MEDIA AND MESSAGES FOR NUTRITION AND HEALTH: Assessing Media Appropriateness For Nutrition And Health-Related Social And Behavior Change Communication In Four High Stunting-Burden Provinces Of Lao PDR DISCUSSION PAPER JUNE 2020 Nkosinathi V.N. Mbuya Ramon V. Calleja, Jr. Tomo Morimoto Sophavanh Thitsy / MEDIA AND MESSAGES FOR NUTRITION AND HEALTH: Assessing Media Appropriateness for Nutrition and Health–related Social and Behavior Change Communication in Four High Stunting–Burden Provinces of Lao PDR Nkosinathi V. N. Mbuya, Ramon V. Calleja, Jr., Tomo Morimoto, Sophavanh Thitsy June 2020 i Health, Nutrition, and Population (HNP) Discussion Paper This series is produced by the Health, Nutrition, and Population Global Practice of the World Bank. The papers in this series aim to provide a vehicle for publishing preliminary results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations, or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. For information regarding the HNP Discussion Paper Series, please contact the Editor, Martin Lutalo at mlutalo@worldbank.org or Erika Yanick at eyanick@worldbank.org. Rights and Permissions The material in this work is subject to copyright. Because the World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street, NW, Washington, DC 20433, USA; fax: 202- 522-2625; e-mail: pubrights@worldbank.org. © 2020 The International Bank for Reconstruction and Development / The World Bank 1818 H Street, NW Washington, DC 20433 All rights reserved. ii Media and Messages for Nutrition and Health: Assessing Media Appropriateness for Nutrition and Health–related Social and Behavior Change Communication in Four High Stunting–burden Provinces of Lao PDR Nkosinathi V. N. Mbuyaa Ramon V. Calleja, Jrb Tomo Morimotoc Sophavanh Thitsyd a Health, Nutrition, and Population, World Bank, Washington, DC, USA. b Indochina Research (Lao PDR) Ltd, Manila, the Philippines c Health Nutrition, and Population, World Bank, Yangon, Myanmar d Health Nutrition, and Population, World Bank, Vientiane, Lao PDR The Government of Japan provided financial support for this work through the Japan Trust Fund for Scaling Up Nutrition ABSTRACT: The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition–related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition. Keywords: Media Audit, Undernutrition, Mass Media Campaigns, Lao PDR, Social Behavior Change and Communication Disclaimer: The findings, interpretations, and conclusions expressed in the paper are entirely those of the authors, and do not represent the views of the World Bank, its Executive Directors, or the countries they represent. Correspondence Details: Nkosinathi Mbuya, World Bank, 1818 H Street, NW, Washington, DC 20433, +1 202-458-1935, nmbuya@worldbank.org. iii Table of Contents ACKNOWLEDGMENTS ................................................................................................. 6 ACRONYMS AND ABBREVIATIONS ............................................................................ 7 EXECUTIVE SUMMARY................................................................................................. 8 PART I — INTRODUCTION.......................................................................................... 11 Part II — METHODS AND DATA COLLECTIONS ....................................................... 14 2.1. IN-DEPTH INTERVIEWS .......................................................................................14 2.2. MEDIA CONSUMPTION SURVEY ..........................................................................14 2.2.1. Location of Study .........................................................................................................14 2.2.2. Sampling Strategy ........................................................................................................14 2.2.3. Data Collection .............................................................................................................16 PART III — FINDINGS .................................................................................................. 18 3.1. FINDINGS FROM THE HOUSEHOLD SURVEY ..........................................................18 3.1.1. Sociodemographics .....................................................................................................18 3.1.2. Overall Media Access ..................................................................................................19 3.1.3. Understanding the Television Medium ........................................................................19 3.1.4. Understanding the Radio Medium ...............................................................................23 3.1.5. Understanding Mobile Phone Usage ...........................................................................25 3.1.6. Understanding Out-of-Home Media Access ................................................................28 3.1.7. Understanding Online Access .....................................................................................30 3.1.8. Understanding the Newspaper Medium ......................................................................33 3.1.9. Salient Communication Relevant to Health Governance and Nutrition Development Projects 34 3.2 HIGHLIGHTS OF THE QUALITATIVE COMPONENT ....................................................37 3.2.1. Overall Nationwide Media Reach and Consumption ...................................................37 Television ................................................................................................................................. 37 Radio ....................................................................................................................................... 38 Newspapers ............................................................................................................................. 38 Telecommunication.................................................................................................................. 39 3.2.2. Implementation Strategies for Information Dissemination Campaigns .......................39 Methods for implementing information dissemination activities .............................................. 39 Recommendations for Effective Social and Behavior Change Communication for Rural Areas ....................................................................................................................................... 40 PART IV — CONCLUSIONS ........................................................................................ 41 4.1 SPECIFIC CHARACTERISTICS OF EACH MEDIA CHANNEL ........................................41 4.1.1. Television .....................................................................................................................41 4.1.2. Radio ............................................................................................................................41 4.1.3. Mobile Phones .............................................................................................................41 4.1.4. Out-of-Home Media .....................................................................................................41 4.1.5. The Internet ..................................................................................................................42 Facebook ................................................................................................................................. 42 4.1.6. Newspaper ...................................................................................................................42 Appendix A. Summary of Key Informant Interviews................................................. 44 Appendix B. Figure 3.4 and Figure 3.10 Summary Data ........................................... 47 Appendix C. Survey of Households Questionnaire .................................................. 48 Appendix D. Survey of Village Heads Questionnaire .............................................. 82 iv Appendix E. Qualitative Field Instruments .............................................................. 102 List of Figures and Tables List of Figures FIGURE 3.1. OVERALL MEDIA ACCESS, PREFERENCE, SATISFACTION, AND TRUST ............................. 19 FIGURE 3.2. OVERALL TELEVISION VIEWERSHIP ................................................................................20 FIGURE 3.3. TELEVISION WATCHING, ENGAGEMENT AND PROVIDER ..................................................20 FIGURE 3.4. TOP TEN MOST WATCHED TELEVISION CHANNELS AND TV CHANNEL REPERTOIRE ........ 21 FIGURE 3.5. PRIME-TIME TELEVISION ON ALL CHANNELS, BY SEX AND AGE ....................................... 22 FIGURE 3.6. PRIME-TIME TELEVISION ON TOP FIVE LOCAL CHANNELS ...............................................22 FIGURE 3.7. PROGRAM TYPE WATCHED ON TELEVISION....................................................................22 FIGURE 3.8. OVERALL RADIO LISTENERSHIP .....................................................................................23 FIGURE 3.9. RADIO-LISTENING ENGAGEMENT AND BANDWIDTH .........................................................24 FIGURE 3.10. TOP FIVE MOST LISTENED TO RADIO STATIONS AND STATION REPERTOIRE ................. 24 FIGURE 3.11. PROGRAM TYPE LISTENED TO ON RADIO .....................................................................25 FIGURE 3.12. PRIME-TIME RADIO ON ALL STATIONS, BY SEX AND AGE ..............................................25 FIGURE 3.13. ACCESS TO INFORMATION VIA MOBILE PHONE .............................................................26 FIGURE 3.14. MOBILE PHONE ACCESS, OWNERSHIP, AND SOCIAL MEDIA.............................................27 FIGURE 3.15. ACCESS TO INFORMATION VIA OUT-OF-HOME CHANNELS .............................................29 FIGURE 3.16. FREQUENCY OF ACCESS TO INFORMATION VIA OUT-OF-HOME MEDIA ........................... 29 FIGURE 3.17. FORMS AND PROXIMITY OF OUT-OF-HOME MEDIA EXPOSURE ...................................... 30 FIGURE 3.18. ACCESS TO INFORMATION ONLINE ...............................................................................30 FIGURE 3.19. DEVICES, FREQUENCY, AND DURATION OF INTERNET ACCESS ..................................... 31 FIGURE 3.20. FACEBOOK ACCESS, ONLINE ENGAGEMENT, AND DAY OF THE WEEK ACCESS .............. 