Research paper: teen pregnancy
Executive Summary
At 90 births per 1,000 girls aged 15- 19, Nicaragua has the second-highest adolescent fertility rate in Latin America. To reduce the number of teenage pregnancies, the Nicaraguan government should commission an advertising campaign to be shown across media outlets to encourage the use of condoms among adolescent girls.
Teenage Pregnancy in Nicaragua
As of 2014, Nicaragua had one of the highest adolescent fertility rates of any non-African country, second only to the Dominican Republic. Currently, 28 percent of all births in Nicaragua occur before the mother reaches the age of 18. Teenage girls who become pregnant face a higher risk of pregnancy complications, which can affect both maternal and infant mortality rates. Besides health outcomes, unplanned pregnancies limit girls’ ability to finish their education and become productive members of the labor force. To combat the high adolescent fertility rate, the Ministry of Health (MINSA) supports the use of contraception and family planning, and access to affordable contraceptives in health clinics has been improved with the help of the United Nations Population Fund (UNFPA).
Changing Norms Surrounding Contraceptives
72 percent of women aged 15- 49 in Nicaragua currently use contraception, with use among adolescents in particular being as low as 54 percent (Decat et. al., 2015). However, much of this use is sporadic. Because of the cultural norm of “machismo,” relationships are typically male-dominated. This limits the regular use of condoms in sexual relationships. The woman often feels as if she has no say in requesting or enforcing condom use with a male partner (Lion, Prata, and Stewart, 2009). Though condoms and contraception are accessible in urban areas, Nicaragua’s adolescent fertility rate will not decrease if teenage girls feel as though they are not able to request and enforce the use of condoms with male partners.
Advertising Across Mass Media Outlets
In 2012, 94.6 percent of female adolescents in Nicaragua reported using mass media, namely television and the Internet. The Nicaraguan government should take advantage of this ubiquitous platform and commission an advertising campaign that encourages teenage girls to use contraception. An image of the outline of a condom with the words “Úsalo” or “Just use it” would provide a simple and clear reminder that the government supports safe sex among adolescents. Showing this image during commercial breaks on television, especially during shows popular among teenagers, would help young women understand that they should feel comfortable asking male partners to use condoms. This image should also be used as an advertisement on social media sites such as Facebook and Twitter and should be featured in popular magazines. These advertisements would also reach the adolescent male population and help change the social norm that contraception is not their responsibility, but rather their female partners’ (Decat et. al., 2015).
Family Planning Advertisements in Tanzania
Other developing countries have used advertising campaigns to encourage contraceptive use and family planning with positive results. Between 1991 and 1994, USAID and the Tanzanian Ministry of Health launched an informative media campaign across multiple mediums including newspapers, radio, and public billboards. The campaign covered different methods of family planning to nudge women to use contraception. A study reported that women who recalled viewing only one media source with a family planning message were twice as likely to be using contraceptives as women who had not seen these messages at all (Jato et. al., 1999). Similarly, women who recalled seeing six media sources with the same advertisement were 11 times more likely to be using contraceptives. Showing family planning advertisements across multiple media outlets increased the salience of the message and helped encourage women to engage in safe sexual practices by increasing knowledge and shaping social norms (Jato et. al., 1999).
Media Advertising Campaign: Cost and Effect Estimates
Because of the simplicity of the recommended advertisement, development costs would be very low. Displaying this advertisement on television would cost an average of $13,000 for a 30-second spot on a major cable network, but as little as $1,000 for the same time on a local network. Advertisements in Hecho, a Nicaraguan culture magazine, would cost around $20,000 for a full-page image. Online advertisements typically run around $10,000 per year. With these figures in mind, the Nicaraguan government should expect to pay a maximum of $200,000 for the first year of advertising, after which both the advertisement and the targeted media outlets could be adjusted.
With over 94 percent of teenage girls having access to a mass media outlet, this advertising campaign could reach up to 600,000 girls aged 15- 19 in Nicaragua. The government can expect girls who view the advertisement through at least one media source to be twice as likely to use contraception. This will result in a significant decrease in the adolescent fertility rate, dropping as much as 45 births per 1,000 girls in the year after the campaign is implemented. Cost is thus estimated at $4,500 for each adolescent birth reduced. If a maximum of 600,000 adolescent girls view this advertisement through at least one media form, the cost could be viewed as only $0.30 per girl who sees the ad. Because of the immediate economic and educational benefits that result from a reduction in the adolescent fertility rate, the Nicaraguan government should implement this advertising campaign to nudge adolescent girls to request and enforce the use of condoms with their male partners.
