The media or the message? Experimental evidence on mass media and modern contraception uptake in Burkina Faso

Mass media can spread information and disinformation, but its impact is hard to rigorously measure. Using a two-level randomized controlled trial covering 5 million people, we test both exposure to mass media (with 1,500 women receiving radios) and the impact of a high-quality, intensive 2.5 year, family planning mass media campaign in Burkina Faso (8 of 16 local radio stations received the campaign). We find women who received a radio in noncampaign areas reduced contraception use by 5.2 percentage points (p=0.039) and had more conservative gender attitudes. In contrast, modern contraceptive use rose 5.9 percentage points (p=0.046) in campaign areas and 5.8 percentage points (p=0.030) among those given radios in campaign areas. Births fell 10%. The campaign changed beliefs about contraception but not preferences, and encouraged existing users to use more consistently. We estimate the nationwide campaign scale-up led to 225,000 additional women using modern contraception, at a cost of USD7.7 per additional user