Association Between Mass Media Use and Maternal Healthcare Service Utilisation in Malawi

Figures & data

Figure 1 Percentage of women receiving family planning text messages. As shown in figure 1, radio (42.8%) was the most commonly cited source of family planning messages followed by drama (31.8%) and poster (27%).

Figure 2 Urban rural difference in the percentage of women receiving family planning text messages. Its shows the urban rural difference in receiving family planning messages by the types of sources. It was evident that the percentages were noticeably higher in urban for all types of sources with the largest difference being reported for internet (8% in urban vs 1.6% in rural).

Table 1 Prevalence of Maternal Healthcare Use by Sociodemographic Variables (N=13,217)

	ANC Timing		ANC Frequency		Place of Delivery
	Late	Timely	<Four	Four/More	Home/Other	Health Facility
	% CI	% CI	% CI	% CI	% CI	% CI
Age
15–19	8.90 [8.24, 9.61]	7.46 [6.43, 8.63]	9.98 [9.09, 10.95]	7.35 [6.57, 8.21]	6.93 [5.15, 9.27]	8.75 [8.16, 9.39]
20–24	28.69 [27.47, 29.94]	29.33 [27.37, 31.38]	29.96 [28.52, 31.45]	27.56 [26.08, 29.10]	23.94 [20.13, 28.23]	29.06 [27.94, 30.22]
25–29	23.61 [22.54, 24.71]	24.03 [22.37, 25.78]	23.62 [22.42, 24.88]	23.70 [22.32, 25.13]	21.98 [18.85, 25.46]	23.77 [22.80, 24.78]
30–34	19.29 [18.32, 20.31]	20.83 [19.16, 22.62]	18.03 [16.92, 19.19]	21.28 [20.02, 22.59]	17.97 [14.62, 21.89]	19.80 [18.90, 20.72]
35–39	12.21 [11.41, 13.06]	11.79 [10.53, 13.18]	11.73 [10.83, 12.71]	12.52 [11.60, 13.52]	16.95 [14.13, 20.20]	11.81 [11.13, 12.54]
40–44	5.27 [4.78, 5.81]	4.77 [3.99, 5.68]	4.82 [4.26, 5.44]	5.50 [4.84, 6.23]	8.46 [6.34, 11.19]	4.94 [4.51, 5.42]
45–49	2.03 [1.67, 2.46]	1.79 [1.36, 2.35]	1.86 [1.48, 2.34]	2.09 [1.73, 2.51]	3.77 [2.42, 5.82]	1.86 [1.59, 2.17]
Religion
Christian	84.80 [83.05, 86.39]	85.86 [83.55, 87.90]	84.16 [82.18, 85.95]	85.49 [83.68, 87.12]	85.23 [80.51, 88.97]	84.81 [83.12, 86.36]
Other	15.20 [13.61, 16.95]	14.14 [12.10, 16.45]	15.84 [14.05, 17.82]	14.51 [12.88, 16.32]	14.77 [11.03, 19.49]	15.19 [13.64, 16.88]
Education
No Education	12.76 [11.69, 13.91]	11.05 [9.68, 12.58]	13.62 [12.40, 14.94]	11.43 [10.34, 12.62]	21.72 [18.13, 25.80]	11.88 [10.97, 12.86]