31 FIGURE 3.21. ACTIVITIES DONE AND TOP WEBSITES VISITED ONLINE ................................................32 FIGURE 3.22. MOST FREQUENTLY SEARCHED INFORMATION ONLINE.................................................33 FIGURE 3.23. ACCESS TO INFORMATION VIA NEWSPAPERS ................................................................33 FIGURE 3.24. NEWSPAPER READERSHIP ...........................................................................................34 FIGURE 3.25. WIDELY READ TYPES OF NEWS ...................................................................................34 FIGURE 3.26. EXPOSURE TO HEALTH GOVERNANCE AND NUTRITION DEVELOPMENT PROJECT–RELEVANT COMMUNICATION ..............................................................................................................................35 FIGURE 3.27. HEALTH GOVERNANCE AND NUTRITION DEVELOPMENT PROJECT–RELEVANT COMMUNICATION ........................................................................................................................................................36 FIGURE 3.28. MEDIA CHANNELS FOR RECEIVING HEALTH GOVERNANCE AND NUTRITION DEVELOPMENT PROJECT–RELATED SOCIAL AND BEHAVIOR CHANGE COMMUNICATION MESSAGES ........................... 36 TABLE B.1. TEN MOST WATCHED TELEVISION CHANNELS AND TELEVISION CHANNEL REPERTOIRE .... 47 TABLE B.2. FIVE MOST LISTENED TO RADIO STATIONS AND STATION REPERTOIRE ............................ 47 List of Tables TABLE 2.1. ORIGINAL ALLOCATION OF SAMPLE SIZE BY PROVINCE, DISTRICT, AND VILLAGE ............... 14 TABLE 2.2. SAMPLE SIZE BY VILLAGE ................................................................................................15 TABLE 3.1. DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENTS ...............................................18 v TABLE 3.2. HOUSEHOLD FACILITIES AND AMENITIES ..........................................................................18 TABLE 3.3. FREQUENCY OF MOBILE PHONE UTILIZATION AND THE TYPES OF SERVICES USED ........... 27 TABLE 3.4. MOBILE PHONE ADS, PROMOTIONAL MATERIAL, AND INFORMATION CAMPAIGN RECEIVED 28 ACKNOWLEDGMENTS This report was prepared by a World Bank team comprising Nkosinathi V. N. Mbuya (Senior Nutrition Specialist), Tomo Morimoto (Senior Health Specialist), Hannah Louise McDonald-Moniz (Senior External Affairs Officer), Sophavanh Thitsy (Operations Analyst), and Jutta Krahn (Consultant). The fieldwork and preparation of the fieldwork report were carried out by a team from Indochina Research (Lao PDR Ltd., led by Chansada Souvanlasy (Managing Director), Ramon V. Calleja, Jr. (Survey Director), and Darathip Sounthavong (Senior Research Manager). The authors are grateful to World Bank peer reviewers, Menno Mulder-Sibanda (Senior Nutrition Specialist), Joe Qian (External Affairs Officer), Viengsompasong Inthavong (Water Supply and Sanitation Specialist), and Vannaphone Sittirath (Consultant) for providing the technical guidance and quality review of this report. The authors would also like to thank His Excellency, the Minister of Health and his staff, particularly, Visith Khamlusa (Director of the Centre for Information and Education for Health), Southanou Nanthanontry (Deputy Director General, Department of Planning and Coordination), and Amphone KeoOudome (Consultant) for their guidance and contributions. The authors are grateful to the World Bank for publishing this report as an HNP Discussion Paper. The government of Japan provided financial support for this work through the Japan Trust Fund for Scaling Up Nutrition. vi ACRONYMS AND ABBREVIATIONS GoL Government of Lao PDR GPS Global Positioning System HGNDP Health Governance and Nutrition Development Project KII Key Informant Interview Lao PDR Lao People’s Democratic Republic MA Media Audit M&E Monitoring and Evaluation MOH Ministry of Health NNSPA National Nutrition Strategy and Plan of Action NSEDP National Social Economic Development Strategy OOH Out-of-Home P3M Preceding Three Months SBCC Social and Behavior Change Communication TA Technical Assistance UNICEF United Nations International Children’s Emergency Fund 7 EXECUTIVE SUMMARY The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. There have not, however, been proportional gains in poverty reduction and related challenges. Childhood chronic undernutrition (stunting) levels remain high. About 33 percent of children under five years of age suffer from chronic undernutrition (stunted growth), 21 percent are underweight, and 9 percent are acutely undernourished (wasted). Stunting affects several groups disproportionately—the poor, ethnic minorities, rural children, and upland areas of the country—and stunting and underweight rates among children in the poorest wealth quintile (which is predominantly rural) are more than three times the rates for children in the richest quintile. The government of Lao PDR’s (GoL) commitment to finding solutions to the pressing issues of poverty and malnutrition is clearly spelled out in its National Development Strategy. Notably, among the key objectives of the Eighth National Social Economic Development Strategy (NSEDP) 2016–2020 are developing human capital, graduating from least developed country status by 2020, and achieving a reduction in poverty to 15 percent by 2020 through sustained and inclusive growth. The NSEDP calls for poverty reduction among all ethnic groups and equal access to education and health as well as decreased malnutrition for both genders in all ethnic groups. In support of the GoL’s health and nutrition programs, the World Bank (WB) has provided funds to support the government of Lao PDR to implement the Health Governance and Nutrition Development Project (HGNDP). The objective of HGNDP is to increase coverage of reproductive, maternal and child health, and nutrition services in target areas. Specifically, Component 3 of the project aims to develop and implement nutrition-related social and behavior change communication (SBCC) strategies and action plans at both the national and village levels, giving priority to the latter. Broadly, SBCC activities can be categorized into two types—(i) mass media and (ii) community- based approaches, which for successful campaigns are best delivered in a complementary manner. In addition, SBCC includes advocacy activities for nutrition, targeted at different levels of leaders and decision markers. In addition to HGNDP and also in response to the multidimensional causes of malnutrition in Lao PDR and in support of the GoL’s National Nutrition Strategy and Plan of Action (NNSPA), the World Bank has made a commitment to a multisector action plan to support the government’s efforts in tackling childhood stunting. In this regard, World Bank–financed projects in the Health, Agriculture, Education, Social Protection and Water, Sanitation, and Hygiene sectors were identified as key to addressing the immediate as well as underlying causes of maternal and child undernutrition in Lao PDR in a coordinated manner. This “convergence approach” ensures that World Bank–supported nutrition-sensitive and nutrition-specific interventions in Lao PDR will be coordinated to the extent feasible in four key areas: (i) geographic convergence of nutrition-specific and nutrition-sensitive interventions in the same communities and households in the “convergence provinces,” that is, Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh; (ii) use of common nutrition SBCC strategies, action plans, and tools for consistent messaging; (iii) leveraging of each other’s delivery platforms, for example, preestablished community structures; and (iv) exploring possibilities for common monitoring and evaluation (M&E) frameworks. Media play an important role in shaping and promoting sociocultural and economic development. They are a means to inform the public about government policies, and they can also 8 provide people with an opportunity to express their voices and have them heard. They are at the forefront of all campaigns to improve people’s lives, protect the environment, and promote peace and stability. Media, of course, come in different forms, such as print media, electronic media (radio, television), new media (the internet and other information and communications technology [ICT] platforms), and so on. Given the multiple forms of media that could be used for communication, the World Bank sought to identify a potential media mix that could be used by the government of Lao PDR and concerned stakeholders to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake for a given level of communication expenditure. This information would inform SBCC activities under HGNDP as well as other WB-supported projects constituting the multisectoral nutrition convergence approach. This media audit (MA) is the result. Specifically, the MA was expected to inform the development and production of mass media advocacy and communication tools and materials with a focus on maternal and child health and nutrition, sanitation, personal and environmental hygiene, and/or other determinants of health and nutrition, as well as immunization. Overall, the four most accessed media channels for receiving information among the target respondents are village announcements (98 percent), mobile phones (86 percent), television (74 percent), and out-of-home (OOH) media (66 percent). Out-of-home media refers to any outdoor advertising that reaches the target population while they are outside their homes, for example, posters, billboards, flyers, etc. Of the accessed media channels, the top three most preferred are village announcements (40 percent), television (26 percent), and mobile phones (19 percent). However, in terms of satisfaction, the target respondents are more satisfied with mobile phones than television, represented by 52 percent compared to 41 percent satisfaction rate, respectively. Among the top three media channels, village announcement is the most preferred, has the most satisfied users, and is the most trusted. The MA found television to be popular among the residents of Xiengkhuang Province, females, older age groups, and the Lao Tai ethnic group. In terms of television channels, the top two most watched channels among the project target beneficiaries are Thai television channels 3 and 7. Approximately 68 percent of respondents reported they watch channel 3, and 88 percent channel 7. The most watched local television station is the Lao Star channel, with only 21 percent of respondents reporting that they watched it the most of all channels, and 30 percent reporting that they watched the channel occasionally Radio listenership is highest in Phongsaly Province, among men, older age cohorts, and the Lao Tai ethnic group. The majority of respondents (48 percent) who listened to the radio in the previous three months spent about one to two hours per day listening, with an average duration of 1.91 hours per day. When asked which types of radio programs they listen to most often, 73.0 percent reported that the news program was their most preferred. General music programs (50.5 percent) and song requests (48.5 percent) came second and third, respectively. Respondents across the four target provinces