Effectiveness of information campaigns on contraceptive methods

The first campaigns

Remember the «diabolical handbills» anonymously distributed by Place:at the beginning of last century, the birth rate in England and Ireland dropped at the time of his campaigns. It did the same following the propagada of Bradlaugh in different parts of England, and al-so following the sale of almost 200,000 copies of Annie Besant’s book. Likewise, a drop in birth rates is connected in different parts of France with the campaigns of Robin and of the HumanRegeneration League. In the United States Margaret Sanger successfully published 100,000 copies of «Limitation of the Family».

Common Current Problems of Contraception Campaigns

A specialist, Bogue, states, «We must make much greater use of the written word. From its very beginnings, the idea of family planning has grown by means of the printed letter». Stu-dies in different Latinamerican countries have shown that written contraception advice is far more effective than the costly group meeting or individual interview, which attract on-ly those who are already interested. Thus it is that printed propaganda is «much moreEffec tive than was previously believed for populations with a certain level of lite Jcy» (Stycos).

All in all, present day contraception programmes are a long way from giving the results which might be expected. Not only are they not planned on a large scale, but they are defi-cient even in their contents: analyses in seven countries lead to the conclusion that such propaganda is irrelevant (V. Herskanen), and L. M. E. Atucha notes in Latin America that the message is not clear, perhaps as a result of wishing to avoid religious, moral or political difficulties, and even counterproductive where sublimated in drawings, etc.

The reasons for this situation are largely obvious: normally, family planning is in the hands of doctors who see the propaganda as designed to attract people to the clinics. Swam-ped with work, they look even unfavourably on a massive campaign, being unable to attend so many patients. The very propaganda is circulated amongst those who least need it -patients in the clinics, members of organisations, etc. The contents show a great distance between the motivations and language of those who produce them (or who translate them) and that of the groups which really require the information. Unreasonable bl ir Iness in favour of clini-cal methods (since it would be impossible for very long to apply cynical methods to whole populations) leads them to forget, or even to advise against non-clinical approaches. Since non-clinical methods are important for our purposes, we should remember the features of two of them:

1) Withdrawal. Those with sexual prejudices which deny other than coital methods for achieving orgams, describe as unhealthy a method practised on a vast scale throuluut Europe for more than a century and, today, used by half or more of those practising birth control in Italia, Spain, Roumania, Yugoeslavia, Turkey, Lesotho, etc. This proves that it cannot have such bad sanitary effects… nor be so unrealiable as is sometimes thought. In fact, its effectiveness is «surprisingly high» (Beebe) if not left only to the least motivated and marginal. Tietze puts the figure at 83%. The advantages of the technique are worth re-calling: 1) It is very well-known. 2) It is simple. 3) It costs nothing. 4) It does not de pend on doctors, medical channels, etc. 5) It allows complete sexual contact. 6) It is «na-tural» and even instinctive (the rythm method is reasoned). 7) It is available until the last moment. 8) It is the only possible method for certain emergencies.

2) The vaginal sponge This was the preferred method of many of the pioneers of contracep-tion, who were thus even called the «sponge party». Today, it is recovering from a long and unjustified period of neglect, partly as a result of its very cheapness. It is effective,at least as much so as the diaphram, at 8524 effectiveness (Food and Drug Administration, USA), 86% (G.W. Beebe) and even more (F.P. of Thailand, Dr. Upadhaya of Madras, F. Mascaux of Bel gium, etc.) Its advantages are: 1) Simplicity. 2) Minimal cost. 3) Independence of doctors and of specific commercial channels. 4) Absence of counterindications. 5) INdependence from sexual activity. 6) Use of a known object of multiple uses.

Our contraception campaigns and their results

In 1969, we carried out a campaign with almost a million copies of a contraception in-formation sheet, which was given out in the streets of the cities of Colombia, and the birth rate of 39.7 underwent a «abrupt change» in the words of the analysts, to 39.0 in 1970, 35.4 in 1971, 33.9 in 1972, 32.3 in 1973, etc. Coincidence? As a test, a similar number of sheets was distributed in 1976 in Venezuela, but, this time, only in the cities of Caracas and Valencia. The birth rate was stable throu4-1 out Venezuela from 1977 to 1979, except in those two cities where it dropped 10%. In 1981, another campaign, with contraceptive information, was carried out in Spain. The birth rate then was only 17 per thousand, so that we believe that the results of the campaign will take the form of less readily quantifiable factors, such as a drop in unwanted children, (from one third to half, according to the surveys), clandestine abortion (estimated at 300.000 or one for every two births), etc. In 1982, we distributed a million contraception information sheets in the Federal District of Mexico, and the cities of Puebla, Aguascalientes, and on a smaller scale, in Cuernavaca. Postal distribution also took place, using telephone adresses, in Lower Southern California, Colima, Tlaxcala and Quintana Roo. We hope that all this will reflect in a reduced birthrate.

Two different conceptual bases to our campaigns

The core of our campaigning is to explain in technical terms methods, including the tradi-tional ones, of contraception, using language which is precise, yet clear, and adapted to the circumstances (in each campaign, every sentence of the text is written and checked seve-ral times). In Colombia, Venezuela and Spain, we add an individual and collective motivation to birth control. The very direct and (for some) polemical nature of this motivation,the ob-ject of analysis in various of our articles and books, asisted in the distribution of the contents of the sheet, especially in Colombia. We used another approach in Mexico: here,the greater part of the population is known to desire fewer children so that to reach more easi-ly those groups which remain cut off from these ideological viewpoints, we substituted a•va riety of points on health information (materno-infantile health, first aid, digitopuncture) which helps the sheet to be kept by those who (because of age or for some other reason) are not interested in contraception, while also distributing the sheet amongst their circle out of intemst in any of the subjects includen, even the horoscope.

Immediate plands and request for collaboration

Shortly, in 1983, we hope to complete our campaign in Mexico. We have Brazil, Peru and other countries in our sights. Although until now we have operated on an almost entirely in-individual basis, we hope for and seek the support of those who might, in some way, wish to contribute to this work, with comments, personal or ecoomic contribution, provinding prin-ted material for distribution, etc. Given the foregoing, we believe that the large- scale distribution, by the millions, of these information sheets with concrete advice on all con-traceptive methods may make a significant contribution, in relation with the resources nee-ded, to relief of the problem of population increase.