Entertainment Summit West - Los Angeles

Entertainment Summit West - Peter Vaughan Transcript

Peter Vaughan, PCI Researcher

VAUGHAN: Thank you. For the last 11 years, I've had the privilege of working with my colleague, Everett Rogers, at The University of New Mexico, to study the effects of one of PCI's radio dramas in Tanzania, called Twende na Wakati which translates into English as, Let's Go with the Times.

I'm going to give you just a bare bones description of the radio program. If you're interested, come to the afternoon session, I can tell you much more. But it's basically designed on PCI's methodology using positive and negative role models as well as transitional role models to model behavior change. It's been broadcast now continuously since 1993 with two new 30 minute episodes every week. Over the course of time, it's dealt with many issues. But from the beginning, it was designed to deal both with family planning and HIV, AIDS prevention. I'm going to deal just with the family planning component in my talk today. I have three goals that I'm going to try to get across in the next few minutes. Many people think that behavior change on a national scale takes a very, very long time to happen. I'm going to try to show you that, at least in Tanzania, behavior change, even about the very intimate and important issues of fertility and family planning use, is actually happening quite rapidly. The second is I'm going to show you just a tiny bit of our evidence that Twende na Wakati is responsible for at least some of that change. And then the third point is to figure out how much it costs to achieve an important behavioral change in the viewers of Twende na Wakati.

The data here that I'm going to use comes from four demographic and health surveys. These are completely independent of PCI. They would have gone on whether PCI existed or not. We were just able to insert a few questions about the radio programs into these surveys. There's no quiz on these numbers. I just put them up there to show you that these are very large samples, 11,000 in 1991. Again, in 1994, '96, and '99, a total of about 35,000 people were interviewed in Tanzania in these studies.
The second point I want to make about these studies is that they're nationally representative. Each of those little triangles up there is an enumeration area, which is an area sampled in each of the four years of the surveys. You can see that they are distributed throughout the country to capture the ethnic and cultural diversity in the country. So, we can say our results truly reflect changes that were occurring amongst the whole population.

That blue line shows how many Tanzanians existed, beginning in 1950 and projected out for the next 50 years. If you go back to 1950, there were only about eight million. Now there are just over 30 million. In my lifetime, the population of Tanzania has quadrupled. That is a huge challenge for the country because that means they've had to provide the entire infrastructure for schools and jobs, Etc. That's a huge problem in the developing world. And the UN median projection is that they're going to approximately double again in the next 50 years. The green line is a little ray of hope. That is the average number of children that a woman will have during her lifetime. And what I want you to see is that for the period in the 1960s and the 1970s, as far back as I could get this data, on average, women in Tanzania were having just under seven children each. But something started to happen in the '80s. The total fertility rate started to decline and then right about here, in 1991, between 1991 and 1994, that slope of that curve really plummeted and it really declined rapidly.

Now, it would be nice if all I had to do was stand up here and say and point out that that happens to be when Twende na Wakati began broadcasting. But, I think you all are smart enough to see that while something was going on before the program began broadcasting, and just because the curve steepens when the program was airing, doesn't mean that the program caused that change. The challenge, and Jane alluded to this, is to know how much of the change was caused by the program and how much of the change was caused by other things that were going on in the country at the same time.

This is the second slide to show you that there are big changes happening. I want to show you that the fertility rate is really declining quite rapidly in Tanzania. Also, the use of contraceptives is increasing quite dramatically in Tanzania. This is data from 1991, '94, and '96 and '99. What you see is the number of women in a sexual union who are using a modern contraceptive doubled between 1991 and 1994. They're really low levels, still, I appreciate that, but it doubled. A very rapid behavior change – a 156% increase over the decade of the '90s. To my mind, that's very rapid behavior change.
We're going to move on to my second point. Did Twende na Wakati have anything to do with this? Jane and her talk alluded to the difficulty of constructing a control group in these mass media studies, but in Tanzania we were actually able to do that. This is a map of Tanzania and each of those circles attached represents a radio transmitter where from 1993 to 1995. People living in those areas could listen to the program because the program was broadcast there. We were able to broadcast the program at such a time that the people living in the middle of the country were listening to locally produced programming at the time and they couldn't hear the program unless they had short-wave radio. We know from another study that only about two percent of the people in this comparison area here, for the first two years of broadcast, were listening to the program, whereas listenership rates were much higher in these other areas as shown in this next graph.

