Impact Evaluation of the Multimedia Communication 
Campaign 2010
Final Report
 Prepared by: 
Nino Lomia 
Lia Umikashvili
Maia Shishniashvili
Nino Mchedlishvili
SUSTAIN
JSI Inc.
United States Agency for International Development
February, 2010 
Introduction
Sustaining Family Planning and Maternal and Child Health Services Project in Georgia 
(SUSTAIN) is a five-year project, October 2009 through September 2014, funded by the US 
Agency for International Development (USAID). The project is implemented by John Snow, Inc. 
(JSI), a Boston-based, leading public health and management consulting company with 
subcontractor Harvard School of Public Health. SUSTAIN aims to meet critical maternal and 
child health (MCH) and reproductive health and family planning (RH/FP) needs while laying the 
foundation for long-term, sustainable maternal & neonatal health and reproductive health 
programs in the private sector and through private insurance industry plans, existing health 
clinics and planned health training units. It also helps the most vulnerable populations by 
assuring a continuous access to a broader range of contraceptive supplies in the private sector. 
The project has four strategic objectives: 
1. Launch new private sector led service delivery, health insurance and product specific 
social marketing models for MCH and RH/FP services. 
2. Building strong commercial sector distribution of contraceptives and public/ private 
partnerships to finance BCC campaigns. 
3. Catalyzing the Georgian health insurance sector to become the vanguards of FP/MCH 
services.
4. Incorporating FP/RH modules and practicum into medical and nursing school curriculum. 
Georgia continues to have the world’s highest documented total abortion rate, 3.1 abortions per 
woman.
1 A second-round Reproductive Health Survey in Georgia showed that contraceptive 
prevalence in 2005 was 28 percent, an increase caused by greater use of modern contraceptive 
methods. Almost all contraceptive users are married. Among married women, nearly half were 
currently using contraception in 2005 compared with 40 percent in 1999. The use of modern 
methods is still relatively low (27 percent) despite a 20% increase between 1999 and 2005.2
In July 2010, SUSTAIN launched the national multimedia communication campaign on the 
theme of “Contraception: Safe and Reliable Choice”, which ended in December 2010. The 
target audience was married women aged 18-35 with children, throughout Georgia. The 
SUSTAIN national communication campaign was a comprehensive campaign designed to 
promote and increase demand for quality FP/RH and MCH services through TV ads, TV Talk 
shows and programs, radio spots, internet social networking, press articles and a hotline service. 
In addition, client and provider oriented point of service print materials (booklets, posters) had 
been distributed and maintained nationwide through existing networks of MCH and FP/RH 
health facilities. 
 
1 Westoff CF, Serbanesku F. 2008. The relationship between contraception and abortion in the Republic of Georgia: 
Further Analysis of the 1999 and 2005 Reproductive Health Surveys. Calverton, Maryland, USA: Macro
International Inc.
2 Serbanescu F, Imnadze P, Bokhua Z, Nutsubidze N, Jackson DB, Morris L. Reproductive Health Survey Georgia
2005. Atlanta, GA (USA)
TV and Radio 
SUSTAIN supported radio exposure of 10-12 commercial jingles per day, 15 moving billboards 
on public buses, and ten stationary billboards. There was commercial placement on four national 
TV channels: Rustavi 2, Imedi, Public Broadcast and Ajara. As part of the project’s PPP efforts, 
Ajara provided free air time. The campaign was airing 5 to 7 spots per day during programming 
most watched by the target audience. Overall, approximately 1,378,460 people were exposed to 
the SUSTAIN TV advertisement during the period of July – December 2010. 
Internet
The internet campaign envisaged placement of the flash banner “Contraception – Your Safe and 
Reliable Choice” on top-rated websites including www.angel.ge; www.ambebi.ge; 
www.geoclass.ge; www.facebook.ge; www.odnoklassniki.ru. This resulted in about 108,100 
clicks counted from July to December, which directed people to the jsi.ge website for more 
information about contraception and locations of services. 
Print Media
The print press activities included the news release “Contraception – Your Safe and Reliable 
Choice” and press articles published in the high circulation magazines “Sarke” and “Tbiliselebi” 
highlighting the benefits of modern family planning methods as an effective alternative to 
abortion. 
Hot-Line Service
SUSTAIN established a national telephone Hot-Line service in July, corresponding to the start 
up of the media campaign. The Hot-line was an important complement to the media campaign 
as the campaign encouraged women to call the hotline or go to the SUSTAIN website. The 
service had been providing free telephone consultation on FP/RH issues and information on 
location of services nationally. It was available 12 hours a day (from 10am to 10pm), 7 days a 
week. The hotline calls indicated the great interest of the target audience as the number of calls 
received each month had been steadily increasing. Overall, 1,848 calls were registered from July 
when the hotline started, through December 2010. 
