Mapping the Reproductive Health Communication Landscape: A State-of-the-art Review


Background: Reproductive health communication encompasses family planning, maternal, neonatal and child health, and sexual and reproductive health communications for adolescents and youth as fundamental elements for intervention.

Objective: To summarize, examine, and identify gaps in the theoretical, methodological, empirical, and measurement literature on reproductive health communication as it relates to Ethiopia.

Methods: A systematic search was conducted using electronic databases such as the Medical Literature Analysis and Retrieval System (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (PsychINFO), and Google Scholar to locate theoretic, psychometric, and empirical literature on reproductive health communication.

Results: Local literature identified by the databases were mainly based on crosssectional designs, had small sample size and lacked essential psychometric protocols. Results showed that most studies replicatively focused on spousal communication centering reproductive choices and decisions. A common strategy was to use student populations as data sources limiting the generalizability of findings.

Conclusion: The need for more diverse designs and areas of investigation using better instrumentation is indicated.

[1] Pillai, V. K. and Gupta, R. (2006). Cross-national analysis of a model of reproductive health in developing countries. Social Science Research, vol. 35, no. 1, pp. 210–227.

[2] World Health Organization. (2017). Programme Reporting Standards For Sexual, Reproductive, Maternal, Newborn, Child and Adolescent Health. World Health Organization.

[3] Dixon-Mueller, R. (1993). The sexuality connection in reproductive health. Studies in Family Planning, vol. 24, no. 5, pp. 269–282.

[4] Sadana, R. (2002). Definition and measurement of reproductive health. Bulletin of the World Health Organization, vol. 80, no. 5, pp. 407–409.

[5] World Health Organization. (1999). Interpreting Reproductive Health: ICPD+ 5 Forum, The Hague, 8–12 February 1999. Geneva: World Health Organization. Unpublished document WHO/CHS/RHR/99.7.

[6] Babalola, S., Figueroa, M. E., and Krenn, S. (2017). Association of mass media communication with contraceptive use in sub-Saharan Africa: a meta-analysis of demographic and health surveys. Journal of Health Communication, vol. 22, no. 11, pp. 885–895.

[7] Ross, J and Stover, J. (2001). The family planning program effort index: 1999 cycle. International Family Planning Perspectives, vol. 27, no. 3, pp. 119–129.

[8] Valente, T. W. and Saba, W. P. (1998). Mass media and interpersonal influence in a reproductive health communication campaign in Bolivia. Communication Research, vol. 25, no. 1, pp. 96–124.

[9] Westoff, C. F. and Bankole, A. (1997). Mass Media and Reproductive Behavior in Africa. Calverton, MD: Macro International.

[10] Campbell, P. (2011). Boundaries and risk: media framing of assisted reproductive technologies and older mothers. Social Science & Medicine, vol. 72, no. 2, pp. 265–272.

[11] Ippoliti, N. B. and L’Engle, K. (2017). Meet us on the phone: mobile phone programs for adolescent sexual and reproductive health in low-to-middle income countries. Reproductive Health, vol. 14, no. 1, p. 11.

[12] Celik, R. and Toruner, E. K. (2019). The effect of technology-based programmes on changing health behaviors of adolescents: systematic review. Comprehensive Child and Adolescent Nursing, vol. 43, no. 2, pp. 1–9.

[13] Hightow-Weidman, L. B., Muessig, K. E., Bauermeister, J., et al. Youth, technology, and HIV: recent advances and future directions. Current HIV/AIDS Reports, vol. 12, no. 4, pp. 500–515.

[14] Willcox, J. C., van der Pligt, P., Ball, K., et al. (2015). Views of women and health professionals on mHealth lifestyle interventions in pregnancy: a qualitative investigation. JMIR mHealth and uHealth, vol. 3, no. 4, p. e99.

[15] Gurman, T. A., Rubin, S. E., and Roess, A. A. (2012). Effectiveness of mHealth behavior change communication interventions in developing countries: a systematic review of the literature. Journal of Health Communication, vol. 17, no. 1, pp. 82–104.

[16] Ames, H. M., Glenton, C., Lewin, S., et al. (2019). Clients’ perceptions and experiences of targeted digital communication accessible via mobile devices for reproductive, maternal, newborn, child, and adolescent health: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews, vol. 10, no. 10, CD013447.

[17] Sixsmith, J., Fox, K. A., Doyle, P., et al. (2014). A Literature Review on Health Communication Campaign Evaluation With Regard to the Prevention and Control of Communicable Diseases in Europe. Sweden: European Centre for Disease Prevention and Control.