reported high access to information via their mobile phones (86 percent). Slightly more male than female respondents reported using their mobile phones to get information (88 percent compared to 83 percent). Seven out of ten respondents (70 percent) own a “dumb” phone (those mobile phone devices that can only make or receive calls and send or receive text messages), while a small percentage of respondents (16 percent) have feature 9 phones (those that play stored multimedia files and have a camera). Only three out of ten respondents (30 percent) own a smartphone, where apps may be installed and used. Access to newspapers is very low in the target population—approximately 13 percent of the households interviewed. Newspaper readership was lower among female respondents (9 percent), the oldest age group (9 percent), and the Hmong ethnic group (10 percent). Among those who read newspapers, the respondents mostly read them one to two times a week. Overall, approximately 66 percent of respondents reported accessing information through OOH channels. The audit found that the most common forms of OOH media seen over the three months preceding the survey were posters in public places such as health centers or markets (88 percent) and billboards (62 percent). Most respondents had most recently seen posters (58 percent) followed by billboards (25 percent). To reach the target audience with health and nutrition–related messages, media channels that must be considered are those that are readily available in the village so they can easily reach the target audience. Effectiveness of these communication channels can be viewed in terms of preferences, satisfaction, and trust. Village announcements through loudspeakers have the highest reach and are widely used in most villages in the country. In terms of trust, village loudspeakers are the most trusted channel, distantly followed by all other media channels. Mobile phones follow in terms of reach. However, given low literacy rates, reading these texts could be a major constraint. Reaching the poor, rural communities via television would be a challenge, with close to half of the television channels airing in these communities being Thai television channels. 10 PART I — INTRODUCTION The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. There have not, however, been proportional gains in poverty reduction and related challenges. Childhood chronic undernutrition (stunting) levels remain high. About 33 percent of children under five years of age are stunted, 1 21 percent are underweight, and 9 percent are acutely undernourished (wasted). Stunting affects several groups disproportionately— the poor, ethnic minorities, rural children, and upland areas of the country—and stunting and underweight rates among children in the poorest wealth quintile (which is predominantly rural) are more than three times the rates for children in the richest quintile. The causes of undernutrition in Lao PDR are multifaceted and multisectoral. They range from factors that are determined before the child is born—such as mother’s stature, education, health, care, diet, and age during pregnancy—to factors affecting the child after birth, such as inadequate breastfeeding, low macro- and micronutrient intake due to low dietary diversity, poor hygiene, and poor sanitary environment, especially one including open defecation. Most factors are influenced by social, gender, and cultural norms and practices as well as lack of appropriate knowledge. A significant proportion of children are likely not fed important food groups even when the household consumes them or the food is available at the household level, suggesting low levels of nutrition knowledge and awareness. To address these concerns, the government of Lao PDR (GoL), with support from the World Bank, has been implementing the Health Governance and Nutrition Development Project (HGNDP) with the objective to increase coverage of reproductive, maternal and child health, and nutrition services in target areas. Specifically, Component 3 has supported the National Nutrition Committee to prepare a high-impact, integrated social and behavior change communication (SBCC) strategy, which is a key priority identified in the Multisectoral Food and Nutrition Security Action Plan. Some other key activities under this component include financing technical assistance (TA) for (a) stocktaking of existing SBCC materials and delivery approaches, as well as additional formative research (mostly qualitative) to help fill priority gaps (e.g., maternal nutrition); (b) development of an integrated national SBCC Strategy and Implementation Plan, including stakeholder consultation; and (c) development of an SBCC campaign concept and umbrella slogan, and a set of integrated campaign tools, such as mass media tools (television spots, videos, radio programs, posters, banners, social media applications, and collaterals) and also tools/scripts to organize community edutainment events, interpersonal communications toolkits for village facilitators, and job aids for health center (outreach) staff. In addition to HGNDP and in response to the multidimensional causes of malnutrition in Lao PDR and in support of the GoL’s National Nutrition Strategy and Plan of Action (NNSPA), the World Bank has made a commitment to a multisector action plan to support the government’s efforts in tackling childhood stunting. In this regard, World Bank–financed projects in the Health, Agriculture, Education, Social Protection and Water, Sanitation and Hygiene sectors (the multisectoral nutrition 1. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. It is measured by height-for-age. Children whose height-for-age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those whose height-for-age is more than three standard deviations below the median are classified as severely stunted (Lao Statistics Bureau 2018). 11 convergence projects) were identified as key to addressing immediate as well as underlying causes of maternal and child undernutrition in Lao PDR in a coordinated manner. This “convergence approach” ensures that World Bank–supported nutrition-sensitive and nutrition-specific interventions in Lao PDR will be coordinated to the extent feasible in four key areas: (i) geographic convergence of nutrition-specific and nutrition-sensitive interventions in the same communities and households in the “convergence provinces,” that is, Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh; (ii) use of common nutrition social and behavior change communication (SBCC) strategies, action plans, and tools for consistent messaging; (iii) leveraging of each other’s delivery platforms, for example, preestablished community structures; and (iv) exploring possibilities for common monitoring and evaluation (M&E) frameworks. Mass media approaches can be in the form of “edutainment” or social-marketing campaigns. Edutainment is characterized by radio and television messages, dramas aired on radio or television, songs containing relevant messages, and may also include social media. Mass media campaigns commonly used for family planning are increasingly used for a broader set of interventions, such as for promotion of optimal feeding for young children or for sanitation and hygiene behaviors. Informed by an understanding of the mass media consumption habits of the target audience, mass media approaches can be an effective way to reach large numbers of people to increase awareness and knowledge and change attitudes toward a certain behavior. They can help to create repeat exposure to consistent messaging. Interpersonal communication with trusted peers is often needed to support the actual change of a behavior, and hence the need to deliver both mass media and community- based approaches in tandem. Media play an important role in shaping and promoting sociocultural and economic development. They are a means to inform the public about government policies, and they can also provide people with an opportunity to express their voices and have them heard. They are at the forefront of all campaigns to improve people’s lives, protect the environment, and promote peace and stability. Media, of course, come in several forms, such as print media, electronic media (radio, television), new media (the internet), and so on. 2 Given the multiple forms of media that could be used for communication, the World Bank sought to identify a potential media mix that could be used by GoL and concerned stakeholders to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake for a given level of communication expenditure. This information would inform SBCC activities under HGNDP as well as in other multisectoral nutrition convergence projects. This media audit (MA) is the result. Specifically, the MA was expected to inform the development and production of mass media advocacy and communication tools and materials with a focus on maternal and child health and nutrition, sanitation, personal and environmental hygiene, and/or other determinants of health and nutrition, as well as immunization. A media audit entails the collection of information such as the incidence, level of satisfaction, level of trust, peak hours, and preference of each media channel. This information then enables a better understanding of the target audience in terms of media usage habits, interests, choices, and so on. In Lao PDR, MAs were conducted in the form of media index surveys in 2014 and 2017, covering a vast array of media, including television, radio, print (newspapers and magazines), 2. Choudhury 2011. 12 internet (browsing and social media), and mobile phone usage (including texting and other activities to access news and information). While media have an important role in influencing at least all those that they reach through a variety of messaging approaches, the following concepts are particularly cogent for this effort’s measuring of media habits and consumption indicators: • In advertising, media studies provide a picture of how a target audience can be made aware of a product or service. Brand managers can easily curate a media plan that can reach a targeted segment of the society to effectively market such products and services. • In social sciences and program development, media can be used to influence the population in program areas, affecting changes in behavior geared toward the desired outputs and impacts of development programs. Making more people aware of useful information and essential services and products and influencing them to use these effectively are the ultimate goal, and the MA measures the potential effectiveness of media efforts to reach this goal. 13 PART II — METHODS AND DATA COLLECTIONS The media audit comprised two main components: in-depth Interviews of key informants and a media consumption survey of potential beneficiaries of the multisectoral nutrition convergence projects. The survey was conducted simultaneously across the four provinces in March 2019, using face-to-face computer-assisted personal interviews. 