Point of Service Print Materials
SUSTAIN designed and printed point of service materials (posters, client brochures, PAC 
counseling materials, and service provider materials). These print materials had been integrated 
with the communication campaign by carrying forward the theme and branding, and insuring 
correct and consistent messaging. In addition, the POS provided clients a distinct link between 
the service provider and the national campaign. SUSTAIN POS materials had been distributed 
through the following channels: (617 ) family planning sites - women’s consultation centers, 
polyclinics, etc.; all provider training sessions conducted by SUSTAIN and partners; (16) 
parent schools; (18) high volume maternity hospitals that are implementing effective perinatal 
care protocols; selected sample of pharmacies in major market territories.
SUSTAIN, in collaboration with the Ukrainian market research firm Business Credit, conducted 
an analysis of the Georgian pharmaceutical market. Business Credit has collaborated with JSI 
since 2008 by sharing contraceptive sales data. According to the sales data, the Georgian market 
for contraception grew more than the overall pharmaceutical market and this growth occurred 
during an economic recession. The overall pharmaceutical market growth was 1.3-1.5 % in 
2010, while the market for oral contraceptives increased by 5.43%, as seen in the chart below. 
This is an unusual pattern which could be the result of SUSTAIN activities. Follow up will be 
done with the pharmaceutical companies to identify the reasons for this growth in contraceptive 
sales in order to confirm SUSTAIN’s role, as well as identify which SUSTAIN activities were 
most effective. 
Figure 1. Oral Contraceptive Sales in Boxes 2007-2010 
 
0
20000
40000
60000
80000
100000
120000
79268
95158
96456
101702
sale 2007/boxes sale 2008/boxes
sales 2009/ boxes sales 2010/boxes
Objectives
In order to evaluate the SUSTAIN communication campaign’s impact on the women’s 
knowledge and awareness of modern contraception and available FP services, and identify the 
possible sources of information, SUSTAIN conducted a rapid survey in selected regions of 
Georgia. 
It is expected that the results of this evaluative research will be used to improve quality, 
efficiency, and effectiveness of SUSTAIN’s future communication campaigns and, thus, better
focus on results. 
Methods
This cross-sectional study was conducted by JSI SUSTAIN in collaboration with NGO HERA, 
in Family Planning service provider sites in various regions of Georgia: Tbilisi, Imereti, 
Samegrelo, Kakheti and Shida Kartli regions, during the period of September-October 2010. 
The study population included women aged 18-35 with one or two children residing in the 
selected regions. 
The survey was designed to collect information from a convenience sample of approximately 
351 married women aged 18-35 with at least one child, visiting primary health care facilities in 
the selected regions for various services, not necessarily for FP. The survey instrument for this 
sample, a self-administered questionnaire, was developed to elicit the necessary information on 
knowledge and awareness of modern contraception and possible source of information during the 
last three months. 
In addition, in the same sites, all new contraceptive users (84) for the period of communication 
campaign were interviewed by the trained health care providers. The survey instrument included 
the questions regarding the sources of information about modern contraception and availability 
of family planning services. All participants were enrolled after undergoing an approved 
informed consent process. 
The information from the 435 completed questionnaires was entered into the Excel database. The 
data analysis was conducted using SPSS software, Version 14.0.
Results
According to the survey results, of 351 women interviewed in the first study sample, the majority 
were rural residents (77.20% vs 22.80% urban residents). Overall, 77.49 % (272) of all surveyed 
women have heard and/or seen the message on modern family planning methods during the last 
three month (during the campaign) (Figure 2). A positive response to this question was received 
from 88.75% of urban residents and 74.17% of rural residents (figures 3,4). 
The most successful communication channels to reach the target audience were found to be TV, 
medical personnel, and word of mouth. The survey results showed that 41.88% saw TV 
commercials (37.41% urban residents vs. 62.59% living in rural area), 40.46% heard the message 
from health care providers – doctors and nurses (37.86% urban residents vs. 62.14% rural
77% n=272
23% n=79
Figure 2. Have you heard anything about Family 
Planning- Contraception during the last three month ? 
Women 18-35 years of age with one or two children, 
n=351
Yes
No
89% 
n=71
11% n=9
Figure 3. Have you heard anything 
about Family Planning- Contraception 
during the last three month ?
Women 18-35 years of age with one or 
two children. 
Urban n=80
Yes
No
74% 
n=201 26% 
n=70
Figure 4. Have you heard anything 
about Family Planning- Contraception 
during the last three month ?
