rate of spread of the innovation
in a social system. .A.genera1 finding of past research is that the
adoption of an innovation f0110ws a bell-shaped curve when plotted over
time, and approaches normality. This finding has led to the development
of categories of adopters falling in different segments of the normal
curve. Themcriterion for innovativeness is the degree to whiCh an in-
dividual is relatively earlier to adopt new ideas than otherfmembers of
the social.system. The continuum.of innovativeness has been divided
into five categories: Innovator, Early Adopter, EarlyflMajority, Late
Majority, and laggard, on the basis of mean and standard deviation of

the time of adoption. (35)

Characteristics of Innovativeness

 

Infireviewing the studies on diffusion of innovations, Rogers
(35, 36) arrived at the generalization that earlier adOpters are younger
in age, have higher social status, more favorable financial position,
more specialized operations, and a different type of mental ability from.
late adopters. Earlier adopters also utilize infOrmation sources that
are more impersonal and cosmopolite. It is in the early adopting group

that opinion leadership, so crucial in the diffusion process is f0und.

15
These generalizations, mainly derived.frcm1research studies of the

diffusion of agricultural practices, have found general confirmation

in other fields (38, 39).

Opinion Leadership

 

Studies of personal influence have conclusively demonstrated the
limitations of mass media in changing attitudes and behaviors of people
(25, 38). Previously the potentiality of mass communication in deter—
mining response to their appeal was highly rated (19). Studies of
social and political behaviors conducted by Lazarsfeld and his asso-
ciates (21) found that ideas often flow from.radio and print to opinion
leaders and from.there to less active sections of the populations. This
is the well-known "TWO-Step Flow of Communication" hypothesis (18).
Opinion leaders are individuals who are influential in approving or
disapproving new ideas.

A.reformu1ation of the "two—step flow" hypothesis (35) suggests
thatinnovations spread from sources of new ideas via.re1evant Channels
to opinion leaders and from.them.by way of personal communication Chan—
nels to the followers. It is likely that the first step from source to
Cpinion leaders is mainly the transfer of information, While the second
step, from.0pinion leader to the fOllowers, may also involve the spread
of influence.

Recent_researCh indicates (51) that a three step or~mu1tiple flow
of communication may exist under certain conditions. In that Case,

opinion leaders influence other opinion leaders and they in turn influ—

ence their followers.- This Chain of personal influence causes a rapid

16
adoption of innovations after the practice is accepted by the opinion
leaders.

The role of opinion leaders in exerting personal influence is
hardly in dispute. But the issue regarding whether they are monomer—
phic (one opinion leader fOr one practice) or polymorphic ( an opinion
leader influencing adoption of several practices) is not settled. It
has been observed that opinion leaders are not significantly different
fromltheir followers in respect to socioeconomic characteristics; that
is, a condition of homophily exists between the leader and the follower
(55).

The concept of opinion leader is highly relevant to family plan-
ning innovations, where people prefer to talk to their close and inti-
mate friends rather than the change agent, who is an outsider to the
social system. If the opinion leader can be identified, the rate of
adoption can be accelerated by focussing the attempt for conversion on
the influential.

Several techniques for identifying opinion leaders are described.
Most commonly people are asked to identify their sociometric Choice
for their most frequently consulted source of infbrmation. The repu-
tational method, where selected persons are asked to identify the
opinion leaders, is also used. The simplest technique is to ask the
respondent himself'whether~he was sought out for advice and/or whether
he sought others for advice. None of these techniques have proven
their’validity in identifying the persons Who are really influential
and exert personal influence upon a certain number of people in the

specific situation.

17

Specific Item

 

Rogers (40) has enumerated five Characteristics of an innovation
which facilitate the diffusion of an item. They are: complexity, rela-
tive advantage, compatability, divisibility, and.communicability.
Niehoff (29) cited several cases where Characteristics played a sig—
nificant role in their acceptance in the social system.

In family planning, it is not only the general concern about
birth control that is diffused, but the specific contraceptives whiCh
have their own advantages and limitations and may determine the success
of the program. Berelson (7) attributes paramount importance to the
method of contraception in the success of a family planning program.
Convenience, safety, Cheapness, reversibility (non-permanence), dur—
ability and freedom.from discomfort and side—effects seem to be some of
the Characteristics which are important in making family planning inno-
vations attractive (24).

Family planning researCh is concentrating on specific single
items or a few methods fOr investigation. we can find in family plan-
ning literature studies on IUD, sterilization, conventional contracep-
tives like condom and f0am.tab1ets, pills, etc. The Characteristics of
the acceptors have been found to differ from method to method. Ghani
(14), in a small pilot study in KaraChi, found that more educated,
younger respondents who exercised more Choice, accepted condoms more
often than IUD or anm.tab1ets, which were more likely to be popular
with older and lower status women. In a rural setting, it was found
that women first selected foam tablets, then changed to condoms, and

later adopted IUD and probably would accept sterilization at a later

18

period of their reproductive life (1, 22).

Channel

Concern with the selection of communication channels has drawn
attention of the investigators in contemporary studies of diffusion.
Katz (20) directed his criticism at the neglect of looking at the inter-
personal relationships in research in the field of mass communication,
rural sociology, and marketing. Rogers (40) and waisanen (51) identify
the possibility of a multi-step flow of communication in certain types
of situations.

In synthesizing the findings on the effects of'mass communication,
Klapper (24) asserts that mass communication is more likely to reinforce
existing opinions than to Change them and more likely to produce modi-
fication (change in intensity) than conversion (change in direction).
Rogers (35) draws a distinction between cosmopolite and localite sources
of communication in respect to their impact. Interpersonal Channels,
according to his findings, provide ftm*maximum.interaction, a large
amount of feedback, which makes attitude Change possible, while, on the
other hand, mass media Channels provide a potent means of rapidly spread-
ing information with high accuracy, even though the direction of message
flow is one way. Mass media communication is more important in changing
cognition While interpersonal communication is more likely to cause
attitude change (37).

Seldomlhas the persuasive effect of various channels been in-
\nestigated in family planning researCh. Mbst studies on contraceptive

Exractices seek recall from the respondents of the source of information

, 19
or influence . The generalized communication model described by Berlo
(8) , which analyzes the process involving Source, Message, Channel,
and Receiver (better known as SMCR Model), might be interpreted differ-
ently under such conditions, as questions regarding the source are es-
sentially about the channel.

There are hardly any family planning studies where a distinction
is clearly made between the source of information and the channels
through which it has been received. Studies conducted in different
countries and by different persons frequently report the responses of
the sample about the initial awareness of the innovation.

Misra\ 4218) found that his male respondents had maximum exposure
and thoroughness in learning a family planning message through his wife,
a friend, and written communication, in that order. From an analysis
of data collected in India about diffusion of innovation, Kivlin (23):}
found that friends , followed by change agents , were best sources of
knowledge as well as practice of birth control methods . In Dubey ' 3
study (12:)X the source of information varied from stage to stage. Mass
communication was found, in the Hooghly study (4): to be effective in
increasing the awareness of family planning. Similarly, in the Songdong
Gu study in Korea (422; )1, " <women coming to health clinics attributed their
Visit to a program of mass media campaign. All these studies show some
influence of mass communication on awareness and interest in family
planning.

But in most of the studies, interpersonal channels were found
to be most influential as sources of knowledge . In a study in Korea

( 56), in which respondents were asked to name the source of their

20
knowledge, neighbors were mentioned most frequently. Next in order of
frequency were health centers, radios , village chiefs, relatives, and
lastly newspapers. In the same country, a study designed to investi-
_ gate the effect of Channels on the acceptance of family planning re-
proted (45) that home visits were most effective, followed by group
meetings, mailing, and media alone. The rates of acceptance under each
of the aforementioned experimental conditions were between 10 and 20
per cent.

Wherever users of specific methods were identified as a separate
category of influentials, they have been.most:often.mentioned by the
clients. In Taiwan, (17) satisfied users who were neighbors and friends
of IUD clients were reported as most influential, while those neighbors
and friends who did not wear an IUD were near the bottom of the list of
influentials. Similarly in Thailand (41), IUD users and friends were
most often mentioned as the persons who motivated the visitor to the
clinics.

In the national IUD study in Pakistan conducted before the ims
plementation of the new family planning sCheme, 100p users were most
frequently mentioned as the source of information (3). In this and in
another study in a hospital environment in Pakistan, doctors were most
often mentioned as the source of infOrmation and as the person whose
advice would be taken beftme adoption of family planning (59).

In reviewing the findings of communication research in family
planning, Berelson says:

Thus far, information on family planning has apparently

been more effective than education, person-to—person
contact more effective than mass media in implementation,

21

and informal diffusion through trusted associates,

supplementary in an important degree to the formal

program. (6, p. 13)

Later on he says:

Fremlwhat we know, in other circumstances, the per—

suasive effect of the mass media are likely to be

middle and long run than immediate. Media can be

importantly influential in determining the climate

of discussion about family planning even when they

do not directly convert. (6, p. 15)

Rogers (37) upholds mass media as a catalytic agent in the mod—
ernization process in line with Lerner's model of modernization (26).
Rogers and Bettinghaus (39), while comparing the studies on agricul—
tural innovations and family planning innovation, decry the neglect of
attitudinal, social relationship variables in family planning researCh.
Specific variables which Should receive the focus of investigation,
according to their recommendations, include knowledge level, attitude
towards innovations , opinion leadership ,. group participat ion , cosmo-
politeness, mass media exposure, interpersonal communication, and
intensity of change agent contact.

There is a growing realization of the significance of commun-
ication strategy in family planning programs. The diffusion model
should be of special significance to administrators and promoters of

programs who seek to introduce new ideas in order to aChieve definite

. @2112).

‘. -_— ._._—_ h

CHAPTER III

THE SAMPLE

Background of the Study

 

The communication strategies of the family planning program.of
Pakistan, under the new family planning scheme, incorporated the theo-
retical assumptions and results of attitude surveys and pilot action
projects (1, 21, 56) and also the recommendations of the consultants.
The theories and the recommendations have generally been derived from
western experiences, and therefbre might not hold true in the widely
varying cultural conditions of Pakistan. Continual researCh and eval—
uation are designed to investigate whether1the assumptions hold true.
The National ResearCh Institute of Family Planning was established
with a mandate to conduct empirical researCh and to help in the formu-
lation and the modification of the executive policies on the basis of
the findings.

.A study was designed to assess the success of the communicationr’
programlpursued for about a year. It was designed in early 1967 when
the programlhad been in Operation in 25 districts for more than a year.
These districts lie in four regions of West Pakistan having at least
three sub-cultural and linguistic groups. The present investigation,
as part of the larger study, is an attempt to explore the applicability
(of the diffusion mode1.in a Pakistani setting and in a specific practice

22

723
(family planning). Diffusion is essentially a communication problem
and, as such, this study can provide a fruitful exercise in the applica-

tion of the relevant framework.

