Key Social Norms Take-aways The Confiance Totale campaign influenced perceived descriptive and injunctive norms, couple communication, and self-efficacy, suggesting that ideational changes, particularly trust in providers and peer behaviors, play a crucial role in contraceptive uptake and reproductive autonomy. The campaign had stronger effects among women, who traditionally have lower access to health information and autonomy in decision-making, highlighting the importance of tailored gender-sensitive norm-based messaging.
Objectives The study aimed to evaluate the reach and impact of the Confiance Totale radio campaign in Togo on family planning outcomes, including whether the ideational model underpinning the campaign was supported by data and how associations varied by gender.
Methods A cross-sectional household survey was conducted among 2,200 adults aged 18–49 in Lomé and Blitta, Togo, using a stratified random sampling strategy. Multivariable regression models were used to test associations between campaign exposure and ideational and behavioral family planning outcomes, controlling for demographic factors.
Intervention Details The Confiance Totale campaign was a high-frequency mass media intervention using the Saturation+ approach to disseminate nine 45-second radio messages in French and local languages. These messages emphasized the safety, effectiveness, and availability of facility-based family planning services during the COVID-19 pandemic and promoted couple communication and trust in healthcare providers. The campaign aired across seven radio stations, broadcasting 15 times per day between July and December 2021.
Results About 45% of respondents reported exposure to the campaign. Exposure was associated with significantly higher odds of using facility-based family planning methods, intent to use family planning, and intent to visit a health facility. It also correlated with increased knowledge, more supportive family planning attitudes and social norms, greater self-efficacy, and improved reproductive autonomy. Gender-stratified models showed stronger effects among women, particularly regarding communication with partners, postpartum family planning attitudes, and provider trust. Although men had higher exposure rates, effects were less consistent.
Conclusions The Confiance Totale campaign successfully influenced a range of ideational and behavioral outcomes, supporting the ideational model of social and behavior change communication. The findings emphasize the power of mass media to shift social norms and improve reproductive health outcomes, especially among women, and underline the importance of tailoring messages to address gender disparities in access to information and autonomy.