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Impact Data - Tikambe (Let's Talk) Project Phase 3

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"Tikambe... has helped me to know where to find help and support, and I have learned that as a boy child it is OK to seek help when I am in need."

Tikambe (Let's Talk) is a joint project by BBC Media Action and Restless Development in Zambia that uses media and interpersonal communication to encourage young people to talk openly about their sexual reproductive health and rights (SRHR) issues and experiences. The project uses television, radio, and online media, as well as a network of peer educators, to help young people look after their sexual health, improve their reproductive rights knowledge, and access and use youth-friendly SRHR services. Launched in 2014, the project has been implemented over three phases, with Phase 3 running from 2020 to 2024.

The project uses two main approaches based on the strength of each partner:
 

  1. Strengthening the technical capacity of radio stations to produce engaging quality programmes and public service announcements (PSAs) on SRHR (BBC Media Action). During Phase 3, BBC Media Action supported eight local radio stations to produce 448 radio, TV, and social media PSAs and 261 drama segments.
  2. Interpersonal communication through young volunteers who engage in peer-to-peer education, community awareness-raising events, the delivery of youth-friendly services in health clinics and teaching comprehensive sexual education (CSE) in schools (Restless Development). 
     

Tikambe's media content and outreach activity worked in line with the CSE curriculum and was tailored to one of two age groups: those aged 14-19 or 20-24.

See Related Summaries, below, for more information about the project.

Methodologies

A survey was conducted in 16 districts across the four focal provinces of the project (Lusaka, Central, Northern, and Copperbelt provinces) in September and October 2023. In the 16 districts, the research team selected a regionally representative sample of 1,411 young men and women aged 14-24 years old from randomly chosen households across both urban and rural areas. In addition, researchers conducted 311 interviews with purposively selected young men and women across schools in Kabwe and Kasama districts to provide a sufficiently robust sample size to evaluate outcomes from the project's interpersonal initiatives conducted by project partner Restless Development.

The research aimed to understand levels of knowledge, behaviours, and attitudes towards SRH among young Zambians who had been regularly exposed to the Tikambe project compared with those who had not been regularly exposed to it. Categorical variables were compared using a chi-square test.

Regression analysis was used to establish the association between listenership and levels of knowledge of key SRH issues as well as attitude towards, and uptake and discussion of, positive SRH behaviours. This approach enabled researchers to understand this relationship while controlling for social and demographic factors that might have influenced respondents, such as gender, age, education, relationship status, and province. The regression created separate models for exposure to media content only, and exposure to the combination of media and interpersonal communication - to explore the impact of multiple interventions on key health outcomes.

Knowledge Shifts

The endline survey showed that Tikambe had a significant impact on its young audiences' knowledge and awareness of various SRH issues. For example, regression analysis (controlling for other factors) showed that young people aged 14-24 who were regularly reached by Tikambe were 2.7 times more likely to know about different sexually transmitted infections (STIs) than those unexposed and were 1.1 times more likely to name different types of family planning methods than those unexposed.

The majority of young survey respondents were able to mention at least two ways to avoid STIs. Young 14- to 17-year-olds regularly exposed to Tikambe were significantly more likely than their unexposed peers to be aware of different types of STIs (78% versus 68%, respectively).

The endline research found that young people who were regularly reached by either or both Tikambe interventions were significantly more likely to be aware of youth-friendly spaces than their unexposed peers and were open to using these services. Regression analysis, controlling for other factors, showed that 14- to 24-year-olds who were regularly reached by Tikambe outreach and media were 2.9 times as likely to be aware of youth-friendly centres, and those regularly reached by Tikambe media alone were 1.9 times as likely to be aware of these centres than unexposed young people.

Practices

Over half of the young people reached by Tikambe media reported a subsequent change in their SRH behaviour - notably in:
 

  • Using modern contraceptives, especially condoms;
  • Taking measures to prevent pregnancies and STIs; and
  • Discussing information from Tikambe programmes with parents, relatives, friends, and others (e.g., how to use modern contraceptives).