[18] Angus, K., Cairns, G., Purves, R., et al. (2013). Systematic Literature Review to Examine the Evidence For the Effectiveness of Interventions That Use Theories and Models of Behaviour Change: Towards the Prevention and Control of Communicable Diseases. Sweden: European Centre for Disease Prevention and Control.

[19] Hutchinson, M. K. (2007). The parent–teen sexual risk communication scale (PTSRC-III): Instrument development and psychometrics. Nursing Research, vol. 56, no. 1, pp. 1–8.

[20] Bongaarts, J. (2011). Can family planning programs reduce high desired family size in sub-Saharan Africa? International Perspectives on Sexual and Reproductive Health, vol. 37, no. 4, pp. 209–216.

[21] Bongaarts, J., Cleland, J., Townsend, J. W., et al. (2012). Family planning programs for the 21st century. New York: Population Council.

[22] Mwaikambo, L., Speizer, I. S., Schurmann, A., et al. (2011). What works in family planning interventions: a systematic review. Studies in Family Planning, vol. 42, no. 2, pp. 67–82.

[23] Hinson, L., Edmeades, J., Murithi, L., et al. (2019). Developing and testing measures of reproductive decision-making agency in Nepal. SSM-Population Health, vol. 9, 100473.

[24] Shackelford, T. K. and Goetz, A. T. (2004). Men’s sexual coercion in intimate relationships: development and initial validation of the Sexual Coercion in Intimate Relationships Scale. Violence and Victims, vol. 19, no. 5, pp. 541–556.

[25] Pulerwitz, J. and Barker, G. (2008). Measuring attitudes toward gender norms among young men in Brazil: development and psychometric evaluation of the GEM scale. Men and Masculinities, vol. 10, no. 3, pp. 322–338.

[26] Upadhyay, U. D., Dworkin, S. L., Weitz, T. A., et al. (2014). Development and validation of a reproductive autonomy scale. Studies in Family Planning, vol. 45, no. 1, pp. 19–41.

[27] Matsuda, Y., McGrath, J. M., and Jallo, N. (2012). Use of the sexual relationship power scale in research: an integrative review. Hispanic Health Care International, vol. 10, no. 4, pp. 175–189.

[28] Morokoff, P. J., Quina, K., Harlow, L. L., et al. (1997). Sexual Assertiveness Scale (SAS) for women: development and validation. Journal of Personality and Social Psychology, vol. 73, no. 4, p. 790.

[29] Straus, M. A., Hamby, S. L., Boney-McCoy, S., et al. (1996). The revised conflict tactics scales (CTS2) development and preliminary psychometric data. Journal of Family Issues, vol. 17, no. 3, pp. 283–316.

[30] Maroufizadeh, S., Almasi-Hashiani, A., Amini, P., et al. (2019). The Quality of Marriage Index (QMI): a validation study in infertile patients. BMC Research Notes, vol. 12, no. 1, p. 507.

[31] Nutbeam, D., Harris, E., and Wise, W. (2010). Theory in a Nutshell: A Practical Guide to Health Promotion Theories. New York, NY: McGraw-Hill.

[32] Donovan, B. (2004). Sexually transmissible infections other than HIV. The Lancet, vol. 363, no. 9408, pp. 545–556.

[33] Abraham, C., Krahé, B., Dominic, R., et al. (2002). Do health promotion messages target cognitive and behavioural correlates of condom use? A content analysis of safer sex promotion leaflets in two countries. British Journal of Health Psychology, vol. 7, no. 2, pp. 227–246.

[34] Kobetz, E., Vatalaro, K., Moore, A., et al. (2005). Taking the transtheoretical model into the field: a curriculum for lay health advisors. Health Promotion Practice, vol. 6, no. 3, pp. 329–337.

[35] Rogers, E. M. and Shoemaker, F. F. (1971). Communication of Innovations: A Cross-cultural Approach. Florence, MA: Free Press.

[36] US Department of Health and Human Services. (2005). Theory At a Glance: A Guide For Health Promotion Practice. US Department of Health and Human Services.

[37] Sharma, M. (2016). Theoretical Foundations of Health Education and Health Promotion. Jones & Bartlett Publishers.

[38] Schiavo, R. (2013). Health Communication: From Theory to Practice. John Wiley & Sons.

[39] Etana, D. and Gurmu, E. (2018). The effect of mass media on women’s reproductive health behavior in Ethiopia. Eastern Africa Social Science Research Review, vol. 34, no. 2, pp. 37–58.

[40] Adugnaw, B., Sibhatu, B., Alemayehu, A., et al. (2011). Men’s knowledge and spousal communication about modern family planning methods in Ethiopia. African Journal of Reproductive Health, vol. 15, no. 4, pp. 24–32.

[41] Sack, D. E., Nagpal, D., Birara, M., et al. (2016). Family planning messaging sources at primary health centers in Addis Ababa, Ethiopia. Annals of Global Health, vol. 82, no. 3, p. 524.