Sampling Procedure

 

A.stratified sample of seven districts was drawn to achieve lin-
_ guistic representation. Strata.were fOrmed on the basis of dialects
and languages spoken in the provinces. Administrative and research
problems, however, necessitated the curtailment of the sample to six
districts. Among the problems fOrcing this decision.was the delay in
starting the project and hence prolonging the period of data collection
beyond the estimated time, so that personnel became unavailable. Since
no purposive selective processes were involved in the sample, it is
assumed that the findings of the study are not greatly biased.

For each district in the sample, fOur areas under the jurisdic-
tion of the Family Planning Officers were randomly selected, three rural
and one including an urban locality. Four units (villages in rural
areas and mohallas in urban localities) were drawn at random.from the
lists given in the District Census Reports 1961. .A sCheme for identi-
fication of the households fer random selection was designed. Five
households were sampled from.eaCh of the sampling units. The main bread-
winner of the household was to be interviewed if he was married and not
over sixty years of age; we assume that his wife would be in the Child-
bearing age. When the main breadewinner did not belong in this cate-
lgory, the next male in the household was to be interviewed. Certain

adjustments were made to obtain a sample of 500 males from.the six

24
districts with some considerations for the population of the districts.
No substitution of households was permitted. Data collected from 487

cases were analyzed fOr this report.

Interview Schedule

 

An interview sChedule was developed to seek infbrmation about
the demographic characteristics of the respondents , their exposure to
mass media of communication and to the Channels of communication employed
in spreading information about family planning program, the knowledge
of, Opinion about, and responses to family planning infOrmation sources.
Items were included about eaCh of the important Channels (a translated
schedule is given in Appendix B). An attempt was made to precode items
where suitable. However, where appropriate, free responses were also
included.

The instrument was pretested on a.sma11 sample of respondents
who came from.different regions and possessed varying Characteristics
but were living in KaraChi. The questionnaire was printed in.Urdu, the
official and the main language of the province. To facilitate inter-
viewing in the local language, the schedule was translated in three
additional languages: Sindhi, Punjabi, and Pushto. The responses were
recoreded in Urdu for the convenience of coding.

Three interviewers, eaCh a college graduate belonging to one of
the three linguistic regions, were selected after an interview. They
‘were trained for a.week in the technique of'interviewing other tOpics
.related to the project. They moved from.one Union Council to anther

Jindividually on a scheduled program.drawn up in consultation with the

‘25

DPCEO (officer in charge of the district).

Data Collection

 

Interviewing was done from April 1967 to July 1967 as the inter-
viewer~had to move from one place to another and the field work could
not start simultaneously in all the regions. It was the non-availability
of one of the interviewers beyond this period whiCh fOrced the curtail-
ment of the sample. Completed schedules were sent to the NRIFP at
KaraChi where necessary editing and coding was done by the regular emr
ployees. A coding design was prepared by the principal investigators
including construction of an educational and occupational scale, as no

standard scale existed for the measure of social status in Pakistan.

Characteristics of the Sample

 

Table 2 describes the main features of the sample. Of the 487
cases 71 per cent came from rural areas, 4 per cent from.eemieurban,
and 25 per cent from.urban localities. The mean age of the respondents
was 37 years with a standard deviation of 11 years. The mean number of
living Children was 3. On an eight-point occupational scale the mean
was 4 (farmer cultivating 5 acres of land). TWenty—nine per cent said
they had some supplementary source of income. On a seven—point scale
designed to rate education and literacy, the mean education of the hus-
bands was 3.4 (part elementary sChool) with standard.deviation of 2.3,
and the mean education of the wives was 1.7 (literate no sChooling)
vith.standard.deviation of 1.5. But 77 per cent of the wives and 39
:per'cent of the husbands were illiterate. Fifteen per cent of husbands

(Claimed to be members of some formal organization, and 74 per cent were

26

Table 2. General characteristics of the sample.

 

 

Category of Standard
Characteristic Response Per cent Mean Deviation
Rural 71.3
Residence Semi urban 4.2
Urban 24.5
Age Years since
born 3 37.1 11.3
Parity Number of
Children
living 3.0 2.2
Occupation Kind of work 4.1* 1.7
Other sources Any other
of Income occupation 29.2
Education of
Wife Grades completed 1.7** 1.5
Respondent's
Education Grades completed , 3.4*** 2.3
Organizational Appointed to
Membership local body 15.2
Headship of
House Himself as the head 74.1

 

* Equals a little higher than cultivation of fifteen acres of land.

** Code 2 is literate but no sChooling, 77 per cent were illiterates.
*** Code 3 is part primary (elementary); 38.6 per cent were illiterate
heads of their households. Where the husbands were not the head, the
occupational status of the head was a little lower on the average. In
the absence of a valid and standard occupational scale and in view of

the predominance of farmers in the sample, the scale used in this an-

alysis can not be defended.

27
In view of our knowledge of the country, the sample does not
appear to be greatly biased, though there seems to be a slight tendency
for the selection of the higher status persons to be included in the
sample. This should not present a serious flaw, in View of the Objec-

tives of the study.

Media Exposure

 

Exposure to mass crmmunication, in underdeveloped societies in
_ general and the rural pOpulation in.particular, is limited due to 11—
literacy and the availability of electricity, resulting in limited ac-
cessibility to media like newspapers, television, cinema, and radio.
Only recently, transistor radios, still beyond the means of a common
man, have been made available in the market.

Thirty—nine per cent of the respondents claimed they owned a
radio, although some of the sets were not working at the time. For
those not having a.working set, 61 per cent mentioned having access to
a public place fOr radio listening, the remaining 39 per cent of non-
owners (which constituted 25 per cent of the total sample) had no ac-
cess to a.radio set.

Fifteen per cent mentioned subscribing to a newspaper, not neces-
sarily a daily or even a regional weekly. An additional 34 per cent
could read or listen to a newspaper at some other place in the locality.
Thus, 51 per cent were without any newspaper exposure.

Only 40 per cent of the respondents had ever been to a movie.
Ninety—four per cent traveled by a public bus, which could roughly be

considered an indication of some degree of outside contact.

28
When viewed in the light of the fact that 25 per cent of the
respondents came from urban areas, where exposure to mass communication
is generally high, exposure of the rural population to mass media of
communication was extremely low. It was the realization of this in-
adequacy of mass media to saturate the population that accent was laid

on interpersonal communication in the family planning program of Pakistan.

Exposure to Family Planning Communication

 

Table 3 describes the exposure and the reaction of the inter-
viewees to family planning information. Respondents were asked if they
knew of any person in the locality who had adopted family planning.
Thirty per cent said they knew such persons. Since 24 per cent were
themselves practitioners, it seems that there is some communication be-
tween the practitioners. Possibly they knew each.other's practice.

Seventy-fbur per cent of the respondents were aware of persons
who urged others to adopt birth control. Of this number, 66 per cent
identified the person as an employee of the family planning organization,
17 per cent mentioned the secretary of the union council, and 25 per cent
the organizer. Only 3 per cent mentioned another villager as the moti—
vator. This indicates that the stage of voluntary activity has not yet
been reached. Since only 32 per cent admitted having met a worker, re-
spondents seem.to be only aware of the functionary, and persuasion has
not reaChed a high level of activity among the workers. Personal con-
tact is still sparse.

Asked to name the functionaries of the organization.working in

that area, 66 per cent could correctly name the FPO, and 63 per cent

29

Table 3. Communication behavior of the respondents

 

 

 

Media Category of Response Number Per Cent
Radio Owns a set 190 39.0
Available at other places 188 38.6
Listens at other places 107 22.0
Newspaper Subscribes 113 23.2
Available at other place 137 28.1
Cinema Goes to watch 194 39.8
Bus Travels by public bus 460 94.5

 

the organiser. The higher percentage of those who knew the FPO could
possibly be due to the sample being all males. Had a female sample been
included, it is likely that greater awareness could be fOund for the
organisers, Who contact wives. Forty-six per cent knew of a distribu-
tion agent, 33 per cent a clinic, and 15 per cent a doctor. Awareness

of the functionary seems to have reaChed a high level in the short period
of less than two years.

Ninety—feur per cent had heard about the family planning innova—
tion. Some 88.5 per cent of the sample had heard since the introduction
of the new sCheme. Only 5.5 per cent of the respondents knew about it
before that. Thirty—nine per cent had attended a.meeting Where family
planning was discussed, even though.holding group meetings is not yet
a Characteristic feature of the programs Mass meetings on family plan-

ning are becoming popular.

30
Utilization of mass media fer creating awareness can be gauged
fromlthe fact that 33 per cent of the respondents received some message
on the subject of family planning through radio, 32 per cent through
advertisements in the newspaper, 77 per cent through posters, 35 per
cent through pamphlets, 14 per cent through bus panels and 26 per cent

through advertisement on cinema slides.

Statistical.Analysis

 

The coded data were comprised of 155 variables. Basic statis—
tics with blanks on non-applicable items, were computed on the standard
computer program available in the Stat Series of the.MSU Agricultural
Experiment Station.* Severl items had dichotomous distribution and in
most of the items, the distribution was not normal. This could lead to
a lower coefficient of correlation than could be obtained by using non-
parametric statistics (34).

To explore the application of theory in more comprehensive con—
cepts, five communication indices, described in Appendix A, were construc-
ted by adding responses on several items related.tc a.certain.dimension
of the behavior. The scope of the study does not justify assignment of
weights to the items. Even in more sophisticated studies like that of
Lerner (26) or Waisanen (53), the researChers did not consider suCh a
step necessary.

For comparison between the Channels, percentages have been used

 

* . . . . .
Calculation of Basic Statistlcs when M1531ng Data 15 1nvolved

(The MDSTAT Routine), Stat Series Description No. 6, 1968.

31

to indicate the relative effectiveness.

Measures
The important independent variables were assigned numerical

values on the basis of the responses on items related to the measure.

a. Residence
Localities were classified as rural, semi-urban, and urban. The
respondents were coded as l, 2, and 3, respectively, based on the place

they lived at the time of interview.

