Asia-Pacific Population Journal - Volume 18, Issue 1, 2003

The mass media can serve to dis seminate in for mation about sexuality, health and other aspects of well-being to a variety of au diences, in cluding adolescents and young adults. They can improve knowledge and shape perceptions and attitudes about various subjects, and in fluence sexual and reproductive behaviour (Alan Guttmacher Institute, Henry J. Kaiser Family Foundation, and National Press Foundation, 1996; McCauley and Salter, 1995; Strasburger, 1989). The effectiveness of media campaigns as preventive strategies for major social and health problems among youth is also well documented (Hall, 1995; Sultz and others, 1989). The mass media, however, can also be a source of misinformation, misperception, and negative ideas and attitudes about reproductive health issues. They may even encourage risky be haviour, for example by promoting in effective means of contraception. Ideally, the media should provide accurate guidance about sexuality, reproductive health and responsible sexual behaviour, especially to young people, who are generally thought to be more susceptible than older adults to their influence. For these reasons, it is important to examine adolescents’ and young adults’ exposure to the mass media and the factors associated with that exposure.

The sexually transmitted infections (STIs) are significant causes of morbidity and mortality among women of reproductive age. Not only do some of the STI-related complications result in spontaneous abortion, infertility, ectopic pregnancy and cervical cancer, but common STIs can also cause long-term impairment of reproductive health and in crease the risk of HIV transmission from one person to another (Cameron, Simonsen and D’Costa, 1989; Wasserheit, 1992; Population In formation Program, 1993). It has been estimated that sexually transmitted infections and their complications collectively rank second in importance in the world among diseases in women of reproductive age (World Bank, 1993). Ignorance of and misinformation on sexual illnesses are of ten considered power fulbarriers to resolving such health problems in the traditional communities (UNAIDS, 1998).

In recent years, the quality of services of the family planning programme has been identified as a fundamental determinant of contraceptive use and continuation, since the potential clients are more sceptical and more concerned with the quality of care than past clients (Hull, 1996; Jain, 1989; Koenig and others, 1997; Mroz and others, 1999; Simmons and Phillips, 1990). However, the quality of care, which consists of a series of varied and interacting factors, has been defined in different ways in different contexts by various experts (Adeokun, 1994; Bertrand and others, 1995; Brown and others, 1995; Bruce, 1990: Hardee and Gould. 1993). hi his classical study. Brace (1990) has identified six elements of quality of care in family planning, such as choice of contraceptive methods, providers’ technical competence, provider-client information exchange, interpersonal relations, mechanisms to encourage continuity of contraceptive use, and appropriate constellation of services. Jain (1989) stated that quality of care refers to the way clients are treated by the system providing sendees. Quality of care, in this sense, places much emphasis on the interpersonal dimension of interactions between providers and clients. In this context, the role of field workers is crucial in fulfilling the demand for quality of care, as they are the programme representatives working at maintaining the important link between the programme and the clients. Clients interact with the programme through outreach staff who promote the practice of contraception, disseminate information and distribute supplies.

Recent years have seen increasing attention being drawn to the issue of gender equality in the demographic and reproductive health literature (Federici, Mason and Sogner, 1993; Jejeebhoy, 1995; Dixon-Mueller, 1998). While some argue for this focus in the language of reproductive rights (Sen, Germain and Chen, 1994), it is also frequently asserted that greater gender equality will contribute positively to fertility decline (see, for example ESCAP, 1987).