2.1. IN-DEPTH INTERVIEWS In-depth interviews of key informants were conducted to obtain an overall description of media habits and main channels of communication nationwide. Prior to conducting these surveys, a systematic review of broader literature and secondary data related to media coverage and usage in Lao PDR was undertaken. This review then informed the formulation of questions for key informants. A total of five key informants were chosen from development agencies (one from a nongovernmental organization [NGO] and another from a United Nations agency), government (one from the Ministry of Posts and Telecommunications and another from the Ministry of Information, Culture, and Tourism), and from a media company. All interviews were conducted in Vientiane. 2.2. MEDIA CONSUMPTION SURVEY 2.2.1. Location of Study The survey was conducted in 12 target districts in four high-stunting burden provinces (also referred to as convergence provinces) of Phongsaly, Oudomxay, Huaphanh, and Xiengkhuang. A total of 881 villages in the four provinces will be reached through HGNDP. The survey covered all 12 project districts and a random selection of 55 villages (three of those were added during data collection when the sample of target households did not meet the sampling quota). 2.2.2. Sampling Strategy The number of villages selected in each of the 12 districts was proportional to the distribution of the population of the districts. In each village, 10 households with children under five years of age were selected for interviews, for a sample of 520 households. In villages where the sample of households with children under five years was fewer than 10, additional households were either added from the others of the already sampled villages or from additional villages adjacent to the sampled villages. Please refer to Table 2.1 for the original sample allocation and Table 2.2 for the actual distribution of the sample, altered as a result of an insufficient sample of households with children under five. Table 2.1. Original Allocation of Sample Size by Province, District, and Village Distribution Allocation Number of Total of population of sample respondents Total sample   population (%) villages* per village size Totals in target areas 345,785 52 10 520 Phongsaly 98,085 100 13 10 130 Mai 26,145 27 4 10 40 Khua 25,557 26 3 10 30 Samphanh 22,981 23 3 10 30 Boon tai 23,402 24 3 10 30 Oudomxay 53,828 100 13 10 130 La 16,506 31 4 10 40 14 Namor 37,322 69 9 10 90 Huaphanh 109,210 100 13 10 130 Huameuang 32,234 30 4 10 40 Xamtay 36,696 34 4 10 40 Kuan 24,525 22 3 10 30 Zone 15,755 14 2 10 20 Xiengkhuang 84,662 100 13 10 130 Kham 47,256 56 7 10 70 Nonghed 37,406 44 6 10 60 Source: Findings of the media consumption survey conducted as part of this study Table 2.2. Sample Size by Village Province District Village Sample size Phongsaly Mai Expansion Village 11 202019 B. Om kar neng 7 202032 B. Poung ngang 5 202066 B. Na luang 7 202077 B. San luang 10 Khua Expansion Village 2 203029 B. Hard suai 7 203055 B. Narm mar nuea 11 203060 B. Mouck kuang 10 Samphanh 204053 B. Narm lee 10 204073 B. Phou sang kow 7 204095 B. Santan 13 Boon tai 207002 B. Boun tay 10 207008 B. Sing say 10 207036 B. san enh may 10 Oudomxay La 402028 B. Pernsahvang 8 402031 B. Houaipa 12 402033 B. Tadahan 10 402068 B. Mai 10 Namor 403001 B. Houmsai 10 403010 B. Jomsane 9 403018 B. Nasavang 10 403024 B. Numkor 10 403046 B. Saisamphun 11 403049 B. Pangthong 10 403051 B. Numphang 10 403068 B. Nathong 10 403079 B. Hopuaisoy 10 Huaphanh Huameuang 705047 B. Homkong 10 705058 B. Done 10 705094 B. Bouamnham 10 705098 B. Homesay 10 Xamtay 706009 B. Phienghome 10 706057 B. Ka 12 706076 B. Saikoon 8 706129 B. Siengdy 10 15 Kuan 709006 B. Houyhai 10 709012 B. Sanhom 10 709122 B. Nongvane 10 Zone 710060 B. Bomfard 10 710089 B. Say 10 Xiengkhuang Kham 902019 B. Phonhkam 10 902026 B. Yumchong 10 902050 B. Sam 10 902062 B. Saubong 10 902115 B. Bouamphieng 10 902120 B. Nongold 10 902125 B. Phoncheng 10 Nonghed 903008 B. Nheer 10 903012 B. Houaidanh 10 903071 B. Numkouang 10 903078 B. Keobone 7 903083 B. Phuckckeretay 10 903117 B. Hohailand 13 Total 520 Source: Findings of the media consumption survey conducted as part of this study Target respondents for the survey include women of reproductive age (ages 15–49), pregnant women, lactating women, women with children under five years old, husbands of these women, and other caregivers of the children under five. The “other caregivers” category comprised grandparents or other elders in the household over 49 years old who take care of children under five in the household. Excluded from this survey were single men and women even if they are of reproductive age, and older men and women who are not caregivers of children five years old and below in the household. 2.2.3. Data Collection The questionnaire used for the survey was an adaptation of the aforementioned media index and customized for the target beneficiaries of HGNDP. It was prepared in English and translated into Lao, and the translated questionnaire went through cognitive pretesting to make sure that the messages were conveyed accurately prior to field pretesting. After the cognitive pretests, field-testing of the questionnaire was conducted among 30 respondents in Nasala Village, Xaythany District, and Vientiane Capital. The objectives of the field-testing were to determine the time length of the interview, improve the wording of the questions, eliminate unnecessary questions or add new items where needed, test question sequence and correct and improve translation, change open-ended questions into multiple-choice questions, find out which items are conceptually vague, check accuracy and adequacy of the questionnaire instructions, determine whether the focus of the question is clear, and identify interviewers’ recording difficulties. The computer-assisted personal interviews used the application (app) SurveyToGo. Among other benefits, this app allows for geo-tagging and automated recordings of the interviews. The geo- tagging of all interviews ensured that all interviews have corresponding global positioning system (GPS) coordinates. The survey was not sent to the server until after a GPS coordinate was captured by the tablet used for the interview. 16 To supplement field quality controls (QCs), all uploaded interviews were checked by office QC staff. In terms of data security, log-in credentials with appropriate access levels were provided to all team members including the client for real-time monitoring of data-collection progress. Random recordings of interviews for either a single question, a section, or the entire interview were carried out to ensure that the questionnaire was implemented according to the training, and interviews were in fact occurring with valid respondents. There were also built-in data QC checks, such as range rule, skip, and fill patterns, among others, in the survey on tablets for more consistent and cleaner data. Data were uploaded in real time whenever internet access was available. The data were uploaded to central servers where additional checking and cleaning occurred. This is where a consolidated, cleaned, and annotated data set was prepared. QC entailed conducting random checks of the data, extraction of open-ended answers, and completed consolidation and coding on a weekly basis 17 PART III — FINDINGS 3.1. FINDINGS FROM THE HOUSEHOLD SURVEY 3.1.1. Sociodemographics This media audit collected sociodemographics of adults in the four target provinces. 3 Table 3.1 and Table 3.2 display these sociodemographics of respondents, including gender, age, distribution of target audience (i.e., parents and guardians of children under five years old), and ethnicity. The respondents interviewed for this study were almost evenly split among mothers (184), fathers (179), and nonparent caregivers (157). The predominating ethnic groups were the Mon- Khmer (about 25 percent) and the Hmong-Mien (24 percent). Almost 26 percent of respondents had no formal education and 30 percent had completed primary school, but only 9 percent had postsecondary education or training. Table 3.1. Demographic Characteristics of the Respondents Province N Ethnicity N Education N Phongsaly 65 Mother 184 Sino- 61 No formal 118 Tibetan schooling Oudomxay 65 0–5 months 41 Mon- 128 Primary 155 Khmer school Huaphanh 65 6–23 months 80 Hmong- 126 Lower 61 Mien secondary Xiengkhuang 65 24–59 months 63 Lao Tai 73 Upper 30 secondary Sex Father 179 Others 132 Vocational 44 Male 260 0–5 months 25 Tai Dam 20 University 3 Female 260 6–23 months 72 Thai Dang 16 Other 109 Age group 24–59 months 82 Lue 16 15–25 years 130 Guardian 157 Yung 8 26–35 years 130 0–5 months 24 Thai Khao 13 36–45 years 130 6–23 months 70 Thai Done 8 46 years and 130 24–59 months 63 Pounoy 5 older Phong 46 Source: Findings of the media consumption survey conducted as part of this study Table 3.2 shows that a little over 6 out of 10 responding households (61.5 percent) own a television, almost 94 percent have access to a mobile phone, but only 7 percent and 5 percent have a personal computer and/or a tablet, respectively. There is also high access to electricity (77.3 percent municipal source and 18.6 percent generators). However, stability and consistency of supply would need to be taken into account. Table 3.2. Household Facilities and Amenities Household property N Household N Television 321 Own house 513 Personal computer 38 Own property/land 505 Fixed-line telephone 62 Have access to electricity 402 3. Adult refers to individuals ages 15 years and older. 