To save some time, I'm just going to talk about 1999. In 1999, 31% of men said that they were regular listeners to this program. That means they listened at least once a week. Women’s listenership was lower, women have less access to radio, but 23% of women reported being regular listeners to this radio program. This is in a country where radio ownership in 1999 was only 49% of the households. So, we're reaching most of the people who have access to the radio.

I only wanted to show one effects variable, so I chose this one. This is a, a so-called “Stages of Change Model”. If you're from public health background, you'll be somewhat familiar with it. All 35,000 of those people in these surveys were asked a suite of questions. If they had never heard of a modern family planning method and couldn't name any modern family planning method, they were in the pre-contemplation stage and they got a one. If they knew of at least one modern method of family planning, we put them in the contemplation stage, thinking about it potentially, and we gave them a two. If they stated in their survey that they intended to use family planning in the future, and that they approved of family planning, they were put into the preparation stage. If they had ever talked about family planning with their sexual partner, they got a four and we put them in the validation stage. If they had ever used a family planning method, but were not now, they got a five. We put them in the action stage. And then finally, if they were currently using a modern family planning method, we called that the maintenance stage, they got a six.

This is the hardest graph I'm going to show you. Here we have women on top and men on the bottom and each year you have a treatment group where they could hear the radio program beginning in '93, and our comparison group, where they couldn't hear the program until after 1995. For both women and men in the treatment area, we calculated the average stage of change increased by 21% for women, but it only increased marginally in the comparison area at the same time For men, you see exactly the same thing, only the change is a little bit larger. Again, we had more men listening to the program in the treatment area. In our comparison area there was relatively little change during that period of time.

Retrospectively, we asked the question, how much did this program cost? Fortunately, PCI didn't throw out all its financial records and the UNFPA, United Nation Population Fund, hadn't thrown out all their records, so we were able to go back and reconstruct the cost of the program. I want you to take away a few basic points. This program was done on a shoestring. Beginning in 1992, with pre-production, formative research, about $100,000 a year is what it cost to put this program on the air. There were complaints from the actors and the creative teams and we had occasional near strikes, but it was a very low budget operation. If you add up all the previous years all the way from 1992 to 1999, it cost less than a million dollars to put this program on the air. Those are the number I want to impress you with. You can just do some simple division and ask, okay, how much did it cost to get a regular listener, somebody who listens at least once a week? I'm just going to do the 1999 data and save time. A nickel to get one listener, if you just use the 1990 cost. But if you're a skeptic, and you say, “well, you had to produce all of those programs from '93 to '99 to get those listeners, you have to include those costs.” That's 27 cents. It was very inexpensive. But remember, people aren't listening to just a single episode. These regular listeners are tuning in at least once a week, and if you calculate for the four years and you make some assumptions about how often people are listening, there were over a billion Twende na Wakati episode exposures. That comes out to less than a tenth of a penny per episode exposure.

It was a good buy all right. What about change? Finally, in 1999, we were able to insert a couple of questions. We simply asked, did you do anything as a result of the program? 14% of our respondents, which equates to 752,000 people, said that they had talked to their spouse or partner about family planning as a result of listening to the program. That cost about a quarter, if you just use the 1999-year. Or, if you took all of the programs from '93 to '99, a buck thirty to get a couple to talk about family planning. Nine percent of our listener respondents, about a half a million people, said that they had adopted a modern family planning method because of listening to the program. That comes out in 1999 dollars, just 34 cents or roughly the cup of a Starbucks cup of coffee, if you take all of the money from '92 up to '99. So, I think we're seeing some dramatic change.
It's not all caused by Twende na Wakati, but some of it clearly is. It includes changes that we see as most fundamental to who we are as human beings, about our sexual lives and so on. That we can show this through a control group demonstrates that Twende na Wakati is responsible for a pretty sizable chunk of the behavior change. The last conclusion here is that the cost was really very reasonable. If you attend the reasearch and evaluation workship later this afternoon, I will elaborate on the findings in more detail. Thank you.

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