13.533

The age in years stated by a respondent was assigned a two—
column field in analysis. The interviewers were instructed to help the
respondents in calculating their ages by mentioning significant and
historical events known in that area. The age distribution of the
sample shows misstatement of ages, largely through a preference to

certain digits (mostly 5 and 0 at upper ages).

c. Parity
Parity was measured by the number of Children born to the re-

spondent who were alive at the time of interview. This eliminated
the need of questioning about the number of marriages or recalling the
number of children born alive who had died. It was assumed that the
number so stated was more meaningful for family planning, and more ac-

curate, than recalling eaCh pregnancy.

d. Occupation

 

The respondents were asked to describe the job they were doing

32
and, in the case of farmers, to mention the number of acres of land they
farmed. Their statements were classified according to occupational
scales. Most commonly used occupational scales in U.S.A. were utilized,
with modifications as deemed necessary for the rural conditions of
Pakistan. Eight categories were thus fOImed: (0) unemployed, (1) un-
specified day worker, (2) unskilled laborers, (3) skilled workers, (4)
farmer cultivating less than 5 acres, (5) farmers cultivating 5 acres
or more, (6) small business and shopkeeper, (7) white-collar worker, (8)

professional, including teaCher.

e. Education

Each respondent was asked if he could read or write simple ma—
terial in any language. If the answer was in the affirmative, he was
asked to tell the grades in school he completed. .A seven-point scale
was designed as (1) illiterate, (2) literate no schooling, (3) part
elementary, (4) completed elementary sChool (grade V), (5) part secondary,

(6) completed secondary (7) college education.

f. Membership in Organization

 

To avoid undue inflation of data by including meaningless and
nonfunctioning organizations, only the membership in the local bodies,
or being recognized head of the village, including Lambadar (responsible
for rent collection designated by the government; a.high status position)

were considered positive responses.

pg. Head of the Household

 

In Pakistan, most often the oldest male member in the extended

33
family sharing a kitchen is considered the head of the household unit
and has more authority in family decisions. The subjects were asked

if they were the head.

h. Other Sources of Income

 

Respondents were asked if, besides the occupation stated earlier,

they had some additional source of income.

1. Media Exposure

 

Media exposure was a composite score formed by the addition of
scores on their duration of radio listening, frequency of newspaper

reading or listening, and frequency of watChing movies in the cinema.

j. Message Exposure

 

Message exposure was an index formed by adding the scores on
exposure to family planning messages through various channels of com-

munication.media, including interpersonal.

k. Knowledge of Information Sources

 

Score on this index consisted of the sum of all the persons and
places mentioned where information on family planning is available,

namely functionaries, agents, doctors and clinics.

1. Discussion of Message

 

The respondent was asked if he discussed family planning infor-
mation received through various channels with others. Aiiirmative re-

sponses were added to produce his score on this index.

mu Message Approval

 

For eaCh item in whiCh the respondent mentioned.having been

34
exposed to family planning information, he was asked to state his
opinion. These were summed to form the index.
A positive response on an item was given a score of l, a neg-
ative response was coded as zero. On opinion questions, neutral re-
sponses were scored as l, and favorable as 2. Details of the index

formation are given in Appendix A.

CHAPTER IV

FINDINGS I: CHARACTERISTICS OF RESPONDENTS AND
ADOPTION OF INNOVATION

Analyses of the data were designed to explore the application
of the diffusion of innovation model, WhiCh asserts that over time,

an innovation (family planning practice) will be adopted by the members

 

of_the social systems (married couples in Pakistan, represented in this

 

study by males up to the age of 60 years in west Pakistan) through the
communication channels (interpersonal visits with the functionaries of
the department or change agents, local leaders, neighbors and relations,
and messages through mass media—~radio, newspaper, billboards, posters,
pamphlets, bus panel, cinema slides and family planning films).

In this Chapter the data about the Characteristics of the re-
spondents will be used to explore whether the correlates of family plan—

ning agree with the relationships observed in other diffusion studies.

Characteristics of Respondent and Media Exposure

.As independent variables, demographic Characteristics are in-
variably studied by the social scientists not only from.theoretical
interest but also for the promotion of a program.of social Change. The
relationship between identifiable Characteristics and a predisposition
'to intended change serves as a guidepost to the Change agent in selecting
his target. The measures of demographic Characteristics, described in

the previous Chapter, were related to cognitive, motivational, and be—
35

36
havioral components as applied to family planning.
Table 4 describes the Pearson's product moment correlation (r)

between the measures of respondent characteristics and the indices of

Table 4. Correlation between characteristics and indices.

 

 

 

Media Message Knowledge Message Message
Variable Exposure Exposure of Source Approval Discussion

Urbanity .422*** .390*** .103* .402*** .320***
Age -.161*** -.l26** .045 -.070 —.072
Parity —.108** -.047 —.007 —.036 -.034
Occupation -.003 -.069 -.047 -.032 -.030
Education .641*** .676*** .299*** .672*** .520***
Wife's

Education .477*** .466*** .288*** .456*** .456***
Member

Organization .047 .169*** .045 .087 .106*
Head of

Household -.l20** —.040 .121** .004 -.048
Number of Cases 487 487 487 487 487

* Significant at .05 level for 485 degrees of freedom.

** Significant at .01 level fOr 485 degree of freedom.
*** Significant at .001 level fer 485 degree of freedom.
communication behavior. Media exposure (usually associated with moder-
nity) should be expected to be related to personality Characteristics
indicative of modernity. The correlations of urbanity, respondent's

education, and wife's education with media exposure were significantly

high, .422,.641, and .477, respectively. The nature of the components

37
of this index should guarantee the association. In west Pakistan where
newspapers, radio, and cinema are mostly available only in urban areas,
and the literate population can make use of them, urban literate per~
sons are more likely to be exposed to media.

Media exposure was not correlated.with occupation and membership
in organizations. Perhaps these measures were not valid indicators of
social status.

Age, parity, and headship of the household were significantly
but negatively correlated with media exposure; the r's were -.161, -.108,
and -.102, respectively. It seems that persons Who have lived longer in
the social systems when there was not much availability of electronic
and print media and when literacy was lower, did not feel inclined to
develop the new tastes and new habits of the younger generation. The
status hieraraChy might additionally keep them.away from.involvements
with the matters that are the center of interest of the newer'generation

and to whom.the.ma881nedia caters in selecting the coverage.

Characteristics of Respondents and Message Exposure

Since several items contributing to this index were contingent
1rpon.mass media exposure, it is expected that the correlates of message
«exposures should be about the same as media exposure. This held true.
Ilrbanity, husband's education, and wife's education were significantly
:related to message exposure, but generally to a lower degree than.with
1nedia.exposure.

Age was significantly but negatively related to message exposure

as media But parity and.headship of household were not significant

38
even though the direction of relationship remained the same.
Occupation was also not related. Membership in organizations
‘was significantly related to message exposure. Probably responsible
persons are more exposed to interpersonal communication on family plan-
ning, by virtue of their positions whiCh bring them.into contact with

workers.

Characteristics of Respondents and Knowledge of Infbrmation Sources

 

Knowledge of infOrmation sources was also significantly corre-
1ated.with urbanity, education of the respondent, and.his wife's edu-
cation, the correlation coefficients being .103, .288, and .299,
respectively, lower than the correlation of the variables exposure with
mass media. Headship of the household.was positively and significantly
related with knowledge of information sources. Probably his position
is that of the "gatekeeper."

Age, parity, occupation, and membership in organizations were
only negligibly correlated to knowledge of information sources. Heter-
.ogeneity of the sources of informations have probably led to individual
selection of the source suited to a person's situation rather than mul-

tiple—source selection.

Characteristics of Respondents and.Message Approval

The scores on this index came fromlthe approval of messages to
whiCh a.person was exposed. Only when a.person.was exposed.to family
planning message, was he asked to express his opinion on the message.
Urbanity, respondent's education and wife's education were significantly

correlated with the approval of family planning messages, the r's being

39
.402, .672, and .456, respectively.
.All other correlations were insignificant. Even if people do
not adopt a.practice, they do not seem.to show disapproval of the came
paign. Probably urban and educated peOple are in favor, and the older

and more traditional do not muCh care and remain neutral.

Characteristics of Respondents and Message Discussion

 

The scores on an index of message discussion were also signif-
icantly related to the same three variables, urbanity, respondent's
education, and.wife's education. The values of r's in this case were
.320, .520, and .456, respectively. At a lower level of statistical
significance was the association with.membership in organizations.

Age, parity, occupation, and headship of the household were all

insignificantly though negatively correlated.

Summary of Correlates of Communication Indices

 

Residence, education of the respondent, and wife's education
were significantly related with all five communication indices. Edu-
cated peOple living in urban areas are more likely to use mass media of
communication, they listen to the family planning message, are aware
where supplies and services and also advice on family planning can be
obtained, they are in favor of family planning, and discuss the matter
with others.

Occupation, generally considered the most reliable index of
social status, was not related to any of the indices. This might be
due to some flaw in the scale, or the preponderance of farmers in the

sample. Maybe occupation has no significance fOr family planning as it

40
represents several aspects of personality influenced by education, in-
come, heredity, and aspiration.

In some cases age, parity, and headship of the household were
negatively correlated with the communication indexes. But for know-
ledge of information sources the relationship was different. They were
aware of the sources in view of the relevance of the subject to them.
The head of the household in a status-conscious society must know what
is being discussed.

Membership in formal organizations has no consistent relationship.
Respondents apparently are users of media and talk with others, but are

not particularly interested in family planning matters.

Correlates of Adoption of Family Planning

 

In adoption of an innovation an individual undergoes a number of
stages. In this study three items were included to explore this aspect
of behavior. One was related to the time of hearing, another was con-
cerned with the intention to adopt, and the third was the use of contra—
ception. They purported to measure awareness and intention, decision-
making, and implementation. Innovativeness is measured by the earliness
of adoption in respect of these variables. In this section their asso-

ciation with the Characteristics of respondents will be discussed.

1. Characteristics of Early Awareness

 

ReSpondents who had heard about family planning were divided
into two groups: those having heard before the new scheme, and those
hearing after the new sCheme (after 1965). Table 5 shows the correlations

between demographic Characteristics and early awareness. Only two

41

Table 5. Correlations between characteristics of respondents and

 

 

 

innovativeness.
Early Early Early

Characteristics Hearing Intention Practice
Urbanity .004 .2409”? .131
Age .042 -.135 .003
Parity -.038 -.100 .020
Occupation -.018 —.008 -.045
Other Income .009 .180 .296
Education .211** .337** .197**
Education of

Wife .069 .396 .253**
MemberShip in

Organization .175 -.l2l —.087
Head of

Household .078 -.241 .156

Indices

Media Exposure .093 .478** .377**
Message Exposure .108 .205** .004
Knowledge of

Infbrmation

Sources .010 -.080 -.200**
Message Approval .074 .211 .085
Message Discussion .051 .198** .020

 

** Significant at

.05 level for 114 degrees of freedom.

_.42
variables, education and membership in the formal organizations, were
significantly correlated with the time of hearing, the value of r being
.211 and .175, respectively. There was no significant correlation with
any other variable, not even with urbanity and wife's education. It
seems that educated persons, and those holding some responsible position
knew of family planning before the new scheme was introduced. This
early awareness could be due to emphasis on conventional contraceptives
and their distribution through clinics and general hoSpitals. Among the
communication indices only message exposure was significantly related

to early awareness, the r being .108.