18 Mobile telephone 488 (municipal) Tablet 24 Have access to electricity 97 Motorcycle 467 (others, e.g., generators) Car 72 Have access to municipal 44 water Radio 58 Have internet at home 5 (nonmobile) Refrigerator 176 Have bank account with ATM 80 Source: Findings of the media consumption survey conducted as part of this study 3.1.2. Overall Media Access The four most accessed media channels for receiving information among the target respondents are village announcements through loudspeakers (98 percent), mobile phones (86 percent), television (74 percent), and out-of-home (OOH) media (66 percent) (Figure 3.1). Out-of- home media refers to any outdoor advertising that reaches the target population while they are outside their homes, for example, posters, billboards, and flyers. Of the accessed media channels, the top three most preferred channels are village announcements (40 percent), television (26 percent), and mobile phones (19 percent). However, in terms of satisfaction, the target respondents are more satisfied with mobile phones than television, represented by 52 percent compared to 41 percent satisfaction rate, respectively. The order of trust is similar to that of access, with village announcements being the most trusted (64 percent) followed by mobile phones (14 percent) and television (11 percent). Among the top three media channels, village announcements are the most preferred, have the most satisfied listenership, and are the most trusted source of information. Figure 3.1. Overall Media Access, Preference, Satisfaction, and Trust a. Access b. Preference, Satisfaction, and Trust 98% 100% 86% Village announcements 74% 100% 75% 66% Social media 75% Mobile phones 50% 50% 25% Print TV 25% 18% 17% 0% 14% 13% 13% 0% Online Out-of-home Facebook Radio Access Most preferred Very satisfied Most trusted Source: Findings of the media consumption survey conducted as part of this study 3.1.3. Understanding the Television Medium Television is “most accessed” by female, by older population groups (46 years and older), by the Lao Tai ethnic group, and by residents of Xiengkhuang Province (Figure 3.2). “Most accessed” is defined in terms of frequency of television watching—in this case, those who said they watched television every day. Fifty-two percent of respondents in Xiengkhuang Province reported they watched television every day, while the rates of people watching television on a regular basis in the other three provinces was, on average, about 40 percent. Females were found to watch television 19 more regularly than males (44 versus 38 percent). Frequency of television consumption also appears to increase with age. Approximately 57 percent of respondents 46 years and older watched television every day, while only 27 percent between the ages of 15 and 25 accessed television every day. Compared to other ethnic groups, the ethnic majority Lao Tai watched television most often (58 percent every day), whereas the Hmong watched television the least (18 percent every day). Figure 3.2. Overall Television Viewership 100% 18% 32% 27% 41% 40% 40% 38% 38% 42% 39% 44% 45% 75% 52% 51% 57% 58% 23% 17% 50% 22% 17% 17% 15% 20% 16% 19% 14% 17% 18% 15% 17% 17% 25% 7% 24% 11% 16% 12% 9% 7% 7% 9% 10% 7% 8% 5% 8% 0% 3% 2% 5% Oudomxay Khmer - Hmong Hmong Xiengkhouang 46 years Huaphanh Tibetan – Lao Tai Other Phongsaly Male Female 15–25 26–35 36–45 Mien - and up Akha,… Khmu Mon- Sino- Total Province Gender Age Ethnic Less than once a week 1–2 times a week 3–4 times a week Nearly every day, 5–6 times a week Everyday Source: Findings of the media consumption survey conducted as part of this study Regarding the duration of television consumption per day and the type of service provider, the majority (51 percent) of the target audience spends one to two hours (an average of 1.79 hours) watching television on a daily basis (Figure 3.3). Most households watch satellite television: roughly 8 out of 10 (80.2 percent) respondents reported having satellite television at home. Figure 3.3. Television Watching, Engagement and Provider a. Engagement b. Provider Free to air 60% TV, 0.6% None of the 51% above, 18.9% 50% 1.79 40% Hours cable/digital TV, 0.3% 30% Approx. 20% 20% 17% daily TV 10% viewing 6% 6% average 0% Satellite TV, Less than 1 1 - 2 hours 2 - 3 hours 3 - 4 hours More than 80.2% hour per per day per day per day 4 hours per day day Source: Findings of the media consumption survey conducted as part of this study 20 In terms of television channels, the top two most watched channels among the project target beneficiaries are Thai television channels 3 and 7. Approximately 68 percent of the respondents reported they watch channel 3, and 88 percent channel 7 (Figure 3.4). The most watched local television station is the Lao Star channel, with only 21 percent of respondents reporting that they watched it the most of all channels and 30 percent that they watched it occasionally. If the Ministry of Health (MOH) or other ministries are to air social and behavior change communication (SBCC) messages on local channels, the effective reach through television in the target area would only be up to 51 percent with the Lao Star channel. Figure 3.4. Top Ten Most Watched Television Channels and TV Channel Repertoire TV Channel Thai channel 7 49% 39% Thai channel 3 65% 3% Thai channel 8 18% 2% Lao Star 30% 21% Lao TV 1 22% 9% Lao TV 3 26% 9% Lao PS TV 19% 7% Now 26 9% 2% MV Lao 13% 2% Others 26% 6% 0% 10% 20% 30% 40% 50% 60% 70% Repertoire Most watched Source: Findings of the media consumption survey conducted as part of this study Note: Refer to Appendix B for number of viewers. Figure 3.5 shows the prime time for all television channels, including Thai television, by gender and age groups. Overall, the prime time for all television channels is from 6:00 pm to 9:00 pm, and it peaks at 7:00 pm to 8:00 pm, with a maximum reach of 50 percent of television watchers. There is not much difference by age and sex during prime-time television viewing. 21 Figure 3.5. Prime-time Television on All Channels, by Sex and Age Morning Noon Afternoon Prime time Evening 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Total Gender male Gender female Age 15–25 years Age 26–35 years Age 36–45 years Age 46 years and up Source: Findings of the media consumption survey conducted as part of this study Prime-time television for the top five Lao television channels is also from 6:00 pm to 9:00 pm, peaking at 7:00 pm to 8:00 pm (Figure 3.6). The total reach for these local television channels is at most 12 percent, assuming all five channels are watched by different families at the same time. Lao television 3 and Lao Star only reach about 4 percent of the target audience during the prime-time window. Figure 3.6. Prime-time Television on Top Five Local Channels Morning Noon Afternoon Prime time 14% 12% 10% 8% 6% 4% 2% 0% Lao TV1 Lao TV 3 Lao PS TV Lao Star MV Lao Total Source: Findings of the media consumption survey conducted as part of this study Figure 3.7 shows the type of television programs watched most by the target population. The top three are news programs (74 percent), drama series or soap operas (71 percent), and entertainment programs (45 percent). Figure 3.7. Program Type Watched on Television 22 0% 25% 50% 75% 100% News (local, international) 39% Series / Soap opera 47% Entertainment (concert, comedy, night shows, etc.) 34% Breaking news 18% Sport (news, live, etc..) 37% Lifestyle (health, religion, culture, etc.…) 17% Movies 21% Education 17% Documentary 23% Economics / Business / Finance 15% Reality show 10% Game show 11% Most often Repertoire Source: Findings of the media consumption survey conducted as part of this study 3.1.4. Understanding the Radio Medium Radio listenership is highest in Phongsaly Province, among men, among the older age cohorts, and among the Lao Tai ethnic group (Figure 3.8). Daily radio listenership is relatively high in Phongsaly and Xiengkhuang, with 52 percent of respondents in Phongsaly and 43 percent in Xiengkhuang reporting that they listen to the radio every day. Radio listenership is significantly lower in Huaphanh and Oudomxay, with only 19 percent and 10 percent of respondents, respectively, listening to the radio every day. Men listen to the radio slightly more often than women (33 and 26 percent, respectively). Frequency of radio listenership appears to increase with age, with 37 percent of respondents 46 years and older listening to the radio every day, while the rate is only 15 percent among the 15- to 25-year-olds. Similar to television viewership, among the different ethnic groups, the Lao Tai listen to the radio most often (36 percent), with the Sino-Tibetans the least likely to do so (19 percent). Figure 3.8. Overall Radio Listenership 100% 10% 15% 19% 19% 23% 29% 26% 29% 25% 33% 37% 36% 43% 42% 42% 75% 52% 39% 48% 49% 50% 48% 25% 34% 35% 34% 27% 43% 32% 25% 24% 13% 39% 28% 25% 11% 8% 4% 4% 4% 4% 5% 5% 4% 5% 6% 4% 6% 0% 0% 0% 0% Oudomxay Phongsaly Female Lao Tai Other Huaphanh Xiengkhouang 46 years Male Khmer - Tibetan – Hmong Hmong 15–25 26–35 36–45 Mien - and up Akha,… Khmu Mon- Sino- Total Province Gender Age Ethnic Less than once a week 1–2 times a week 3–4 times a week Nearly every day, 5-6 times a week Every day Source: Findings of the media consumption survey conducted as part of this study The majority of respondents (48.0 percent) who listened to the radio in the previous three months spent about one to two hours per day listening, with an average duration of 1.91 hours per 23 day (Figure 3.9). About half of radio listeners reported they listen to FM radio stations, while most of the other half were unaware of which bandwidth they listened to. Very few (3.1 percent) listen to AM radio. Figure 3.9. Radio-Listening Engagement and Bandwidth a. Listening Time b. Bandwidth 75% 1.91 hours 50% approxim. Dont FM daily know, Radio, radio 47.4% 49.5% 25% listening average 0% Less than 1–2 2–3 3–4 More than AM 1 hour hours hours hours 4 hours Radio, per day per day per day per day per day 3.1% Source: Findings of the media consumption survey conducted as part of this study Among the top five most listened to radio stations, FM 99.7 was the most popular in the target area, with a reach of 39.0 percent (Figure 3.10). When asked which types of radio programs they listen to most often, 73.0 percent of respondents reported the news program was their most preferred. General music programs (50.5 percent) and song requests (48.5 percent) came second and third, respectively (Figure 3.11). Figure 3.10. Top Five Most Listened to Radio Stations and Station Repertoire 30% 25% 25% 20% 15% 14% 14% 12% 10% 10% 9% 7% 5% 5% 4% 4% 0% FM 99.7 FM 90.5 FM 97.3 FM 98.8 FM 93.3 Most listened in to Repertoire Source: Findings of the media consumption survey conducted as part of this study Note: Refer to Appendix B for the number of listeners. 