Women 18-35 years of age with one or 
two children.
Rural n=271
Yes
No
residents); 29.91% received information from neighbor, friend, relatives etc. (17.14% urban vs. 
82.86% rural residents), 2.8% - from pharmacists, 2.6% - from the internet; 2.3% saw the 
billboards, 1.4% reported to receive information from printing materials, and 1.4% heard the 
message from radio (Figure 2). About the half of respondents mentioned more than one source of 
information. 
Figures 6 and 7 show that distribution of the leading communication channels is slightly different 
among the rural and urban respondents. In urban area, the most frequently reported source of 
information was TV commercial (69.62%), followed by medical personnel (49.37%) and word 
of mouth (22.79%). Whereas, in rural settings the major source of information was medical 
personnel (38%), followed by TV commercials (33.83%) and word of mouth - neighbors, 
friends, relatives, etc. (31.99%). Overall, 10.1% of urban respondents named billboard as an 
information source, while none of the rural respondents mentioned it. Similarly, internet (6.3%) 
radio (5.1%) and printing material (3.8%) were found to play a role in communication of FP 
messages in urban area, while in rural area, they reached insignificant percentage of target 
women. In contrast, pharmacists have been reported by 3.7% of rural respondents as an 
information source, whereas they were inefficient among the urban residents (0%). 
0
5
10
15
20
25
30
35
40
45
50 41.9 % 40.5 %
29.9 %
2.8 % 2.6 % 2.3 % 1.4 % 1.4 %
% 
n= 272
Figure 5. What was the source of information about 
Family Planning ? 
Women 18-35 years of age with one or two children, who 
have heard and/or seen the FP message
0
10
20
30
40
50
38 %
33.6 % 31.7 %
3.7 % 1.5 % 0.7 % 0.4 % 0 %
% 
Rural
n=271
Figure 7. What was the source of information about Family 
Planning ? 
Women 18-35 years of age, who have heard and/or seen the 
FP message
0
10
20
30
40
50
60
70
80
90
100
69.6 %
49.4 %
22.8 %
10.1 %
6.3 % 5.1% 3.8% 
0 %
% 
Urban
n=80
Figure 6. What was the source of information about Family 
Planning ? 
Women 18-35 years of age, who have heard and/or seen 
the FP message
 In the second sample, consisted of 84 new contraceptive users, the overwhelming majority of 
surveyed women were from rural area (94.05%). According to new users, TV commercials and 
medical personnel were the main motivators for them to get interested in FP methods (86.9% and 
77.38%, respectively), while word of mouth was relatively less frequently named by 
respondents (14.29%) (Figure 8). Billboard, pharmacist, printing materials did not play an 
important role in engaging women in family planning (3.6%, 2.4%, and 2.4%, respectively), and 
internet and radio were shown to be entirely ineffective. 
As for the sources of information about the availability of FP services in the specific clinic, 
86.9% of new users indicated medical personnel as the major source of information (Figure 9). 
The second most active communication channel named by new users was word of mouth - 
13.1% of respondents reported having heard about the availability of FP services in the particular 
clinic from neighbors, relatives, friends, etc. According to survey results, the other sources of 
information such as hot-line, Web-site, pharmacists (0%, 0% and 1.2%, respectively) were 
ineffective in terms of communicating FP messages, specifically in rural area given the majority 
of surveyed new users were rural residents. 
0
20
40
60
80
100 86.9 %
77.4 %
14.3 %
3.6 % 2.4 % 2.4 % 0 % 0 %
% 
n=84
Figure 8. How did you get interested in Family Planning? 
New users of modern contraception
Conclusion and Recommendations 
The present study aimed to evaluate the SUSTAIN communication campaign’s impact on the 
women’s knowledge and awareness of modern contraception and available FP services, and 
identify the possible sources of information. 
According to the survey results, the majority (77.49%) of surveyed women 18-35 years of age
with one or two children in the first sample have heard and/or seen the message regarding 
modern FP methods. The most successful communication channels to reach the target 
population of the campaign were found to be TV, medical personnel and word of mouth. About 
half of respondents indicated more than one source of information about modern contraception. 
However, there was slight difference in distribution of sources of information between the rural 
and urban respondents. The leading communication channels in urban area were TV 
commercials and medical personnel (69.62% and 49.37%, respectively), whereas in rural area, 
the major sources of information such as medical personnel, TV and word of mouth were almost 
equally effective (38%, 33.83% and 31.99% respectively). 