2. Characteristics of Early Intention

 

The respondents who practiced family planning were asked when
they first considered adoption of the practice. This response was coded
on a fiveapoint scale. Zero order correlations between the responses
about intention to adopt family planning and the demographic Character-
istics are shown in column 2, Table 5. Urbanity, education, wife's
education, and supplementary source of income were positively related
with intention at a statistically significant level, the coefficients
being .240, .337, .396, and .180, reSpectively. It may be recalled that
the same variables were associated.with media exposure and message ex—
posure.

Age (r = -.135), parity (r = -.100), membership in organization
(r = -.121), and headShip of the household were inversely but not sig—
nificantly related to earliness in intention to adopt family planning.

The younger and more educated considered practising family planning at

43
an early stage of the program.

Of the communication indices media exposure, message exposure,
message approval, and message discussion were significantly related to
earliness in intention, the correlations being .478, .205, .211, and
.198, respectively. There was no significant relation with knowledge
of sources. Apparently, change agents did not establish contact with
the elderly persons who were less likely to adopt family planning in

the early stages of the program.

3. Characteristics of Early.Adoption

 

More important than awareness and intention, for practical pur—
poses, is the practice of family planning. The statement about the
time when the respondent first used a birth control method was categor-
ized on innovativeness. wThis measure of innovativeness was correlated
with the Characteristics and the communication indices. The coefficients
are shown in column 3 of Table 5. Correlations with urbanity, respondent's
education, wife's education, other sources of income, and headship of
household were above .10. Since the degrees of freedom.in these cases
is only 114, only income and education were statistically significant.

Media exposure and knowledge of infOrmation sources were both
significantly correlated.with innovativeness; the other correlations
were not significant.

It seems that educated.persons with educated.wives and who are
betterboff financially are early in adoption of family planning. They
are the persons Who use mass media and know the sources of information

supplies and services. They were early in awareness, decision making,

44
and practice.

Even though highly relevant to older'persons and those with high
parity, family planning does not seem.to have its first impact on them.
The mobile and the educated who have been identified as more modern are
first to internalize the practice of birth control. Family planning,
therefore, seems to be an indicator of modernization. Those who are
more amenable to discarding traditional behavior are more likely to
adopt family planning.

However, as shown in Table 6, if we take into consideration only
the adoption of family planning innovations, regardless of the time of
first use, and compare adopters with non—adopters, parity becomes sig-
nificantly correlated with practice, the value of r in this case is .276.
But correlation with respondent's education, wife's education, and media
exposure become statistically insignificant.

It seems that after the more modern members of the community
accept the innovation, family planning, due to its relevance to the high
parity couples, is more acceptable to persons with a larger'number of
living Children. The new sCheme with its emphasis on clinical contra—
ceptives, intensive interpersonal.crmmunioation, and availability of
supplies and services cheaply and conveniently, has greater appeal for

such persons.

Selection of Contraceptive for Adoption

 

Problems associated.with the use of methods of contraception
are significant factors in the adoption and diffusion of family plan-

ning practices, due to socio—cultural as well as medical factors.

45

Table 6. Correlations between Characteristics and adoption behavior

 

 

f j

 

Characteristics Awareness Adoption
Urbanity .030 .071
Age .007 .003
Parity .068 .276**
Occupation -.018 -.045
Other Income .076 .073
Education .213** .154
Education of

Wife .116** .140
Membership in

Organization -.087 .011
Position in house .001 .058

Indices

Media Exposure .251** .152
Message Exposure .233** .308**
Knowledge of

Information

Sources .322** .275**
Message Approval .294** .279**
Message Discussion .195** .257**

 

** Significant at .05 level, for 114 degrees of freedom.

The nature of birth control devices set limitations on their acceptance.
In this study, those who said they were practising family plan-

ning were asked to mention the method used. Table 7 shows the correlates

46

Table 7. Correlation between respondent characteristics and method used.

 

 

 

Characteristic Condom Foam. IUD Sterilization Others
Urbanity .085 .028 —.165 .136 .196*
Age -.134 —.218 .103 .147 -.038
Parity -.057 -.039 .147 -.044 .114
Occupation —.032 —.059 —.102 —.l39 .125
Other Income .059 .057 —.194* .051 -.018
Education .006 -.017 —.273* -.079 .277*
Education of

Wife .110 .055 -.038 .154 .240*
Membership in

Organization .174 -.062 -.123 .042 -.058
Head of

Household .010 .007 .215* .048 -.258*

Indices

Media Exposure .064 .111 -.249* .019 .219*
Message Exposure .045 .103 -.201* -.086 .154
Knowledge of

InfOrmation

Sources .087 .132 -.055 —.211* -.108
Message Approval .039 .020 -.192* -.033 .089
.Message Discussion —.055 .080 -.105 -.044 .173

* Significant at .05 level for 114 degrees of freedom.

Of the adoption of selected methods. To avoid the numbersomeness of the
'table, the correlation with some of the variables mentioned in.the text

.is not shown in the table.

47

Use of condoms was related to membership in the organization and
to no other characteristics of the respondents. Neither was it related
to any of the communication indices. It was, however, related to indi—
vidual items of the communication indices. For example, although not
significantly correlated with the knowledge of information sources index,
it was significantly correlated (r = .345) with knowledge of the moti-
vator. Similarly, though there was no significant correlation with media
exposure, the use of condom as a contraceptive was significantly corre—
lated with use of newspaper (r = .191) and radio (r = .182).

Acceptance of IUD seem to show a different syndrome. It is
negatively but significantly correlated with media exposure (r = -.249),
with message exposure ( r = -.201) and message approval (r = -.l92).
Correlation with other communication indices was negative but not sig—
nificant. Status characteristics, education, occupation, membership in
the organization, and ownership of radio all had negative correlation.
But the correlation was significant only for education.

Foam.preparations were used by persons in the status categories.
Use of this birth control method was negatively but significantly related
to age (r = -.218), and positively but insignificantly related to media
exposure (.111), message exposure (.103), and knowledge of sources (.132).

The use of other'methods was significantly correlated with edu-
cation (r = .277), with wife's education (r = .240), knowledge of family
planning officer (r = .223), knowledge of doctor (r = .270). Of the
crmmunication indices, media exposure was correlated significantly with
the use of suCh methods (r = .219).

Apparently, younger and higher status people like to use condoms

48
and oral pills , which are safe and convenient methods without much side—
effects. But for lower status people higher parity older couples in
rural areas IUD offers greater promise. The rumors about the side-

effects of IUD may prevent higher status persons from using it.

CHAPTER V

FINDINGS II: RELATIVE EFFECTS OF CHANNELS

It was beyond the scope of the study to exercise control over
the content or the form.of the messages of family planning carried
through various channels of communication. For the purpose of this
study, it will be assumed that the best use of the Channels was made
and that the messages were comparable in broad outline. In view of the
limitations and the constraints of media use, percentages will be used
for comparisons. Hence comparisons will be made between the proportions
or percentage of persons exposed to family planning messages to those
who were exposed to the particular medium. Similarly those approving

or discussing the topic to those who were exposed to it will be compared.

Relative Exposure to Messages over Channels

 

Table 8 describes the differential use of various communication
channels. Figures in column 1 and 2 show the number and percent of the
sample Who were exposed to the medium. Thus 309 (64 per cent ) listen
to radio, 199 (41 per cent) read the newspaper or it was read to them,
460 (95 per cent) travel in a bus, and 194 (40 per cent) have seen cinema
films. .Aside from bus riding, whiCh is almost universally used as public
transport, radio seems to be most commonly available Channel as a.medium
of publicity. No measure could be obtained of the possibility of ex—
posure to other media used for spread of family planning message. For

example, it cannot be known how many persons could see the posters or
49

50

Table 8. Relative exposure to family planning messages through various

 

 

 

 

 

 

Channels.
Relative
Media Exposure Message Exposure Effectiveness
Channel N % N % % of Media
Exposure

Iladio 309 63.5 160 32.9 52.3
Newspaper 199 40.9

Articles*** 131 26.9 65.8

Advertising 158 32.4 79.4
Bus Panel 460 94.4 69 14.2 14.8
Cinema 194 39.8

Advertising 125 25.7 63.1

Slides 122 25.0 61.6

Films** 39 8.0 9.8
Poster 375 77.0
Pamphlet 169 34.7
Attending

Meeting 297 61.1
Contact with

Change Agent* 367 74.3 158 32.4 43.1

 

* Awareness of a person who induces people to adopt family planning.
** Does not necessarily mean that the films were watched in a cinema
*** CouIHUE: any informative material.
billboards displayed in market place, public buildings, highways, etc.

Not all persons with access to a communication medium would be

exposed to content related to family planning. Possibly, some areas did
not utilize a particular medium for program.pub1icity. There might, for
example, be districts whiCh did not put out any bus panels. Films have

not been exhibited in most of the areas, due to non—availability of audio-

51
visual vans. The number of respondents who said that they heard a
message on family planning over a channel can be viewed as a percentage
of the total sample, or the percentage of those exposed to the medium1
concerned.

Both frequencies and percentages are shown for each medium. In
Table 8 the largest percentage of the sample(77 per cent) had been ex—.
posed to posters (the local term includes billsboards in the category).
Next was the percentage of peOple who had attended a meeting where
family planning was the topic. The interview schedule did not allow
fOr probes, but judging from.the experiences of the program, it is not
likely that group discussions have become so widespread. Most probably
these meetings were mass gatherings where some officials or public repre-
sentatives made a plea fer the adoption of family planning. The presi-
dent of Pakistan has urged government officials to include the topic in
their public utterances. The smallest percentage of the sample (8 per
cent) saw a film on family planning. Radio, newspapers, advertisements,
and pamphlets reached about 30 per cent of the sample.

When measured as the proportion of those who had access to the
medium concerned, the adjusted percentage shifts in favor of the news-
paper, as 66 per cent of those using newspaper had heard or read family
planning content in them. .Advertisements in the newspaper reached 63
per cent of the readers. Cinema slides and cinema advertisements were
seen by 62 per cent and 63 per cent, respectively. Bus panels and
cinema films remain at the bottom of the list, since 15 per cent of the
travelers and 10 per cent of the cinema-goers were exposed to family

planning theme.

52
A tentative generalization is that posters and mass meetings
have been most instrumental in creating awareness. But fbr those who
have access to the electronic and print media, these channels have great

potentiality fcr creating awareness.

Media Overlap

 

The overlap between segments of the population exposed to dif-
ferent media should not be ignored. In Table 9, the zero order interb
correlations between exposure to various media are presented as indica-
tors of overlap.