24 Figure 3.11. Program Type Listened to on Radio 0.0% 25.0% 50.0% 75.0% News (local/international) 40.2% 33.0% General music 16.5% 34.0% Song request 15.5% 33.0% Politics 6.2% 21.6% Hot news 5.2% 9.3% Lifestyle (health, religion, culture, etc.) 5.2% 21.6% Economics / Business / Finance 4.1% 11.3% Education 2.1% 12.4% Entertainment 2.1% 11.3% Talk back 2.1% 7.2% Sport (news, commentary and live) 18.6% Movies review 4.1% Documentary 10.3% Most often Occasionlly Source: Findings of the media consumption survey conducted as part of this study Unlike television viewership, prime-time radio listenership is in the morning, with the peak from 8:00 am to 9:00 am (Figure 3.12). During this period, listenership is at 39 percent, with males being the predominant audience; the most popular station is FM 98.8, which reaches an audience of up to 11 percent of respondents. Figure 3.12. Prime-time Radio on All Stations, by Sex and Age Morning Prime-time Afternoon Evening Midnight until dawn 50% Total Male Female 25% 15-25 years 26-35 years 36-45 years 0% Source: Findings of the media consumption survey conducted as part of this study 3.1.5. Understanding Mobile Phone Usage Respondents across the four target provinces reported high access to information via their mobile phones (86 percent) (Figure 3.133). When compared to other provinces, Phongsaly residents reported higher use of mobile phones to receive information (95 percent). For example, such usage in Xiengkhuang is 80 percent. Slightly more male than female respondents reported using their mobile phones to get information (88 percent compared to 83 percent). The rate of mobile phone 25 utilization as source of information is relatively high among all age groups but slightly higher among the youngest to middle-age groups (89 percent to 91 percent). Among the different ethnic groups, Sino-Tibetan (93 percent) and Hmong-Mien (97 percent) use their mobile phones to access information the most. Figure 3.143. Access to Information via Mobile Phone 97% 100% 95% 93% 89% 90% 91% 86% 87% 88% 83% 83% 82% 80% 80% 78% 80% 73% 60% 40% 20% 0% Source: Findings of the media consumption survey conducted as part of this study Among 86 percent of respondents who reported they accessed information over mobile phones, 71 percent use their own mobile devices, while 15 percent use other people’s devices (Figure 3.14). Seven out of ten respondents (70 percent) own a dumb phone (mobile phone devices that can only make or receive calls and send or receive text messages), while a small percentage of respondents (16 percent) have feature phones (those that can play stored multimedia files and have a camera). Only three out of ten respondents (30 percent) own a smartphone, where apps may be installed and used. Among those who own a smartphone, the most popular operating system is Android, representing 23 percent of all phones. The three most used social media platforms are YouTube (24.2 percent), WhatsApp (20.8 percent), and LINE (7.0 percent). 26 Figure 3.154. Mobile Phone Access, Ownership and Social Media a. Mobile Phone Access b. Ownership c. Social Media Window s 14% Viber 0.4% Android 1% 23% Messenger 0.6% Skype 0.6% 15% TikTok 0.9% iOS Instagram 1.1% 2% WeChat 1.2% Dumb Feature 60% 71% Twitter 2.2% 14% LINE 7.1% Use their own phone to access information WhatsApp 20.8% Use other's phone to access information YouTube 24.2% Dumb Feature iOS Android Windows Do not use mobile phones to access information 0.0% 10.0% 20.0% 30.0% Source: Findings of the media consumption survey conducted as part of this study Table 3.3 shows the types of services used by respondents on their phones and the frequency of those usages. Reflecting the high ownership of dumb phones (70 percent) in project areas, the most popular use of phones is to make and receive phone calls and send and receive text messages. Among all who have access to mobile phones, 51.7 percent reported they make and receive phone calls several times a day, while 11.9 percent said they send or receive text messages several times per day. Table 3.3. Frequency of Mobile Phone Utilization and the Types of Services Used Several Once a 4–6 times 2–3 times Once a 2–3 times Once a times a day (%) a week a week week (%) a month month day (%) (%) (%) (%) (%) Making and receiving calls 51.70 12.00 15.80 13.70 3.00 1.60 1.70 Sending and receiving SMS (short message service, better 11.90 5.20 5.90 18.90 7.80 7.60 3.90 known as text messaging on mobile phone) Instant messaging (using app) 9.50 1.20 3.50 4.00 1.00 1.40 0.50 Browsing the internet 6.10 1.60 1.90 4.80 1.10 0.50 0.20 Video messaging (e.g., via 5.00 2.80 1.90 3.20 2.10 2.40 1.20 FaceTime or Skype) Social networking or 4.60 1.00 1.20 3.00 1.00 1.70 1.00 Sharing content online Voicemail 4.50 2.30 1.40 1.70 1.70 0.80 1.20 Playing games 3.50 4.80 2.20 6.60 3.30 2.10 1.50 Sending or receiving MMS (multimedia message on a mobile 1.60 0.90 1.30 1.90 0.40 1.50 0.60 phone) Watching television 1.50 0.30 0.30 3.10 0.80 0.40 0.30 Using location-based (GPS) apps 0.90 0.30 0.00 0.20 0.30 0.90 1.00 Internet banking 0.40 0.00 2.40 0.20 0.00 0.30 2.00 Checking e-mail 0.10 0.00 0.50 0.50 0.50 0.70 2.50 Downloading ringtones 0.10 1.10 0.50 0.60 1.00 1.90 0.90 Source: Findings of the media consumption survey conducted as part of this study 27 This media audit found that some companies send advertising messages to respondents through their phones. As shown in Table 3.4, receipt of mobile phone advertising and promotions is predominantly through text messages (61 percent); about 13 percent receive the information via phone calls. Of those with smartphones, about a quarter of respondents reported they had received advertisements via apps in their phones. Table 3.4. Mobile Phone Ads, Promotional Material, and Information Campaign Received Text info 61.0% Text to receive something for free 29.2% Text to receive free content (news, songs, etc.) 26.8% Text to join a raffle 19.1% Text to vote for promotion 6.7% Text about health warning 6.7% Text about crop and animal prices 4.8% Text to join a survey 3.4% Text to send feedback (television show) 1.9% Text to send feedback (radio) 1.2% App advertising or promotion 25.7% Calls received for advertisements 13.1% Source: Findings of the media consumption survey conducted as part of this study Note: 11 percent cannot remember what they received; 7 percent cannot read the messages because they are in English; and 3 percent cannot read. 3.1.6. Understanding Out-of-Home Media Access OOH media come in innumerable forms: posters at bus shelters, displays on sides of trucks, digital content on public monitors, and so forth. Overall, approximately 66 percent of respondents reported accessing information through OOH channels (Figure 3.15). OOH media are widely accessed across Phongsaly (70 percent), Oudomxay (73 percent), and Xiengkhuang (68 percent), but least accessed among those in Huaphanh (53 percent). The younger to the middle-age groups are exposed to OOH media more than older age groups. Exposure to OOH media ranges from 66 percent (for the middle-age group) to 73 percent (among the younger group). Among the different ethnic groups in the target area, the Mon-Khmer are most exposed to OOH media (78 percent). 28 Figure 3.16. Access to information via Out-of-Home Channels 95% 97% 100% 91% 93% 88% 89% 90% 86% 87% 83% 83% 82% 80% 80% 78% 80% 73% 60% 40% 20% 0% Source: Findings of the media consumption survey conducted as part of this study Of those respondents who reported they had received or seen information on OOH channels, the frequency of access on a daily basis is highest among those in Phongsaly (36 percent) and Xiengkhuang (33 percent). More males reported they had seen information through OOH media more frequently than female respondents (28 percent compared to 14 percent). The Lao Tai respondents (37 percent) also reported they had seen OOH messages more than other ethnic groups (Figure 3.16). Figure 3.176. Frequency of Access to Information via Out-of-Home Media 100 14 8 17 22 12 17 20 32 21 80 20 26 30 24 21 26 Once every 3 months 24 Once a month 60 26 15 Once every 2 weeks 25 11 40 23 28 29 12 13 23 28 17 One day a week 20 26 25 2–3 days a week 20 36 21 33 37 4–5 days a week 28 27 29 21 21 21 20 22 14 14 15 15 8 6 days a week - Every day Source: Findings of the media consumption survey conducted as part of this study The audit found that the most common forms of OOH media seen over the three months preceding the survey were posters in public places, such as health centers or markets (88 percent) and billboards (62 percent) (Figure 3.17). Most respondents had most recently seen posters (58 percent) followed by billboards (25 percent). Fifty-eight percent of respondents reported seeing OOH 29 media within their villages, and 39 percent had seen them outside their villages but within their district. Figure 3.18. Forms and Proximity of Out-of-Home Media Exposure a. Forms b. Geographic Proximity Province Outside 100% 88% 1% province 2% 80% 62% 58% 60% District 39% 40% 25% Village 20% 23% 58% 20% 12% 9% 3% 5% 6% 2% 0% Billboard Poster (health Banner Video/screen in Bulletin board Loudspeaker center, market, shops seen within the Village District road?) village P3M Last Seen Province Outside province Source: Findings of the media consumption survey conducted as part of this study Note: P3M = Preceding three months. 3.1.7. Understanding Online Access Access to information via the internet is relatively low, with only 14 percent of respondents reporting they have accessed information from the internet (Figure 3.18). Surfing the internet for information was most prevalent among residents of Phongsaly (22 percent), followed by those in Xiengkhuang Province (16 percent). Access to information through online channels was also more common among male than female respondents (17 percent versus 10 percent), more common among younger than older age groups (20 percent for 15- to 25-year-olds versus 3 percent for 46- year-olds and older), and highest among the Lao Tai (22 percent, compared with 9 percent among the Mon-Khmer). Figure 3.19. Access to Information Online 25% 22% 22% 20% 20% 17% 18% 16% 16% 15% 15% 14% 12% 11% 11% 10% 10% 10% 9% 5% 3% 0% Source: Findings of the media consumption survey conducted as part of this study 30 Among respondents who had accessed information online (14 percent), all reported they had accessed the internet using their mobile devices (Figure 3.19). The frequency of accessing online content varied from less than once a week (14 percent) to every day (27 percent), with the duration being mostly less than an hour a day. Figure 3.20. Devices, Frequency, and Duration of Internet Access a. Platform b. Frequency c. Duration Laptop Desktop 30% 27% 27% 80% 5% 6% 24% 63% 25% Tablet 5% 20% 60% 13% 15% 34% 10% 40% 10% 5% 20% Smartphone 84% 0% 3% Less than 1–2 times a 3–4 times a Nearly Everyday Smartphone Tablet once a week week week everyday, 0% 5–6 times a Less than an Between 1–3 More than 3 Laptop Desktop week hour hour hours Source: Findings of the media consumption survey conducted as part of this study Of the internet websites accessed by respondents, Facebook was the most frequently visited (Figure 3.20). Online engagement in Facebook averaged approximately an hour per day (64 minutes). Respondents commonly accessed the social media platform during weekends (36 percent) and on Mondays (28 percent). Figure 3.210. Facebook Access, Online Engagement and Day of the Week Access a. Frequency of Usage b. Usage by Day 30% Sunday 13% 25% 24% 64 Monday 28% 20% 18% Minutes 15% 15% 11% Approx. Saturday 9% 10% 8% 23% daily 5% 1% Online Tuesday 0% 8% Every 4 - 5 Once a 4 - 6 2 - 3 Once a Less Log-in hour in times a day times a times a week than a day day week week once a average Friday 7% Wednesday week Thursday 13% 8% Source: Findings of the media consumption survey conducted as part of this study The most popular activities that respondents engaged in while online were downloading and exchanging multimedia such as music and photos (57 percent) and watching entertaining videos (57 percent) (Figure 3.21). For websites accessed the most, YouTube (94 percent) had the highest hits, followed by Google (22 percent) and Facebook (7 percent). Online access is commonly done by respondents when they are alone (41 percent), while some others access online content with their household members (30 percent). 