The impact of a regional family planning service promotion initiative in sub-Saharan Africa:: Evidence from Cameroon

Context: Sub-Saharan Africa has a considerable unmet need for contraception. In 1998-1999, the Gold Circle campaign-a regional initiative to promote and improve family planning service delivery sites-was launched in Cameroon. Methods: During the last quarter of 1999, 571 women who had been interviewed during the 1998 Cameroon Demographic and Health Survey were reinterviewed regarding their exposure to the Gold Circle campaign and their perceptions on and use of contraceptives. The impact of the campaign was evaluated by assessing the panel data and by using an ideation model of behavior change. In addition, service statistics from Gold Circle and non-Gold Circle family planning delivery sites were contrasted to assess the effects of the campaign on clinic performance. Results: More than one-third of the women surveyed reported exposure to the Gold Circle campaign, 52% of whom mentioned being exposed to the campaign through television, Those with primary or postprimary education were four and six times as likely, respectively, as those with no education to have been exposed to the campaign. Exposure was associated with a significant increase in the level of family planning ideation, as well as with an increased likelihood of using a modem contraceptive method (80%). The service statistics indicate that the campaign led to a significant increase in the demand for family planning services at Gold Circle clinics, with the number of new clients more than doubling immediately after the campaign launch. Conclusions: The Gold Circle campaign had appreciable success in promoting family planning in Cameroon. The campaign had a considerable positive influence on both family planning ideation and contraceptive use.