Meeting with a family planning worker is negatively correlated
with listening to radio, seeing an advertisement in the cinema, and
watChing a slide on the screen. No other negative correlations were
found. These media are more common in urban areas, while contact with
the change agent is more characteristic of rural life. In general,
there is low correlation between interpersonal communication and the
mass media.

.A notable exception to the above finding is the correlation be-
tween seeing a pamphlet and attending meetings. The correlation co-
efficient in this case is .346. Probably the general practice of hand-
ing out pamphlets at meetings could account fer this correlation.

There is also the likelihood of the operation of selective factors as
the more educated and prominent memlers of the community receive pam-
phlets and attend meetings.

Correlations between the mass communication media were in the

neighborhood of .30, which is not very high. This low correlation in-

53

 

 

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sflm. mam. mmm. H::. was. mam. was. ems. Dam. saw. ssm. xmecH
madmooxm meow:
mmo. was. ass. wma. mNH. mad. mmfl. 03H. Hos. moo. seam .HH
Nos. Nmo. sow. New. Haw. mam. mam. ems. smm.- museum .oH
moo. mew. mew. saw. mas. mam. moH. NNN.- pcmemmaumw>e<.mamcao .m
mmfi. ass. :om. ass. HHH. mmo. mos. amass mam .m
mam. 0mm. mam. mom. mam. Hes. umaaaama .s
saw. ems. mam. aha. was. umpmom .s
was. som. are. ass. pamammfiunm>e< .m
mam. mos. sea. nmamamzmz .3
has. s:H.- enema .m
mow. magnum: .N
noum>apoz .H
as DH m m s s m a m N H mamacmeo

 

.maooomco_eonm whomooxo owommoa coospoo coapmHmomoonouoH .m manna

54

dicate selective factors. There could be a common factor contributing
to the variances in all the channels. An indication of this possibility
is the high correlation of all the mass media with pamphlet exposure,
and of the media exposure index as well (.658).

The two interpersonal channels, meeting the family planning
worker (motivator) and attending meetings, were not highly correlated
(.209). This seems to indicate that these meetings were not called by

the motivators.

Relative Approval of Messages Through Channels

 

In addition to the comparison among exposures, relative effec—
tiveness or potentiality can be judged from.the proportion of the audi—
ence who approve of the messages through different channels. This is
shown in Table 10 whiCh gives the percentages of persons who said they
were favorable, unfavorable to the message, or expressed no opinion. It
is somewhat observed that, as a.matter of courtesy, people do not express
unfavorable opinions to the interviewer if he belongs to the organizers.
Rather they take a neutral position even if they are mildly unfavorable.

Ninety percent of those attending meetings approved of the dis—
cussion. If we assume, as was discussed earlier, that these meetings
were not sponsored by the family planning organization, there is less
likelihood of selective attendance.

Approval of the content of the posters and the advertisements
were next in getting approval with 78 per cent and 72 per cent of those
seeing them. indicating approval. But when asked about psoters as a

medium of publicity, only 24 per cent approved and the rest took a

55

Table 10. Opinion of family planning messages heard through various
media Channels. '

 

 

 

Channel Number Favorable No Opinion Unfavorable
Radio 208 67.3% 32.7% -—%
Newspaper 199 58.3 39.7 2.0
Advertisement 164 72.0 28.0 --
Poster 375

Content 77.7 21.3 6.7

Method 23.6 72.4 4.0
Bus Panel 109 33.0 52.3 14.7
Slides 122 56.1 45.9 -—
Films 39 71.8 28.2 —-
Meetings 186 90 .9 9 . 1 --

 

neutral position. .Although only a small number (39) had seen film, 72
per cent approved it. least approved was the bus panel as only 36 per
cent of those Who saw one approved it.

A large percentage of favorable responses and very few firm dis-
approvals can be seen as a demonstration of generally favorable climate
of opinion existing in the country in regard to family planning

publicity.

Relative Persuasive Effect of Messages Through Channels
An itemlwas included to tap behavior subsequent to exposure. The

reliability of suCh responses cannot be judged. However, it does provide

56
a crude measure of the differences. Table 11 presents the stated re-
sponses of the people to the items. To facilitate visual comparison,
percentages of people are given by the type of action supposedly taken.
In most of the cases the action involved expressing interest or visiting
a functionary of family planning.

Least action was reported after~watChing a cinema slide. Only
two persons (1.6 per cent) mentioned some action; otherwise 98.4 per
cent were not influenced at all. Similarly about 90 per cent did not
take any action after exposure to poster. Most action was reported
after seeing an advertisement in newspaper, 22 per cent only expressed
interest, 30 per cent visited some functionary, and 2 per cent even
started the practice. Newspaper articles aroused interest in 42 per
cent and 5 per cent went beyond this stage. Meetings do not seem.to be
very effective in this respect, probably because family planning was in—
cidentally mentioned and not the theme of the meeting.

Without consideration of statistical significance, it can be
inferred that radio and newspaper are most likely to lead to some action
in comparison to other media. Posters, whiCh were so often mentioned
for exposure, do not lead to action. Bus panels and cinema slides also
seem to be less influential for action.

Interpersonal communication was not comparable to other channels
of communication in this respect, as the sChedule did not contain come
parable items. Meetings were not conducted specifically for the purpose
of discussing family planning, and individual contacts were not probed
about action and approval. The indirect evidence from opinion leader4

ship points out the importance of interpersonal contacts of a.multi-

57

 

 

.. u- .. o.sm a.ms was mcummmz

m.H m.H s.: m.oH m.Hm 4m mefisu

-- -- -- m. a.wm NNH mmeflam mamcmo

-- u- .. a.mfi m.mm mm Hmama mam

m. -1 H.N N.s 4.0m mam mmmmom

s.a -- a.mm H.NN m.s: mas mcmEmmflmmm>e<

m. m.: .. m.H: a.mm mas mmamamzmz

mm.m mm. mm.sa ms.NH mm.mm mHN enema

moflomsm OHEHU goaeogm pmeREH coaub< 02 no: HmSHmrU
emmnmmm empumm> emmflma> mmmmmmaxm

 

 

. 385850 995 wwwmmoa on. osdmomxo on. pcoooomodm coasoa. :3 manna

58

step nature.

Opinion Leadership,

 

Even though the sChedule composition precluded a firm finding
regarding the effect of interpersonal communication on the adoption of
family planning, analyses of certain items show the persuasive effect
of personal contact. The two-step flow of communication hypothesis
asserts that mass media messages pass through opinion leaders to fol-
lowers and have little direct persuasive effect. The role of opinion
leaders in persuasive communication is given high.consideration in dif-
fusion researCh.

There are several techniques that have been used to identify
opinion leaders. The scope of the present study permitted only self-
designation as a measure of opinion leadership. The subjects were simply
asked to mention if they were sought out for advice by some other members
of the social system. An affirmative answer designated the respondent
as opinion leader. They were also asked if they sought advice from
cthers; if so, they were considered followers for the purpose of the
analysis. The schedule did not include any probe items, or any other
device to check the reliability of their responses. It could not be
possible to ascertain the name or identity of the persons contacted.
Hence those who sought advice would be called followers, While those
respondents from Whom.opinion was sought will be labeled opinion leaders.

Of the 116 respondents Who were practising birth control, 50
(34 per cent) claimed to have been sought out fOr advice by others,

while only half the number, 25 (17 per cent)sought advice. Probably in

59
a traditional society where advice-giving is considered prestigious but
seeking it not a matter of pride, the fOrmer might be inflated and the
latter might be deflated.

As shown in Table 12 none of the demographic Characteristics were
significantly correlated with opinion leadership. Urbanity, education,
and wife's education were positively correlated, and age and occupation
were negatively correlated with opinion leadership with values of r
above .10, not statistically significant.

Three of the five communication indices, media exposure, message
exposure, and message discussion, were significantly correlated with
advice—giving. Information source awareness was not related to Opinion
leadership. Message approval was correlated but not significantly

(r = .161).

Followershipfi

 

Like the question on advice—giving, an advice—seeking item.was
also used in interviewing the practitioners only, even though the pos-
sibility of communication of opinions without leading to adoption cannot
be ruled out. However, in this study non-adopting leaders or followers
were neglected.

Education of the wife was the only characteristic haiving sig—
nificant correlation with fOllowership (r = .224). It could signify
that educated women urge their’husbands to consult others before adopting
the practice.

The same three indices whiCh were significantly correlated with

Opinion leadership (namely, media exposure, message exposure, and

60

Table 12. Correlates of opinion leadership and fOllowership.

 

 

 

Characteristics Opinion Leadership Followership
r r

Urbanity .152 .167
Age —.158 —.058
Occupation —.120 —.046
Education .105 .162
Education of

Wife .164 .224*

Indices

Media Exposure .227* .216*
Message Exposure .247* .228*
Knowledge of

Information

Sources —— ,15m
Message Approval .161 .184
Message Discussion .220* .220*

 

* Significant at .05 level fcr 114 degrees of freedom.

message discussion were significantly correlated with fOllowership as
well. The other two were correlated above .15, but did not attain a
level of statistical significance.

It seems difficult to identify a characteristic whiCh could dif-
ferentiate between the Opinion leaders and the fOllowers, at least so
far as the self-designated label is used in this study. Those who had
sought advice from others and whose wives are educated should be more

competent and hence sought after by others.

61

Advice Sources

 

Of the small number of persons who said they sought advice from.
others befOre the adoption of family planning, one sought advice from
a family planning organizer (Dai), one from.a doctor, three from.emr
ployees, three from some relatives, while 17 (65 per cent) referred to
some friends or neighbors. Even with such small numbers, this finding
concurs with other studies on diffusion of innovations, whiCh show
that people seek advice from their close confidees.

It seems safe to conclude from.this study that there are no
distinctive Characteristics of opinion leaders of family planning, come
pared with early fOllowers. However opinion seeking is from.close

confidees.

CHAPTER VI

SUMMARY.AND CONCLUSIONS

Summary

 

Studies on diffusion have demonstrated the need and importance
of the development of middle range theories as well as the value of
such theories for organizing a program of gradual and directed social
Change. The program.of family planning in Pakistan has been assigned
a very high priority among its development plans in recognition of the
role of the rate of population growth in economic development. The
programlunder the new sCheme was started in late 1965. After a year of
unplementation, a need was felt to assess the impact of communication
strategy. The present investigation is an outcome of suCh a venture by
the National Research Institute of Family Planning at KaraChi, under
the sponsorship of the Central Family Planning Council.

