A reproductive health approach to family planning: Toward strategic communication for development in Kenya.

摘要

This dissertation sought to provide some explanations to the existing discrepancy between awareness and change in reproductive health behavior and practices in Murang'a district, Kenya, from a communications perspective. Reproductive health information, education and services is a basic human right that was recognized and affirmed at the 1994 and 1995 population and women's conferences respectively. It implies that people should have a satisfying and safe sex life, and the capability and freedom to decide if, when and how often to reproduce. Most people are however denied this right due to social-cultural and economic factors that impede their reproductive health decisions causing them to face unwanted pregnancies, sexually transmitted diseases including HIV/AIDS, and sexual and domestic violence. The dissertation then explores how Grunig's Model of Excellence in Communication could be applied to effective health communication in developing nations. Grunig's model is based on strategic communication and emphasizes two-way symmetrical dialogue, understanding, and relationship building between programs and their audiences.; Data for this study were gathered qualitatively using focus group discussions and in-depth interviews among rural men and women of reproductive age in an attempt to understand their knowledge, attitudes, values, believes, practices and related factors that affect their reproductive health decisions. Findings indicate that community norms and other social-cultural and economic factors prescribe how much autonomy individuals have in making reproductive health decisions. A key finding is that men are a decisive factor in women's reproductive health. Other factors influencing reproductive health behavior and practices include: type of communication strategies used; access to, quality, understanding of the information; nature of relationships between family planning service providers and beneficiaries; and recipients' cultural beliefs, values, and practices.; The study contends that all these elements need to be taken into consideration when planning and implementing information campaigns in developing nations. Finally the study provides policy recommendations for reproductive health programs and the Kenyan government and it suggests potential avenues of research for effectiveness in reproductive health communication.