31 Figure 3.221. Activities Done and Top Websites Visited Online a. Activities Check and do bank service 12% Shop/Buy-sell produce 13% Email 13% Play online game 18% Visit & use websites 21% Chat / IM 33% Watch videos for education purposes 34% Surf for info/Search engine 35% Make telephone call using voice over internet protocol 44% SMS to friends 48% Watch videos for entertainment 57% Download & exchange music, photos 57% 0% 10% 20% 30% 40% 50% 60% b. Websites Visited c. Accessed with 3% 12% 7% 22% 41% 14% 94% 30% Alone Household member Friend Peers at work Relative YouTube Google Facebook Source: Findings of the media consumption survey conducted as part of this study When engaged in online activities, the most commonly searched information was entertainment content (30 percent), information about education and training (24 percent), and news (17 percent) (Figure 3.22). Respondents in Phongsaly and Xiengkhuang are more likely to search for entertainment content and information about education and training, while respondents in Oudomxay and Huaphanh are more likely to look for news online. Respondents from Oudomxay are the top users of online platforms for health information (33 percent). People in the older age group (46 years and older) do not access entertainment content online but look instead for other information such as information about job vacancies and livelihoods (29 percent), price information for crops (25 percent), information about health (23 percent), and so forth. 32 Figure 23. Most Frequently Searched Information Online 100% 4% 3% 4% 4% 5% 4% 6% Others 12% 4% 12% 6% 9% 5% 14% 90% 8% 7% 21% 7% 7% 9% 21% 25% 8% 10% 7% 9% 29% 80% 12% 13% 16% 15% Price 6% 10% 15% 10% 4% information for 70% 35% 5% 6% 25% crops 13% 17% 18% 25% 40% 21% Information 60% 22% 29% 28% 38% about job 32% vacancies/livelih 50% 36% ood 7% 27% Information 24% 23% 37% 16% 7% about health 40% 33% 12% 42% 23% 55% 30% 18% News 49% 20% 40% 35% 37% 30% 6% 30% 29% 32% 33% 31% 10% 23% 20% Information 15% 14% 14% about 0% Education/TVET Entertainment Source: Findings of the media consumption survey conducted as part of this study Note: TVET = Technical and Vocational Education and Training. 3.1.8. Understanding the Newspaper Medium Access to newspapers is very low among the target population, at approximately 13 percent of households interviewed (Figure 3.23). In Xiengkhuang, only 7 percent of respondents reported they had accessed information in newspapers. Newspaper readership was lower among female respondents (9 percent versus 17 percent for males), the oldest age group (9 percent), and the Hmong ethnic group (10 percent). Figure 24. Access to Information via Newspapers 20% 18% 18% 17% 17% 16% 16% 14% 13% 13% 13% 12% 12% 12% 10% 10% 9% 9% 7% 8% 4% 0% Source: Findings of the media consumption survey conducted as part of this study 33 Among those who read newspapers, respondents mostly read them one to two times a week (Figure 3.24). They spent about 30 minutes in every reading session. Newspapers were read mostly on Mondays (28 percent). Figure 25. Newspaper Readership a. Frequency b. Preferred Days 60% 13% 48% 28% 50% 40% 34% Approx. daily 23% 30% newspaper reading 8% 20% 16% average = 29 minutes 7% 10% 13% 1% 1% 8% 0% Less than 1–2 times a 3–4 times a Nearly every Everyday Monday Tuesday Wednesday Thursday once a week week week day, 5–6 times a week Friday Saturday Sunday Source: Findings of the media consumption survey conducted as part of this study Figure 3.25 shows the newspapers that are read by people in the target areas. Lao newspapers such as Pasaxon (42 percent), Pathet Lao (37 percent), and Sunday News (33 percent) were the most read newspaper titles. Thai newspapers constituted a very small proportion of the preferred newspapers. Figure 26. Widely Read Types of News 50% 42% 40% 40% 37% 35% 33% 30% 24% 19% 20% 20% 16% 15% 15% 11% 10% 6% 6% 5% 5% 2% 2% 2% 2% 0% Read yesterday Read often Source: Findings of the media consumption survey conducted as part of this study 34 3.1.9. Salient Communication Relevant to Health Governance and Nutrition Development Projects Almost all respondents admitted they had come across communication related to HGNDP (e.g., maternal and child health, nutrition, and sanitation and hygiene information), with only 1 percent reporting they had never heard, read, or seen any HGNDP-related information (Figure 3.26). Their encounter with this information had happened during the month prior to the survey (84 percent). Figure 27. Exposure to Health Governance and Nutrition Development Project–Relevant Communication a. Extent of Exposure b. Frequency 50% No, I have not heard, read or 41% I don’t know 40% seen any information about these related to those topics, 1% topic, 0% 30% 18% 17% 20% 8% 7% 10% 5% Yes, I have heard, 2% 1% read or seen any information 0% Yesterday Over the Over the Last More More More Long related to those past past few month than 3 than 6 than a time ago topics, 99% week weeks months months year ago ago ago Source: Findings of the media consumption survey conducted as part of this study Figure 3.27 shows the different topics related to HGNDP communications heard or seen by the target population. Messages related to vaccination were mentioned as the most heard or seen by respondents (59.8 percent). Other commonly heard or seen messages were on feeding programs (12.3 percent), provision of postnatal care (9.4 percent), and personal hygiene guidelines (7.7 percent). 35 Figure 287. Health Governance Nutrition Development Project–Relevant Communication Other 4.6% Don't remember 0.8% Don't know 0.2% Planting and raising livestock 0.2% No violence against women and children 0.2% Thyroid prevention 0.2% Checking older people's eyesight 0.2% Family planning 0.4% Institutional child birth 1.0% Provision of prenatal care 1.9% Mother and child nutrition 2.5% Clean and green drives 3.3% Personal hygiene guidelines/information 7.7% Provision of postnatal care 9.4% Feeding programs 12.3% Vaccination 59.8% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% Source: Findings of the media consumption survey conducted as part of this study Note: HGNDP = Health Governance and Nutrition Development Project. Almost all (90 percent) of these messages were received via village announcements (Figure 3.28). Only 13 percent of respondents had seen HGNDP-related SBCC on OOH media and television, and only 4 percent had received the messages on their mobile devices. As such, although mobile phones, television, and OOH channels had been mentioned as common media touchpoints, these had not been the source of HGNDP-related SBCC messages. Figure 29. Media Channels for Receiving Health Governance and Nutrition Development Project– Related Social and Behavior Change Communication Messages 100% 90% 75% 50% 25% 13% 13% 4% 2% 2% 2% 1% 0% 0% Village OOH (including bill TV Mobile phones Print (including, Facebook Radio Social Media Online (internet announcements boards, posters, (information daily newspapers, (other social media activities using (loudspeakers) video walls and received via SMS, other press and platforms aside mobile phones, other OOH) voice messaging) printed media from Facebook) tablets or laptop) options) Source: Findings of the media consumption survey conducted as part of this study Note: OOH = Out-of-home (media). 36 3.2 HIGHLIGHTS OF THE QUALITATIVE COMPONENT The first component of this MA involved conducting five key informant interviews (KII) from three types of organization, namely: (i) a development partner organization involved in nutrition- related activities, (ii) the private sector, and (iii) the government of Lao PDR. The main goal of these interviews was to obtain an overview of media habits in the country as well as to understand better the main channels of communication nationwide. These interviews preceded the quantitative survey so that their findings would inform the development of the survey instruments. In total, five KIIs were conducted with representatives from the following: 1. An international nongovernmental organization with a long history of developing and delivering nutrition-related SBCC activities in the country: The context of the discussion was the organization’s various projects in the field of health and nutrition in general and breastfeeding in particular. The organization has implemented most of its projects in the southern part of Lao PDR (Khammuane and Savannakhet). 2. A UN organization that also has a long history of supporting nutrition programs in Lao PDR. The organization’s support has largely focused on program design rather than execution. 3. An advertising and media agency: The context of the discussion included communication projects that are commercial in nature but also have social relevance. Among other programs, the interviewee’s responses focused on long-running scholarship programs in rural areas with grassroot communities as beneficiaries. Some inputs are from media campaigns implemented for various commercial clients. 4. Media Department, Ministry of Information, Culture, and Tourism: The interview was based on general communication programs implemented by the government. Information obtained is largely subjective, as there was a lack of empirical studies by the government to measure the nationwide media landscape. 5. Telecommunication Department, Ministry of Posts and Telecommunication: As in the case of the Media Department, the bulk of information in the interviews was opinion-based, although a few facts were provided. The following section is a presentation of the findings from the KIIs, which are summarized and divided into two parts. The first is the nationwide media landscape provided by key informants from the government of Lao PDR. The second describes actual implementation strategies undertaken by the development partners and the private sector. 