V//5 A stratified sample of 487 married males, up to the age of sixty
years from six of the program districts in fOur regions of west Pakistan,
was randomly drawn and interviewed by a team of specially recruited and
appropriately trained interviewers on a structured interview sChedule
in the middle of 1967. The sChedule included items on demographic
characteristics of the respondents, their communication behavior, their
exposure to family planning information, their awareness of the workers,

and awareness, intention, to adopt and adoption of family planning

62

63
practices. Some of the data from the study were used to explore the
application of the diffusion framework in the adoption of birth control
practices.

Statistical treatment of the data included calculation of per—
centages, means, standard deviations, and product—moment coefficients
of correlation. For composite scores on six variables, indices were
constructed by summating scores on individual items on particular as-
pects of behavior. The indices were exposure to mass media, exposure
to messages on family planning received through the channels, approval
of messages, and actions fOllowing exposure. Another index related to
knowledge of sources of infOrmation, supplies, and services.

Characteristics of the sample do not indicate any serious bias
in respect to education, occupation, social status, age, and parity,
although some contamination would normally be expected in suCh studies
where individuals are selected on a loosely defined criterion and a;
ppigpi_listing does not exist.

If the assumptions of randomness and representative character of
the sample are accepted, the data show a very high level of awareness
about family planning program in Pakistan. .About three-fOurths of the
respondents were aware of family planning workers. .Although the theme
of family planning has presumably been carried over the mass media only
for about a year, those who have had access to media show a substantial
amount of exposure to the subject.

Hearing about family planning was reported by about 95 per cent
of the respondents, overwhelmingly since the introduction of the new

scheme. About 25 per cent of the subjects were, at the time of the

64

interview, practising some method for pregnancy prevention. There

must be a certain percentage of the population who had tried and dis-
continued the practice for some personal reasons, Which would mean that
a substantial proportion of the population has already been induced to
use contraceptive methods. In VIGW'Of the target of inducing all fer-
tile couples to practice family planning during the fiveeyear period,
this aChievement is certainly flattering. The initial period in all
development programs is Characterized by slow acceptance. In terms of
the diffusion model, the period has been reached when the majority will
adopt, leading to acceleration of the acceptance rate.

Demographic characteristics associated.with.media exposure, inno—
vativeness, and opinion leadership were urbanity, education of the re—
spondents, wife's education, and to a lesser degree, membership in
ftmmal.organizations. The same characteristics have generally been rec—
‘ognized as indicators of modernity in other studies. Family planning,
therefore, can justifiably be considered as an index of modernization of
rural and less developed countries. All the indices constructed for the
purpose of this study were correlated with.urbanity, respondent's edu-
cation, and wife's education.

Age, parity, and occupation were either not significantly corre-
lated, or correlated negatively, with the communication indices as well
as with the cognitive, attitudinal, and action component of communication
and adoption behavior.

Early hearing of the innovation was related to education, and
membership in the organizations, urbanity, education, wife's education,

and supplementary sources of income were correlated with early intention

65

to practice as well as early use of contraceptives. Early practitioners
were exposed to mass media, but did not know the family planning workers;
probably the category did not exist at that time.

More persons designated themselves as opinion leaders whom others
consulted fOr advice, than the number who were labeled as followers and
sought others' advice prior to adoption. Both groups were similar in
demographic Characteristics; better education, educated wife and urban
residence. They were exposed to mass media, received family planning
messages through several Channels and talked about them.with others.

It was probably a two-way'commumication between them, within the existing
network of communication relationship. Advice was generally sought from
friends and neighbors rather than from relations or Change agents.

Mere than three-fOurths of the subjects had seen family planning
posters, and:more than sixty percent attended a.meeting where the:matter
was discussed, but most likely not under the sponsorship of the organi—
zation. Films were watched least, and bus panels were seen by a small
proportion of the sample. Those reporting meeting with a worker were
less likely to be exposed to mass media. Meet of the respondents either
approved of the family planning messages or remained neutral.

Action fOllowing exposure to messages was mostly confined to ex—
pression of interest and, to some extent, visiting the Change agent,
probably fOr additional information. Most influential in this regard
were newspapers, and least effective, cinema slides and posters. There
was an overlap in Channel exposure as judged by the intercorrelations,
pamphlet exposure seemed to be most commonly related to others.

Selection of specific methods of contraception.was related to

66
the characteristics of the individuals, even though statistical sig-
nificance was not attained due to the small number of practitioners.
Use of condoms was associated with.memberShip in organizations, know-
ledge of middle level worker, and exposure to the mass media. It was
negatively correlated with age and the education of wife.

Rural residents who were less educated, and lower in social sta-
tus and power were more likely to use IUD. They tend to be older, of
high parity, and likely the head of the household.

anm.preparations were used by comparatively younger1persons who
were exposed to mass media as well as interpersonal channels. The oral
pill, in the miscellaneous methods, seemed to be popular'with higher

status persons in urban.areas.

Limitations of the Study

 

The findings of the study are only tentative and indicative.

The limited time and resources at the disposal of the researCher did
not allow more intensive investigation or sophisticated analyses.

The linguistic diversities, the differential implementation of
the provisions of the program.by the districts, and the variations in
the interviewing conditions might have reflected regional bias whiCh
when merged together might have influenced the findings. Non-inclusion
of women in the sample due to problems of interviewing must place limi-
tation to the generality of the findings in view of the relevance of
family planning to females as well as males.

The scales were constructed without any valid data from.the

local areas and reflected western experiences with assumed similarity.

67
Indices were constructed on assumptions, and the validity or propriety
of summation and equal weights to individual items cannot be defended.
However, intercorrelations seem to justify the step on internal consis—
tency grounds.

Selfedesignated opinion leadership without probe can.bardly be
trusted in traditional societies. The scope of the study could not
permit deeper probe, nor was there any other way of seeking reliability
of the response.

Interpersonal communications could probably be more thoroughly
investigated, in the absence of which comparison of Channel effective—
ness has some shortcomings.

There were no measures of reliability. How much trust can be
placed in the interviewers in regard to their field.work, or the ac—
curacy of their’record of response after translation, or how accurate
the respondents were in making responses can hardly be judged. Absence
of any post survey reinterviewing gave no alternative but to accept
the recorded responses.

The study was designed fOr a different purpose and the use of
data.was Hade to fit another framework. This restricted the thorough-
ness of the investigation and broadened the scope of the study.
Generally the sampling frame of diffusion researCh is different from
the present one. How much the sample can be considered representative

of the conmunities is not known.

Recommendations fOr.Action

 

A.few suggestions fOr outlining a communication strategy stem—

ming from.the findings of this study can be made for the promoters of

6 8
family planning programs.

1. The awareness of the progran1amd.of the functionaries has
reaehed a satisfactory level.«-The focus of communication Should be
shifted from.oreation of awareness, legitimization, and creation of
favorable climate of opinion. An intensive program.of education and
motivation should be the avowed aim of communication.

2. Localite sources seem to have been overlooked.. Communica-
tion networks existing in the local communities should be utilized.
The aim should be to develop a state of infermal exChanges between the
villagers. Local leadership and voluntary groups Should share greater
responsibilities fOr giving popularity to the prognan.

3. It seems that the fUnctionaries of the department have not
established contacts with opinion leaders of the communities. They
should be able to identify them and use them to their'purpose. {p59

Hu‘iThose channels of communication Should be employed which
can give more intensive coverage. Radio and newspapers can be utilized
fer education, rather than display materials like posters, billboards,
and bus panels which have served their purpose. Of course, in new dis-
tricts there is a place for these media.

5.. There is a need of a greater amount of policy direction on
the use of communication channels. Experimentations Should be made in
combining, in a judicious way, various channels of interpersonal and
mass communication .

6. The middle segment of the population, i.e., the early and
late majority, should be the target of communication messages. Users

of contraceptives should be taken into confidence fer diffusion of the

69
practice.

7. For success of continued adoption and internalization of the
practice, a.mechanism.to provide reinforcement to the users should be
developed. Follow-ups and continuing contacts with the adopters are
necessary.

8. The functionaries involved should receive intensive training
and periodic refresher courses to outline and decide communication

strategies appropriate fer the communities and the period.

Needed Future ResearCh

 

1. Family planning research seems to be catching more and more
the fancy of the researChers belonging to a wide variety of traditions
and disciplines and having varied experiences. For a social scientist,
communication aspects of the program seem to offer a fertile ground.
This study points out the need of more intensive and fecussed investi-

. gations.

2. The data deserve more careful, sophisticated and.multivariate
analyses WhiCh could not be pursued due to lack of time and resources.

3. Confirmations of the findings should be obtained through.more
standardized research designs and sampling techniques. For this purpose,
the scope and the objectives could be limited but more focussed; inten-
sive interviewing with.measures to Check reliabilities are needed.

H. Greater care should be taken to investigate interpersonal
connunication, their nature, scope, and effectiveness. It should be
conducted in such a way as to find out the network of communications

existing in the local communities with a View to making use of them fer

70
diffusion of innovations.

5. Comparative studies of males and females (more appropriately,
a husband and wife pair) should be made. Besides providing a check for
reliability of responses, this can help in studying the communication
on family planning and decision making between husband and wife. Little
is known, though guesses are abundant, about such behavior in less
modernized societies.

6. Studies on opinion leaderShip, the concept of homophily in
opinion leadership, and the monomorphy of the leadership is needed. We
should attempt to develop a more valid measure of opinion leadership.

It is to be conclusively established under*what conditions the same
persons are opinion leaders on a wide variety of innovations and under
what conditions they are particularistic.

7. This study could not find a confirmation of correlates of
innovativeness feund in other studies. FUture studies can confirm the
universality of such generalizations over cultures and over innovations.

8. Comparative studies on communities at different stages of
modernization can be made to relate the system.variables to individual
variables.

9. The perception by the members of the social system about
family planning as an.idea and about individual contraceptives should
be studied in fUture studies as variables accelerating or retarding
the process of Change.

10. Studies could be conducted to seek the level of frank dis-
cussions about the subject of family planning in the communities as a

whole, between the sexes (not husband and wife), between the age—groups,

71
between different status persons, between relatives and friends, and with
the Change agent.

11. ResearCh on feedback and reinforcement for continued use,
for discontinuance, and continuation after a period of discontinuation,
is urgently needed. .A change agent is seldom found interested in main-
taining contacts after initial adoption.

12. The consequences of adoption of family planning by the
social system.and by the individuals need investigation. How the Change
in the reproductive behavior will influence adjustments in other spheres
of life should be considered.

13. Experimental studies under field condtions should be started,
controlling variables by design. Family planning offers most promise
in this respect, especially in underdeveloped and transitional societies
where supplies, services, and infbrmation are under substantial control
of the authorities.

1n. Influence of message and source variability should be in-

vestigated in field or in laboratory experiments.