Billboard was effective only in urban area that could be explained by the fact that all campaign 
billboards were placed in urban areas. Low effectiveness of internet as a communication channel 
among rural residents (1.5%) is also logical taking into account the lack of internet access in 
rural areas. On the other hand, ineffectiveness of pharmacists in communicating FP message to 
target population (0% in urban area and 3,7% in rural area) deserves particular attention. 
Currently SUSTAIN is conducting pharmacist’s training throughout Georgia. The training is 
aimed to improve pharmacists’ knowledge of contraception and develop and enhance the 
0
20
40
60
80
100
Medical
Personnel
Word of
Mouth
Pharmacist Hot-line Web-site
86.9 %
13.1 %
1.2 % 0 % 0 %
% 
n=84
Figure 9. How did you hear about our clinic and provided FP 
services ? New users of modern contraception
pharmacist’s skills in FP/RH counseling. It is expected that the trainings will also enhance the 
pharmacists’ role as an effective communication channel for conveying information and 
messages on modern FP methods, particularly during the transition period from free 
contraceptives to the socially marketed products. 
Similar to the first sample, TV commercials and medical personnel (86.08% and 77.38%, 
respectively) were shown to be the most successful communication channels in terms of 
engaging young women in family planning, specifically in rural area. At the same time, medical 
personnel was indicated buy the majority of new users of contraception (86.9%) as the main 
source of information regarding the availability of FP services in the particular clinic. Failure of 
hot-line and web-site as information sources pertaining to FP service availability needs further 
investigation. At the same time, as already mentioned above, it is important the pharmacists to be 
able to provide information on existing FP services during the counseling sessions. 
Based on the study results, it is definitely recommended to further strengthen and increase 
capacity of two effective channels, which are based person-to-person communication. These are 
medical personnel and word of mouth. They especially gain weight after TV communication 
campaign is stopped. Thus, involving community leaders and peer educators in community 
mobilization; upgrading the medical personnel’s knowledge, enhance their communication skills 
and provide them with educational material; and train community leaders and peer educators 
would be keys to successful continuation of the project. These actions will lead to strengthen 
peer to peer and provider to client channel in order to maintain and amplify achieved results. 
The study has several limitations. First, limited resources determined the study methodology, 
specifically convenience sampling and sample size, which did not allow selecting a 
representative sample and, thus, generalizing the study results to the entire target population.
Another concern is some potential for interviewer bias. The medical personnel interviewing the 
new contraceptive users could intentionally or unintentionally prompt respondents to reply in a 
favorable manner affecting the results (diminishing/neglecting the role of other communication 
channels such as pharmacist, hot-line or web-site). A more comprehensive picture regarding the 
impact of SUSTAIN’s interventions on knowledge and the use of modern contraception and 
family planning services will be available by the end of 2011, upon completion of the third round 
of Reproductive Health Survey, conducted by the Georgian National Center for Disease Control 
(NCDC) and the US Centers for Disease Control (CDC) under the USAID funding. 
Despite this, the present rapid survey provides a snap-shot of the impact of multimedia 
communication campaign. It is expected that the results of this evaluative research will be 
considered during the planning of SUSTAIN’s future BCC campaigns in order to improve the 
campaigns’ design, quality, efficiency and effectiveness that will lead to more sustainable 
behavioral changes and eventually contribute to the improvement in women’s health outcomes. 
Annex 1. 
Survey questionnaire for married women aged 18-35 having one or two children 
Raion ____________________ Month __________ 
Name of the Facility ____________________
Date____________________ N__________ 
1. Did you hear any message about the Family Planning during last three months? 
1. yes 
2. No
(if yes go to question 2, if no finish the interview)
2. How did you hear about Family Planning? 
(Please circle all correct answers) 
1. TV
2. Billboard/bus billboard
3. Radio
4. Printing materials (poster, booklets, etc.)
5. internet (internet banner, web-site)
6. Health care provider (Nurse, Doc.)
7. Pharmacist
8. World of mouth (neighbor, friend, relative, etc.)
Annex 2. 
Survey questionnaire for every new contraceptive user
Raion ____________________ Month __________ 
Name of the Facility ____________________ 
Date____________________ N__________ 
1. How did you get interested in Family Planning? 
(Please circle all correct answers) 
1. TV
2. Billboard/bus billboard
3. Radio
4. Printing materials (poster, booklets, etc.)
5. Internet 
6. Health care provider (Nurse, Doc.)
7. Pharmacist
8. World of mouth (neighbor, friend, relative, etc.)
2. How did you hear about our clinic and provided FP services?
(Please circle all correct answers) 
1. By calling on hot-line
2. internet (internet banner, web-site)
3. Health care provider (Nurse, Doc.)
4. Pharmacist
5. Word of mouth (neighbor, friend, relative, etc.)