In addition, the evaluation found that youth who were regularly exposed to Tikambe are significantly more likely to feel "very confident" in taking various positive SRH actions, including going to a health centre to discuss contraception and access STI tests or discussing contraception and SRH issues with others. Regression analysis supported this finding.

Attitudes

In relation to encouraging positive attitudes towards young people's SRHR among gatekeepers, the findings showed that young people who were regularly exposed to Tikambe were more likely to feel supported by their parents and traditional leaders than those who were unexposed. Regression analysis showed that, when controlling for other factors, those who were regularly reached by Tikambe media were 1.3 times as likely to say that they felt "very supported" by their parents and 1.6 times as likely to say that they felt "very supported" by key people in their community (e.g., traditional leaders) around various SRHR issues than those who were not reached by Tikambe media.

The evaluation also found that young Tikambe audience members showed positive attitudes towards decision-making norms around contraceptive use. Further, regression analysis, controlling for other factors, showed that those who were regularly reached by Tikambe were 1.9 times as likely to say that they "strongly agree" that girls/women should be involved in decision-making around contraceptive use to avoid pregnancy.

Increased Discussion of Development Issues

The Tikambe Phase 3 media programmes appear to have stimulated discussion on SRHR issues among audiences as the survey showed that regular exposure to Tikambe had an impact on audiences' willingness to talk about SRH issues: 
 

  • 66% of audience members aged 14-24 years reached by Tikambe media discussed the programme content with others, including their parents, other relatives, and friends, particularly around contraception and STIs.
  • 92% of Tikambe's audience said they would recommend Tikambe to others because they found it educational.

Exposure to both Tikambe's interpersonal and media content also had an impact on audience members' willingness to discuss SRH issues. Regression analysis, controlling for other factors, showed that those who were regularly reached by both forms of Tikambe content were 1.6 times as likely to say they were "very likely" to feel very comfortable discussing SRH issues than unexposed young people.

In particular, 14- to 17-year-olds regularly exposed to Tikambe (44%) were significantly more likely to feel very comfortable talking about SRH issues than their counterparts who were not exposed to Tikambe (34%).

Access

Tikambe media (TV, radio, or Facebook):
 

  • Tikambe media reached approximately 599,988 young people (35% of young Zambians across the four focal provinces). Its audience was 46% male and 54% female, reflecting the gender profile of 14-24-year-olds in those locations.
  • Tikambe media reached a broad spectrum of young Zambians, including those living in rural areas (45%) and those with low educational and income levels.
  • 20% of the young people reached by Tikambe (approximately 119,998 people) were regular listeners who listened to at least every other episode. Over half (58%) of those reached listened regularly. The programme reaches a similar percentage of male (49%) and female (51%) young people regularly.
  • Tikambe media regularly reached more people in the youngest age bracket (14-17 years old) (41%), followed by those aged 18-20 (32%) and those aged 21-24 (27%).
  • Among the survey respondents, 6% said they had accessed or seen content on the Tikambe Facebook page.

Combination of interpersonal communication and Tikambe media: 
 

  • The combination of interpersonal communication and Tikambe media (on TV, radio, or Facebook) reached some 462,848 young people (27% of young Zambians across the four focal provinces).
  • The audience reached by this combined content was 47% male and 53% female, reflecting the gender profile of all 14- to 24-year-olds in the target provinces.
  • This combination reached nearly half of young rural residents (48%) and just over half of young urban residents (52%).
  • Nearly half of the young people reached by this combined content were in the youngest age group (aged 14-17), a third were aged 18-20, and 21% were aged 21-24.
Source

How Is Media Content and Outreach Supporting Young Zambians to Make Sexual and Reproductive Health Decisions? July 2024 [PDF], accessed on August 22 2024. Image credit: BBC Media Action and Restless Development