Conclusions

 

This study was conducted to apply the diffusion of innovation
model to family planning communication in Pakistan. The sampling pro—
cedure fellowed was not the one traditionally fbllowed in diffusion re-
search. The findings have been reported at various places. It seems
that the model was not applicable in detail if the findings of the
study can be relied upon.

While discussing the Characteristics of the adopters, it was

72
feund that characteristics generally associated with early adOpters were
not corroborated in this study. Neither education, wife's education,
or even urbanity were associated with the communicative and adoption
behavior. But the social status Characteristics, occupation, memberShip
in organization, and headship of the household.were not related.
Possibly, what is true in agricultural innovations may not be true in
family planning. The characteristics associated with acceptance and
approval are generally indicators of modernity. We cannot conclusively
establish that family planning fellows or precedes modernization, but
it appears to be a concomitant factor, given the infermation and oppor~
tunity to adopt. The specific nature of family planning innovation
making it more relevant to older and high parity persons, and the re-
striction of free communication on the subject in a traditional society,
places it at a different plane than ether innovations.

The failure of the earlier programs in Pakistan for popularizing
birth control could partly be accounted fer by the neglect to consider
the peculiarity of this practice. Hence, after an initial period of
acceptance by better status persons, the persons who have larger numbers
of Children and are therefore likely to be older, adept the practice,
producing a curvilinear distribution and relation with Characteristics,
not found among the innovators.

Personal influence seems to be more significant in adoption of
family planning than in other areas. 'Ihe confidence placed in the user
who is a trusted friend is what would be expected. But one cannot be
sure to what extent suCh friends are identifiable as opinion leaders.

The study fails to find any distinctive Characteristic for those

73
who claimed to have been sought fer advice. It is hardly evident
whether the same person was sought by several persons or only a few.

The family planning program of Pakistan presents a special
feature inasmuch as the massive communication campaign being employed,
including interpersonal as well as mass media, started only recently.

If the adopters are plotted on a time dimension, the ogive shows a sharp
rise. But the rate of monthly acceptance Shows almost constant growth.
There is no conclusive evidence that interaction is developing rapidly.

The role of change agent in the family planning program.also
assumes a different character, inasmuch as the family planning organizer
belongs to the locality. She has been the confidee of village women in
matters related to pregnancy and child birth. Having a competence in
the area, her appeal cannot be ignored, especially in regard to the ac—
ceptance of IUD by the illiterate village women.

The general findings about mass media seem to hold true for this
study. Awareness was created by mass media, but the reported effect was
very small. Interpersonal influences were mentioned as effecting action.
Similarly, it was feund that the choice of method has its correlates.

In summary it can be tentatively asserted that, with all its limitations,
this study seems to indicate that family planning is a special type of
innovation and is more associated with the models of modernization than
the spread of an innovation isolated from.the general state of the
society.

The appeals for adoption would probably be more effective if they
were in line with the aspirations for modernization. The scope of the

study did not permit more general conclusions.

10.

ll.

12.

13.

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BalaKrishnan 8 Mathiar, "Indian: Evaluation of Publicity," Studies
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Beal, G. and others, "Validity of the Concept of Stages in Adoption
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Berelson, B., "National Family Planning Programs: Where we Stand,"
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Berlo, David K., The Process of_Communication, New Yerk: Holt,
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Bogue, D., Written Communication for Family Planning, Univ. of
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APPENDICES

APPENDIX.A

INDEX CONSTRUCTION

The primary motive in the design and the sponsorship of the
study of which the present investigation ferms a part was to assess
the impact of publicity campaigns pursued through the use of various
media of communication. Hence a number of items identical or similar
in content were included in several sections eaCh related to a.partic-
ular mediumu To facilitate the analysis, to get a widespread range in
the scores and to have a composite score, it was considered appropriate
to develop some index of a dimension of researCh. The common findings
of research about a correlation between various channel and message ex-
posure justified this decision. The exploratory nature of the study did
not seem to demand an assignment of weights to channels.

On examining the interview schedule, it was obvious that at
least five communication indices could be constructed. They were (1)
exposure to media.ef communication; (2) exposure to family planning mes-
sages received over all the channels; (3) knowledge of family planning
workers or the source of supplies and services associated with.the pro-
. gram, (H) opinion about the messages heard over different channels; and
(5) talking to others about family planning messages when exposed to
them. There were two other items for all the Channels whiCh could prob-
ably be added for construction of an index, one relating to hearing frmn

others, and the other relating to the action component of behavior
80

81

subsequent to channel exposure. However, when considering dimension of
behavior covered, the rationale behind the items, and the possible interb
pretation, it was not deemed appropriate to combine them. For example,
what would be the meaning of the fact that a person was more often talked
to about the message. Should he be considered a leader or a follower?
Similarly, what of the person who more often expressed interest or
visited the functionary after hearing messages from different sources?

The five communication indices so constructed are as fellows:

1. Media Exposure: .A score for an individual based on number

 

of channels of communication used. The index was a composite
formed by adding a person's score on seven items related to
radio, newspaper, cinema, the variables number being 16
(possessing a radio that was in working condition), 22
(listening to radio at some other place), 26 (reading news—
paper subscribed by himO, 28 (reading newspaper at some other
place), 107 (number of hours radio listened in all), 118
(frequency of reading newspaper or its being read over to

himD, 1H5 (frequency of going to watch.a.movie).

2. Message Exposure: The score obtained by an individual by

 

adding his responses about hearing family planning messages
over various channels. Ten items constituted the index: 52
(participation in meeting), 53 (meeting a family planning
worker), 11H (listening to family planning over radio), 119
(reading family planning in newspaper), 12H (seeing a family

planning advertisement), 130 (seeing a poster), 137 (seeing a

82
pamphlet on family planning), 1H0 (seeing a bus panel on the
topic), 1H6 (seeing an advertisement in pictureéhouse), 1H7
(watching a cinema slide on the topic), and 152 (watChing a

family planning film.

3. Knowledge of Information Sources: Scores on correct re-

 

sponses of knowledge of sources of information and services

were added. They related to variable number HH(practitioner),

H8 (motivator), 58 (organizer), 59 (Union Council Secretary),
. 60 (Family Planning Officer), 61 (Family Planning Doctor), 62

(Distribution Agent), and 63 (F. P. Clinic).

H. Message Approval: Scores on items relating to the favor—

 

able (2) to unfavorable (0) reaction to the messages received.
There were eight such items: 117 (radio), 122 (newspaper),
128 (advertisement), 131 (poster), 135 (purpose of poster),

1H3 (bus panel), 1H8 (cinema advertisement), and 15H (films).

5. Message Discussion: .A score obtained by adding positive

 

responses regarding talking about the message. This was made

up of five items relating to: 115 (radio), 121 (newspaper),

125 (newspaper advertisement), 132 (poster), and 1H9 (cinema

advertisement).

Correlations between Index—Item.are reproduced in Table 13.
Table 1H shows the intercorrelations between the scores on the five

indices so constructed.

83

ms .Ns .Hs .os .mm .mm .mm .mm .m: .3: mmappanm> HacOmpmapmch
sma mmaamapw> pmaeaewi
mmH .Nma .HmH .omH mmaamanm> memOi
msa .osa mmHQMHnm> Hmcmi mam
:ma .mmH .mja .m:H .sja .sja .mja awareness mamnuo
mNH .mmH .SNH .NNH .Hma .mHH .mm .sN wmanmapm> pmmmamzmz
baa .mHH .HHH .soa .NN .sa mmapmapm> oapmm «

 

 

 

 

 

 

 

mam. mma
mam. s:H
mmm. mm mmm. mad
cow. mm :mo. :ma sz. Ora HHo. mra
mam. Hm HH3. m:H mmm. sma New. mHH
:jm. om 30:. m:H mrm. mma mum. omH mm:. boa
mmm. mm mas. NmH smj. HmH mmm. :NH mum. mm
mmm. mm mos. mma Hem. wma 3mm. HHH mmm. mm
mom. m: was. HNH mos. NNH sum. mm arm. mm
max. :: mms. mHH omm. baa saw. mm :Hm. ma
9 «amosoz a «amoaoz a «amoeoz s «mmoaoz h «Someoz
maouflou> mHouHoMS marmaom> maoufiau> oaoowou>
moogoom cosmmoomflm ommmmmz Hu>oumg< mmummoz moomomxm mwmmmmz whomooxm meow:
ooapmsuoon
mo mmpmazoax

 

 

 

.meHooH coarsesooaeoo Mo mQOflyuHmoooo arroylswsH .mH canoe

8H

Table 1H. Intercorrelations between the indices.

 

 

 

Knowledge of
Media Message Information Message Message
Name of Index Exposure Exposure Sources Approval Discussion
No. 156 157 158 159 160

Media

Exposure —-
Message

Exposure .676
Knowledge of

Information

Sources .305 .518
Message

Approval .702 .856 .H63
Message

Discussion .515 .763 .H52 .783
Mean 3.632 2.852 H.000 5.2H8 1.088
S.D. 2.856 2.392 2.H50 3.981 1.386

N H87 H87 H87 H87 H87

 

APPENDIX B

INTERVIEW SCHEDULE (TRANSLATION)

National ResearCh Institute of Family Planning, KaraChi In-
terview SChedule fer~Family Planning Communication Survey

I. IDENTIFICATION:

1. Name ....................................................
2. Father's name ..... ......................................
3. Residence ............ . ............. .............. .......
H. :Age (in years) ............. . ........... . ....... . ........
5. Are you (a) married and living with.your wife? ...........

(Check (b) married not living with your wife?.. ..... ....

one) (o) widowed? ............ . ........................

(d) unmarried? ...................................

5A. (for a, b, and c). How many of your Children are

liVjIIg? OOOOOOOOOOOOOOOOOO OOOOOOOOOOOO

6. What is your occupation? .................. . ..... . .....
If farmer, How muCh land do you.farmP (number in

acres) ................... . ............

7° IS there any other source of your income? Yes....No .....

If yes, What is it? ............................. . ........

8. Can you read? Yes....No .....

If yes, (i) What languages can you read? ................

(11) What grade in sChool did you complete? .......

9. Can your wife read? Yes....No.....

If yes, (i) What languages can she read? ...... ...........

(ii) What grade in school has she completed? ......

II. HOUSEHOLD INFORMATION:

10. Do you.hold any responsible position in

the village? Yes....No .....
If yes, please name it ...................................
11. Are you the head of your household? Yes....No .....

85

12.

13.

1H.

15.

16.

86

If no, (i) What is your relation with head? ..............
(ii) What is his occupation? .......................

