Politics of donor involvement of increasing contraceptive prevalence in Pakistan: Results from a donor-funded motivational campaign

Contraceptive prevalence rate (CPR) in Pakistan is approximately 30% and increasing at less than 1% per year, falling far short of targets set by the Government. The USAID-funded Key Social Marketing (KSM) project recently released a motivational campaign encouraging spousal communication on contraceptive use and promoting birth spacing. To assess campaign impact, quantitative interviews were conducted with 1205 married men and women.

39% of men and 21% of women exposed to campaign commercials discussed them with their spouses. These respondents were significantly more likely to have begun using contraception since the campaign began than those who did not discuss the ads. 66% of discussing women are now using contraception, versus 40 percent of non-discussing women (Pearson's chi-squared p<0.01). Among men, use was 39% among discussers and 21% among non-discussers (p<0.05).

73% of exposed men, versus 49% of unexposed men, intend to use contraception in the next year (p<0.001).

30% of exposed men and 51% of exposed women began using some form of contraception during the campaign, versus 28% of unexposed men and 38% of unexposed women. These differences were significant among women (p<0.01).

Exposure to the KSM motivational campaign appears to be associated with increased levels of spousal conversation leading to contraceptive use; increased intention to use contraception in the future; and increased contraceptive use. Though these changes cannot be conclusively linked to the campaign, results are encouraging and should be considered as a potential model for donor-funded projects to increase CPR in settings with limited host-country support.