[42] Tilahun, T., Coene, G., Temmerman, M., et al. (2015). Couple based family planning education: changes in male involvement and contraceptive use among married couples in Jimma Zone, Ethiopia. BMC Public Health, vol. 15, no. 1, p. 682.

[43] Singhal, A. and Rogers, E. M. (2001). The entertainment-education strategy in communication campaigns. In R. E. Rice and C. Atkins (Eds.), Public Communication Campaigns (vol. 3, pp. 343–356). Thousand Oaks, CA: SAGE Publications.

[44] Rogers, D. (2018). The impact of mass media-delivered family planning campaigns in developing countries: a meta-analysis (Doctoral dissertation). Retrieved from: cgi/viewcontent.cgi?article=8220&context=dissertations

[45] Genetu, A. (2008). Entertainment-Education and Audience Responses the Case of Menta-Menged Radio Serial Drama in Ethiopia (Doctoral dissertation). Addis Ababa University. Retrieved from: http: //

[46] Ryerson, W. N. (2011). The effectiveness of entertainment-education: case studies from around the world. Using the media to achieve reproductive health and gender equity.

[47] YouthNet Assessment Team. (2004). Assessment of Youth Reproductive Health Programs in Ethiopia. Retrieved from: Assessment{%}20of{%}20Youth{%}20Reproductive{%}20Health{%}20Programs{%}20in{%}20Ethiopia. pdf

[48] Getnet, D. and Getachew, H. (2019). A study on the practice of health communication strategies on family planning at East Gojjam Zone, Amhara region, Ethiopia. International Journal of Business Marketing and Management, vol. 4, no. 9, pp. 93–103.

[49] Kusheta, S., Bancha, B., Habtu, Y., et al. (2019). Adolescent-parent communication on sexual and reproductive health issues and its factors among secondary and preparatory school students in Hadiya Zone, Southern Ethiopia: institution based cross sectional study. BMC Pediatrics, vol. 19, no. 1, p. 9.

[50] Ayalew, M., Mengistie, B., and Semahegn, A. (2014). Adolescent–parent communication on sexual and reproductive health issues among high school students in Dire Dawa, Eastern Ethiopia: a cross sectional study. Reproductive Health, vol. 11, no. 1, p. 77.

[51] Mekonen, M. T., Dagnew, H. A., Yimam, T. A., et al. (2018). Adolescent–parent communication on sexual
and reproductive health issues and associated factors among high school students in Woldia town, Northeastern Ethiopia. The Pan African Medical Journal, vol. 31, p. 35.

[52] Yadeta, T. A., Bedane, H. K., and Tura, A. K. (2014). Factors affecting parent-adolescent discussion on reproductive health issues in Harar, Eastern Ethiopia: a cross-sectional study. Journal of Environmental and Public Health, vol. 2014, Article ID 102579.

[53] Taffa, N., Haimanot, R., Desalegn, S., et al. (1999). Do parents and young people communicate on sexual matters? The situation of Family Life Education (FLE) in rural town in Ethiopia. The Ethiopian Journal of Health Development, vol. 13, no. 3, pp. 205–216.

[54] Yesus, D. G. and Fantahun, M. (2010). Assessing communication on sexual and reproductive health issues among high school students with their parents, Bullen Woreda, Benishangul Gumuz Region, North West Ethiopia. Ethiopian Journal of Health Development, vol. 24, no. 2.

[55] Tesso, D. W., Fantahun, M. A., and Enquselassie, F. (2012). Parent–young people communication about sexual and reproductive health in E/Wollega zone, West Ethiopia: implications for interventions. Reproductive Health, vol. 9, no. 1, p. 13.

[56] Fikre, M. and Betre, M. (2009). Assessment of Parent–Adolescent Communication on Sexual and Reproductive Health Matters in Hawasa Town. Ethiopia: SNNPR.

[57] Shiferaw, K., Getahun, F., and Asres, G. (2014). Assessment of adolescents’ communication on sexual and reproductive health matters with parents and associated factors among secondary and preparatory schools’ students in Debremarkos town, North West Ethiopia. Reproductive Health, vol. 11, no. 1, p. 2.

[58] Neme, D. and Dereje, M. (). Adolescent Parent communication concerning sexual and reproductive health issues among Sendafa High School and Preparatory students. Age, vol. 13, no. 16, p. 156.

[59] Chane, T. and Cherie, N. (2018). Parent–adolescent communication about sexual and reproductive health and associated factors among preparatory school students in Haiyk Town, North East Ethiopia. Research in Medical & Engineering Sciences, vol. 5, no. 2, pp. 417–423.