Is there a radio set in your house? Yes. . . .No .....
If yes, ask A, if no skip to B

 

If yes, (i) What kind? Transistor. . . .Electric. . . .Others .
(ii) Is it presently working? Yes. . . .No .....
(iii) Do people come for listening? Yes. . . .No .....
If yes, How many? ‘
less than 5....5—9....10 or more..... .....
What time generally? Morning. . . .Noon. . . . . . . .

Evening. . . .Night .......

If no in 12, (9) Is there a place where people go
to listening radio? Yes....No... ..
If yes, (i) What is the place? An institution.... .......
Ahouse........ ..... A shop...................

(ii) Generally how many?

Less than 5....5—9....10 or more ........ ..
(iii) Do you go there? Yes....No .....
(iv) What time do people go? Morning... ...... .. . .
Noon....Evening.'...Night...' ....... .....

Do you regularly subscribe to a newspaper? Yes. . . .No .....
If the answer is yes, ask A, if it is no, go to B

 

(i) What is the name of the newspaper/periodical? .......
(ii) What is the language of the paper?..... .............
(iii) How often does it come? ..................... .....
(iv) Do you yourself read it? Yes. . . .No .....

(v) Do you discuss the content outside your
family? Yes . . . .No .....

(If the answer to 13 is no)
(1) Is there any place around where the newspaper
comes regularly? Yes . . . .No. . . . .
If yes, (1) Is it an institution. . . .Library. . . .Shop. . . . . .
House ................
(ii) Do you read or listen there? Yes. . . .No. . . . .
(iii) Do people discuss the content? Yes. . . .No .....

How far is this place from market? A furlong. . . .Half
mile. . . .Mile. . . .More.

How far is the bus stop from here? A furlong. . . .Half
mile. . . .Mile. . . .More.

How far is the cinema? A furlong. . . .Half
mile. . . .Mile. . . .More.

17.

18.

19.

20.

21.

22.

87

How far is railway station? A.fur1ong.. ..Half mile .....
Mile ......... More ..........
How far is the primary
sChool? .A furlong....Half mile .....
Mile ...... ...More... .......
How far is the post office? A.fur1ong....Half mile .....
Mile.. ....... More ..........
How far is the Union
Council? A furlong....Half mile .....
Mile ......... More.. ........
Is there electricity in the area? Yes....No.....

Is there a government office in
the locality? Yes....No.....

III. INTERPERSONAL COMMUNICATION:

. 23.

2H.

. 25.

Have you heard of family planning? Yes....No .....
(If the answer is yes, as following, if it is
no go to Q. 2H)

(i) When did you first hear it9 ........................
(ii) Homwhomdidyouhear?...... ................
(iii) What do you understand by it? .............. . ......

Do you know of a family in this neighborhood who
practice family planning? Yes....No .....
If yes, What do they do fer it9 ............ . .............

Do you know of a person who motivates people

in this village to adopt family planning? Yes..No .....
‘—“ If yes, (i) Who is he? ................. . ................
(ii) What does he say? ............ . .............

j26.

(iii) Have you personally met him? Yes... .No. .

Have you participated in a meeting where
family planning was discussed? Yes....No ..... .
If yes, ask the following, if no skip to Q, 27

 

(1) How many times? Once....2—H times....5-9 times...

10 or more......

(ii) When last? .......................... ..............
(iii) Where last9 ....... . ........................... .....
(iv) What was the occasion? .............................

(v) Who addressed? ............................ . ........

(vi) What is your opinion about it9 .....................

88

(vii) What was the general opinion about it? .............
(viii) Did you talk to others after the meeting

about it?...... .............

(ix) Did you take any action subsequently? Yes. . . .No. . . .

If yes, what was it? .................. .. ...........

IV. RADIO LISTENING:

27. Do you listen to radio? Yes....No....
If yes ask fOllowing, if no, skip to Q. 28.

 

(1) How many hours a day? One....2-3....H-5....5 or
more ........................
(ii) What time generally? MOrning....Noon.. ...... . .....
‘ Evening....Night .............
(iii) What programs? ...... . ...... '........ ......... .......
(iv) Did you hear family planning in any of them?
' Yes....No....
If yes, ask fOllowing, if no skip to Q. 28.
(v) In what program19 ...... ... ............. . ..... . .......
(vi) What was the content? ...........................
(vii) Did you discuss it after listening? Yes. .. .No..
(viii) Did you take any action subsequently? Yes....No....
If yes, wlrat action?.
(ix) What is your opinion about such programs9 ...........

 

V. NEWSPAPER:

28. Do you read any newspaper or periodical? Yes....No....
If the answer is yes proceed, if it is no, skip to Q. 30.

 

(i) WhiCh newspaper9 ........ ... ........... . ...... .. .....

(11) Which periodica19 ...............................
(111) Have you read of family planning in any of them?
Yes. ...No..

If yes proceed, if no, skip to Q. 29.
(iv) What was it? ............................... .. .....
(v) How many times was matter on family planning pub—
lished in newspapers in the last six:months?

 

1 or 2 times. .3 or H times. ...5-9 times ..... ...
10 or more. .................................

(vi) Did somebody talk to you about family planning in
a newspaper? Yes....No. ...
(vii) Did you talk to someone about it? Yes. . . .No. . . .
(viii) What is your opinion about such contents9 ....... ....

(ix) Did you take any action subsequently? Yes. ...No....
If yes, what was it? ...............................

29.

VI. POSTER:

30.

89

Have you seen a family planning advertisement in a news—

 

paper? Yes....No....

If yes proceed, if no skip to Q. 30. i
(1) How many times?... ....... ...... .....................
(ii) What was said in that?.. ......... ...................
(iii) Did you talk to others about it? Yes.. ..No. .. .
(iv) Did someone talk to you about it? Yes....No....

(v) Did you take any action subsequent to it?'
Yes. . ..No....

If yes, what was it? ....................... . ..... ...

(vi) What is your Opinion about suCh advertisements? .....
(vii) What is the general opinion about such

' advertisement? ...... . ..... .

Have you seen any poster on family planning? Yes....No....
If’yespproceed, if no skip to Q. 31.

 

(i) How many? l—2....3-H....5 or more ..................
(ii) What was the content? .............. . ................
(iii) When did you see it first?..........................
(iv) Where did you see it?.................. ...... . ......
(v) What was said in it about family planning?..........
(vi) What do you think about it? ........................
(vii) Is it an effective method of publicity? .............
(viii) Why do you think so? ..... . ..................... .....
(DdIfidymltflkakmtittooflenfl.u.n.u.u.u.u..
(x) Did someone talk to you about it?...................
(xi) Did you take any action subsequent to it?. . . . . . . . . . .

Ifyes, Whatwas it?....O. ....... ......OOOOOOOOOOOOO
(xii) What is the genetal opinion about it? .......... .....

VII. PAMPHLETS:

31.

Have the family planning workers distributed any pamphlets
etc. in this area? Yes....No....
If yes proceed, if no skip to Q. 32.

(i) Where?... ............................. ...... ........
(ii) Did you see one? Yes....No....
(iii) Have you heard about them? Yes....No....
(iv) What was the theme?.... ............ . ................
(v) What was said about it? ..... . ............... . .......

(vi) Did it contain material about
(a) Need of family planning? Yes....No....

(b) Methods of family planning? Yes....No....
(c) Religious permissibility of

family planning? Yes....No....

90

(d) Description of family planning workers?
Yes....No....
(e) Location of family planning services?.....

VIII. BUS PANEL:

32. How often do you travel in public bus? Daily .............
Weekly....Occasionally....Never.... ...........

a. Have you seen a bus pannel on family planning?
' Yes....No....

 

 

b. Have you heard about it'from.some one? Yes....No....
If answer to 32b is yes proceed, if no to both Skip to
Q. 33.
(i) What was the content? .............................
(ii) What action did you take subsequent to it9 ..........
(iii) What is your opinion about such.writings9 ...........

IX. CINEMA SLIDES:

33. Do you go to the cinema? If no skip to Q,_3H.
Yes....No....

 

If yes (1) How often9 ............................. ... ......
(ii) When did you see it last?. .....................
(iii) Where did you see it last?.... ....... . ..... ....

(iv) Do you remeber any advertisements?Yes....No....
(v) Did.you see any slides on family planning?
Yes....No....
If yes proceed, if no skip to Q. 3H.
(vi) What was in it? ..... . ........... . ..............
(vii) What is your opinion about it? .................
(viii) Did you take any action subsequent to it?
Yes....No....
If yes, what was it9 ................. ..... ......

 

X. FILMS:

3H. Have you seen any film on family planning? Yes....No....
a. Have you heard of suCh a film? Yes....No....
If yes to 3H, or 3Ha, proceed, if no to both skip to Q. 35.

(i) What was the name of the film9 ....... ...............

(ii) What is your opinion about it9 ......................
(iii) Did you take any action subsequent to it?

Yes....No....

If yes, what was it? ...............................

91
XI. GENERAL INFORMATION ABOUT FAMILY PLANNING:

35. Please give me the names and designations of those people
who advise the residents of this area about family
planning. Organizer. . . .Union Council Secretary .......
Family Planning Officer. . . .Doctor. . . .Others . . . . . ..... . .

36. Please tell me the places where contraceptives can be
obtained .................................. . . ...........

.37- Please name the family planning clinics for the area.
NUInber 000000000000000000000000000 O OOOOOOOOOOOOOOO O .....

38. Did any person visit your house to advise you on family
planning? Yes. . . .No. . . .
If yes, identify him. Organizer. . . .Secretary. . . .Family
planning Officer. . . . Local leader. .F‘riend. . .
Neighbor. . . R.e1ative. . . .Other ....... . ........... . ......

39 . About what percent of families know about family
plmghere?’......OOOOOOOOOOOOOOO0.......... ...... .0

H0. What, in your opinion, should be the method of family

 

pmg pllblid-ty'? ....... .... ....... ......O...’ .......
H1. Why, in your opinion, do people of this area accept
family planning? ............................ . . . . .......
4, H2. Do you practise family planning? Yes. . . .No. . . .
If the answer is yes proceed, if no go to Q H3.
(1) Since when? ......................... . ...... . ......
(ii) When did you first consider it? ...................
(iii) What methods have you used9 ...... . ...... .. .. .......
(iv) Where do you get the supplies9 . . . ...... . . . . . . ......
(v) Have you changed methods? Yes. . . .No. . . .
If yes, to what? ....... . .........................

(vi) Knowing that you practise family planning, did
somebody seek your advice on the subject?

Yes. ..No. . . .
(vii) Did you seek the advice of a practitioner before
you started? Yes. . . .No. . . .
If yes (a) Whowas he9 .............. ........
(b) Why did you ask h1m .....
H3 . What is your Opinion about Interauterine Device9 ..........

THANK YOU FOR YOUR COOPERATION .

HICHIGQN STR|TE UNIV. LIBRQRIES

I IIII II 9II7I99

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