Primary	65.65 [64.33, 66.95]	64.85 [62.35, 67.27]	67.48 [65.89, 69.03]	63.75 [61.96, 65.50]	69.56 [64.94, 73.81]	65.31 [64.03, 66.57]
Secondary	20.14 [18.90, 21.43]	20.51 [18.61, 22.54]	18.11 [16.73, 19.57]	21.78 [20.36, 23.27]	8.48 [6.04, 11.78]	20.75 [19.58, 21.98]
Higher	1.45 [0.99, 2.13]	3.59 [1.95, 6.53]	0.79 [0.55, 1.15]	3.04 [1.82, 5.04]	0.24 [0.05, 1.20]	2.06 [1.34, 3.13]
Residence
Urban	14.22 [13.14, 15.37]	15.26 [13.24, 17.53]	11.80 [10.40, 13.35]	16.81 [15.47, 18.23]	6.27 [3.69, 10.48]	14.89 [13.96, 15.88]
Rural	85.78 [84.63, 86.86]	84.74 [82.47, 86.76]	88.20 [86.65, 89.60]	83.19 [81.77, 84.53]	93.73 [89.52, 96.31]	85.11 [84.12, 86.04]
Wealth quintile
Poorest	17.74 [16.63, 18.91]	19.25 [17.36, 21.30]	18.26 [17.00, 19.59]	17.71 [16.40, 19.11]	14.47 [11.47, 18.10]	18.22 [17.18, 19.30]
Poorer	17.01 [15.93, 18.15]	19.74 [17.39, 22.32]	14.10 [12.79, 15.52]	20.83 [19.17, 22.58]	5.43 [3.71, 7.90]	18.34 [17.20, 19.54]
Middle	19.45 [18.35, 20.60]	18.09 [16.55, 19.74]	20.02 [18.66, 21.47]	18.47 [17.37, 19.62]	21.09 [17.89, 24.69]	19.10 [18.22, 20.03]
Richer	24.07 [22.77, 25.42]	21.18 [19.24, 23.27]	25.02 [23.56, 26.55]	22.21 [20.68, 23.82]	34.93 [30.52, 39.61]	22.83 [21.65, 24.05]
Richest	21.72 [20.48, 23.02]	21.73 [20.09, 23.46]	22.59 [21.21, 24.03]	20.79 [19.45, 22.19]	24.08 [20.18, 28.45]	21.51 [20.44, 22.62]
Occupation
Unemployed	28.87 [27.50, 30.28]	29.33 [27.25, 31.50]	31.43 [29.79, 33.11]	27.18 [25.69, 28.72]	25.05 [20.96, 29.62]	29.54 [28.26, 30.87]
Blue Collar	65.30 [63.84, 66.73]	62.28 [59.83, 64.67]	63.57 [61.77, 65.33]	65.10 [63.32, 66.84]	72.81 [67.85, 77.27]	63.78 [62.38, 65.16]
White Collar	5.83 [5.18, 6.57]	8.39 [6.75, 10.39]	5.00 [4.32, 5.78]	7.72 [6.52, 9.13]	2.14 [1.12, 4.05]	6.67 [5.88, 7.57]
Parity
1–2	44.24 [42.88, 45.60]	46.63 [44.39, 48.87]	44.69 [43.10, 46.29]	44.69 [43.10, 46.29]	31.77 [27.69, 36.15]	45.56 [44.32, 46.80]
3–4	30.50 [29.39, 31.65]	28.77 [26.88, 30.74]	30.48 [29.11, 31.88]	29.69 [28.47, 30.94]	29.72 [25.66, 34.13]	30.10 [29.13, 31.10]
>4	25.26 [24.10, 26.46]	24.60 [22.79, 26.52]	24.83 [23.54, 26.16]	25.62 [24.16, 27.13]	38.51 [34.81, 42.34]	24.34 [23.33, 25.37]

