January 24, 2016

In Indonesia, spicy IUD TV ads try to boost long-term contraception

Written by David J. Olson, Global health communications expert

This post originally appeared on the Maternal Health Task Force Blog here. Reposted with permission.

“How does it feel after you get an Andalan IUD?” a woman says in the opening line of a ground-breaking new TV spot in Indonesia promoting intrauterine devices to married women. “Now we can do it anytime. For sure, my husband is more content and obedient now,” she says with a mischievous smile.

A second spot targeting married men poses the same question about how it feels after their wives got an IUD. “Now, every day, I just want to return home quickly,” he says with a broad grin. This deals with a widespread myth held by Indonesian men that IUDs dampen sexual pleasure.

Such ads used to be unheard of in Indonesia, where family planning is normally promoted from a population control and public health perspective. Sex is never mentioned. In a country that values discretion, these commercials link IUDs with sexual pleasure and other benefits of using a long term, reversible method.

DKT Indonesia, a social marketing organization launched in 1996, has been advertising its line of Andalan family planning products for several years (Andalan means reliable in Indonesian).

But no one has ever made the link between modern contraception and sexual pleasure before. By encouraging IUD users to discuss how it has impacted their sex lives, DKT is rewriting the narrative that IUDs are not only reliable for family planning, but can also make sex better.

“One of the myths about IUDs is that they will disrupt intercourse,” said Aditya Anugrah Putra, general manager of the Reproductive Health & Family Planning Unit of DKT Indonesia. “This is a myth that we are tackling with these new ads. Also, we utilize the male perspective in one of the ads, something that has rarely happened in terms of family planning communications in Indonesia.”

So far, Putra, said, there has been no negative reaction to the ads. They have been aired since August 2015 and will continue another 12-18 months.

Long-term, reversible contraceptive methods are one of the areas to be focused on by the International Conference on Family Planning, which opens Monday at Nusa Dua, Indonesia.

Extreme measures were deemed necessary to promote IUDs, a highly reliable form of contraception that has not taken off in Indonesia. Indeed, the period between 1991 and 2012 reveals a long slide in popularly for the IUD from 13.3% contraceptive prevalence in 1991 to 3.9% in 2012, according to national Demographic and Health Surveys (DHS).

Todd Callahan, who directed the DKT Indonesia program from 2008-2015, believes that the public has started to accept IUDs more in the last few years and that the 2012 DHS obscured that fact when it started surveying unmarried women, who are less likely to use a long-acting reversible contraceptive like IUDs and implants.

He also cites other data sources, like the National Socio-Economic Survey of the Central Statistics Bureau which show that IUD use as a percentage of the contraceptive method mix rebounding to 7.2% in 2011.

Meanwhile, the IUD has become the second most popular contraceptive method in the world (after sterilization). DKT International has been marketing IUDs since 2000 but, in the last few years, has seen a dramatic increase in uptake, with 2.4 million units sold in 2014.

“With a wide variety of sizes, configurations and mechanics of action, the IUD now offers one of the most effective (99% efficacy), cost-effective and reversible family planning options,” wrote Chris Purdy, the president of DKT International. “Indeed, the tiny IUD is worth a long second look by family planning programs that are trying to provide a low-cost, easy-to-use method with up to 12 years of protection from pregnancy.”

In 2014, DKT Indonesia was the world’s largest contraceptive social marketing program in terms of numbers of couple years of protection delivered. In that same year, it provided 19% of Indonesia’s couple years of protection.

It’s too early to know about any long-term effect of the TV spots but Putra says that DKT has noted a steady IUD sales growth since the campaign began. He attributes this both to DKT’s extensive midwife trainings (50,000 midwives trained since 2001) and, more recentlhy, the two IUD spots.

Callahan said that these IUD advertisements have not only benefitted DKT sales but has lifted all boats, including government-run clinics.

“What DKT is trying to do is to build up the market for IUDs, something that has never been done in the past decades either by government or the private sector,” said Putra. “DKT pioneered a consumer approach to promoting IUDs by utilizing non-technical and non-medical language in order to provide an attractive message for the target audiences. 

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