Notes: N.B. numbers represent column percentages with 95% CIs inside [] brackets. Reading example in bold: among the women who had more than 4 children, 38.51% had their last childbirth at home compared with 24.34% who had it at a health facility.

Table 2 Prevalence of Maternal Healthcare Use by Sources of FP Message

	ANC Timing		ANC Frequency		Place of Delivery
	Late	Timely	<Four	Four/More	Home/Other	Health Facility
	% [Confidence Int]	% [Confidence Int]	% [Confidence Int]	% [Confidence Int]	% [Confidence Int]	% [Confidence Int]
Internet
No	98.06 [97.50, 98.49]	96.27 [94.20, 97.62]	98.25 [97.79, 98.62]	96.98 [95.61, 97.93]	99.56 [98.67, 99.85]	97.47 [96.70, 98.06]
Yes	1.94 [1.51, 2.50]	3.73 [2.38, 5.80]	1.75 [1.38, 2.21]	3.02 [2.07, 4.39]	0.44 [0.15, 1.33]	2.53 [1.94, 3.30]
Poster
No	74.71 [73.38, 76.00]	73.28 [70.78, 75.64]	75.66 [74.12, 77.14]	73.36 [71.60, 75.06]	83.33 [79.25, 86.75]	73.90 [72.62, 75.13]
Yes	25.29 [24.00, 26.62]	26.72 [24.36, 29.22]	24.34 [22.86, 25.88]	26.64 [24.94, 28.40]	16.67 [13.25, 20.75]	26.10 [24.87, 27.38]
Cloth
No	75.52 [74.25, 76.74]	75.03 [72.69, 77.24]	76.64 [75.18, 78.04]	74.61 [72.95, 76.21]	84.21 [80.07, 87.63]	75.03 [73.83, 76.19]
Yes	24.48 [23.26, 25.75]	24.97 [22.76, 27.31]	23.36 [21.96, 24.82]	25.39 [23.79, 27.05]	15.79 [12.37, 19.93]	24.97 [23.81, 26.17]
Drama
No	70.62 [68.91, 72.26]	69.00 [66.77, 71.13]	71.95 [70.24, 73.60]	68.76 [66.96, 70.50]	77.39 [72.86, 81.37]	69.85 [68.34, 71.31]
Yes	29.38 [27.74, 31.09]	31.00 [28.87, 33.23]	28.05 [26.40, 29.76]	31.24 [29.50, 33.04]	22.61 [18.63, 27.14]	30.15 [28.69, 31.66]
Radio
No	59.69 [58.18, 61.19]	55.24 [52.86, 57.60]	60.40 [58.66, 62.11]	57.54 [55.72, 59.33]	66.30 [61.19, 71.05]	58.44 [57.07, 59.81]
Yes	40.31 [38.81, 41.82]	44.76 [42.40, 47.14]	39.60 [37.89, 41.34]	42.46 [40.67, 44.28]	33.70 [28.95, 38.81]	41.56 [40.19, 42.93]
TV
No	92.34 [91.52, 93.08]	88.02 [85.42, 90.22]	93.18 [92.29, 93.97]	89.56 [87.79, 91.10]	97.87 [95.17, 99.08]	90.89 [89.81, 91.87]
Yes	7.66 [6.92, 8.48]	11.98 [9.78, 14.58]	6.82 [6.03, 7.71]	10.44 [8.90, 12.21]	2.13 [0.92, 4.83]	9.11 [8.13, 10.19]
Newspaper
No	92.54 [91.73, 93.27]	91.36 [89.17, 93.14]	93.35 [92.47, 94.12]	91.22 [89.79, 92.47]	98.29 [96.91, 99.05]	91.86 [90.95, 92.68]
Yes	7.46 [6.73, 8.27]	8.64 [6.86, 10.83]	6.65 [5.88, 7.53]	8.78 [7.53, 10.21]	1.71 [0.95, 3.09]	8.14 [7.32, 9.05]
Mobile phone
No	95.39 [94.73, 95.97]	93.70 [92.35, 94.82]	96.03 [95.37, 96.60]	93.96 [92.98, 94.81]	98.18 [95.53, 99.27]	94.76 [94.12, 95.33]
Yes	4.61 [4.03, 5.27]	6.30 [5.18, 7.65]	3.97 [3.40, 4.63]	6.04 [5.19, 7.02]	1.82 [0.73, 4.47]	5.24 [4.67, 5.88]

Notes: N.B. numbers represent column percentages with 95% CIs inside [] brackets. Reading example in bold: among the women who received family planning message through mobile phone, 1.82% had their last childbirth at home compared with 5.24% who had it at a health facility.

Table 3 Association Between of Maternal Healthcare Use by Media Use Variables

	Timely ANC			4 ANC			Health Facility Delivery
	Overall	Urban	Rural	Overall	Urban	Rural	Overall	Urban	Rural
Source of FP information
Internet	1.48** [1.15, 1.91]	1.84** [1.27, 2.67]	^ns	^ns	1.63* [1.10, 2.40]	^ns	^ns	1.24* [1.07, 1.57]	^ns
Poster	^ns	^ns	^ns	^ns	^ns	^ns	1.43** [1.12, 1.82]	^ns	1.35* [1.05, 1.74]
Cloth	^ns	^ns	^ns	^ns	^ns	^ns	^ns	^ns	^ns
Drama	^ns	^ns	^ns	^ns	^ns	1.12* [1.02, 1.24]	^ns	^ns	^ns
Radio	1.15** [1.05, 1.26]	^ns	1.20*** [1.09, 1.32]	^ns	^ns	^ns	^ns	^ns	^ns
TV	1.53*** [1.32, 1.76]	1.69*** [1.32, 2.15]	1.50*** [1.24, 1.81]	1.41*** [1.23, 1.62]	1.34* [1.07, 1.68]	1.32** [1.10, 1.57]	2.99*** [1.78, 5.03]	4.03* [1.17, 13.84]	2.22** [1.25, 3.95]
Newspaper	^ns	^ns	^ns	^ns	^ns	^ns	1.81* [1.08, 3.01]	^ns	2.02* [1.13, 3.61]
Mobile phone	1.23* [1.02, 1.48]	^ns	1.44** [1.14, 1.82]	1.20* [1.01, 1.43]	^ns	^ns	^ns	^ns	^ns

Notes: N.B. numbers represent odds ratios with 95% CIs inside [] brackets. Reading example in bold: among the women who received family planning messages through mobile phone had had 1.2 times higher odds of having their last childbirth at home compared with those who did not receive the messages. Level of significance: *p < 0.05, **p < 0.01, ***p < 0.001.

Abbreviation: ns, not significant.