3.2.1. Overall Nationwide Media Reach and Consumption Television National television coverage is up to 50 percent, and television reception is available in some provinces only in the flat areas, such as Vientiane Capital, Savannakhet, and Champassak. Cities in the northern regions (where the media audit survey was conducted) have notably low television coverage because of the mountainous terrain. The province with the most television coverage in the north is Huaphanh, where a television signal is available in most districts. Most of the signals available use analog transmission. In other provinces in the north, television is only available in town centers and not at all in rural areas. Therefore, the only way to reach far-flung areas in the north via 37 television is through satellite televisions. Lao television channels have the widest reach in these areas. Nevertheless, the challenge with using satellite televisions is the high cost of placing advertisements and communication therein. Government budget limitations are the critical barrier in attaining wider television coverage in the country. Two key challenges to this industry are establishing stations in rural areas and producing interesting and high-quality programs. In terms of most watched television programs, Lao people prefer to watch Thai television shows such as soap operas (series) and game shows more than local television programs. Television series are more commonly watched by women, while men tend to watch sports (e.g., boxing), news, and movies. Entertainment programs are generally more popular among younger generations, while older people prefer to watch documentaries and local and international news about politics and economics. Popular local television programs include dancing and singing contests. However, these shows are no longer available due to budget problems faced by the government’s Media Department. In terms of engagement, people in rural areas tend to spend more time watching television than those in urban areas. Prime time is, in general, from 6:00 am to 7:00 am in the morning and 7:00 pm to 8:00 pm in the evening. Most ethnic minority groups mostly watch news in the morning before going to their farms. KIIs recommended that to capture the attention of the target audience, television programs must be interesting and relevant to their daily lives. Interactive programs will likely be more watched and engaging to the target population. However, due to budget constraints there are currently no studies on television coverage and consumption in Lao PDR. Radio Almost all provinces (95 percent) have access to a radio signal. Amplitude modulation (AM) bandwidth is mostly available in rural areas. Most rural areas are believed to have good radio reception, but there is no empirical evidence to back up this claim. Popular radio stations in rural regions include AM 103.7, AM 90.6, and AM 95.0. Popular programs include music and news shows. Key informants opined that both men and women prefer to listen to these genres. By age, news and traditional music programs are for the older age cohorts, while modern music is appealing to younger audiences. Radio seems more popular than other media touchpoints to ethnic minorities. This is because they can call the station to report any broadcast interruptions. Ethnic groups prefer listening to programs on the radio that are broadcast in their own language and aired daily. A few issues were identified by key government informants regarding radio listenership, and they proposed some recommendations. First, there are currently no statistics on daily radio listenership. Second, there are few qualified and competent disc jockeys, which is the main barrier to producing high-quality and interesting radio programs. To produce effective radio programs for the campaigns in the target area, it was recommended that the programs be broadcast in the local and ethnic languages and should be culturally relevant to the target groups. Newspapers Newspapers reach only the provincial area and some central districts. This coverage pattern applies to the four program areas as well as any other provinces in Lao PDR. The percentage of newspapers reaching rural villages is almost nil. It is only when villagers travel to the district or provincial centers and bring back newspapers that they have the opportunity to access them. In the provincial and district centers, newspaper circulation is based on subscription only. Widely circulated 38 newspapers include Laos Economic Daily (private publisher), Pathet Lao, Pasaxon, and Lao Patthana (government publisher). The target audience of the program will most likely be interested in news, product advertisements, and lifestyle tips and tricks. The interviewees suggested that any communication on the topic relevant to the program may be placed in the health magazine of the Ministry of Health and of the Lao Women’s Union. However, in general, women are less likely to read print media compared to men because of their low literacy. Men would be interested in news, updates on technology, and current global affairs. While women, if they read at all, would be interested in lifestyle, food, and cooking. Younger adults are less likely to read newspapers, and if they did, they would be interested in job vacancy postings. Older adults, on the other hand, would be more interested in news (both local and international) and notices and warnings for women and children’s welfare. There are no data or knowledge on the readership among ethnic groups. Low literacy rates and poor educational attainment are the main barriers to print media penetration. Therefore, to effectively communicate with the rural constituency, simple and illustrative printed materials would be the best. Guidebooks for village facilitators will also be effective. As much as possible, these printed materials must be in their local or ethnic languages. Telecommunication Mobile phone reception is available in all provinces, covering 95 percent of the villages. All four HGNDP target provinces have stable signal quality. While there are no data on coverage by province, signals are believed to reach large local areas. Although all four telecommunication providers in Lao PDR are available nationwide, Unitel and Lao Telecom are more popular in rural areas. There is likely no difference on usage habits between men and women. Younger people use mobile phones more than older people. Unfortunately, there is no information available on ethnic usage of mobile phones, and there is also no data on mobile phone service expenditures. Income, both personal and household, seems to be a barrier for access to telecommunication. Villagers are unable to pay for the service or purchase phones, especially smartphones, through which they may be reached more effectively. Recommendations to reach rural target audiences are to send them an SMS “text blast” at the very least because they cannot afford to buy smartphones. 3.2.2. Implementation Strategies for Information Dissemination Campaigns Methods for Implementing Information Dissemination Activities For development partner projects, health and nutrition–related communication has been conducted through an integrated approach, including direct interaction with beneficiaries in rural areas. This has been achieved through interpersonal communications, village meetings and activities, village fairs or “fun days,” and with village volunteers being the main link between the project and household members in transmitting the messages. The pedagogical approach used counseling rather than an education or lecture approach and often refrained from theoretical discussions and focused more on providing practical guidance. Development partners tended to use a combination of television, radio, and the usual posters as means of communication. There were future plans to broadcast SBCC information across the country through national programs, while regional or local radio programs will be targeted at the provincial level. Social media such as Facebook will also be used as another channel for communication. Moreover, development partners 39 are also exploring newer methods for information dissemination such as via smartphones and mobile phones. However, the challenge for this approach in rural Lao PDR is the low electricity coverage for device charging. For the private sector, fun fairs conducted in the villages were the main mode of disseminating information. Similar to the “fun days” implemented by NGOs, booths for games, consultations, and other activities were set up in the village in a caravan fashion. There was no reported use of television or radio. Recommendations for Effective Social and Behavior Change Communication for Rural Areas Development partners and the private sector provided several recommendations for more effective SBCC in rural settings. First, health and nutrition–related messages might be more effectively communicated through radio than television. Second, print media are not suitable dissemination vehicles outside of cities, especially for beneficiaries at the village level due to low literacy rates among these population groups. Third, carefully crafted research needs to be conducted to better understand what works among different segments of the target beneficiary and which media touchpoint would be more cost-effective. Fourth, the private sector further recommended that projects should employ local people with local languages during project implementation and information session facilitation. 40 PART IV — CONCLUSIONS From the results of this study, it is clear that most “modern” media channels will have limited use for health and nutrition–focused SBCC in these remote rural villages. The one channel that was revealed to be the most impactful and relevant is village announcements using loudspeakers. This is, however, not surprising in a largely rural society with high rates of illiteracy and limited connectivity. 4.1 SPECIFIC CHARACTERISTICS OF EACH MEDIA CHANNEL 4.1.1. Television Television is the most popular among residents of Xiengkhuang, females, older age groups, and the Lao Tai ethnic group. The target audience is spending about two hours per day watching television, with Lao Star (21 percent) as the top television channel in the target areas. If ever television is used, campaign materials must be placed through several television channels to maximize the reach. Prime-time television, where campaign materials must be aired, runs from 6:00 pm to 9:00 pm. Programs gaps, where these materials should be placed, are between news, series, and general entertainment programs. 4.1.2. Radio Radio appears to be the most suitable medium to reach the various ethnic minority groups that populate the project provinces. Currently, there seem to be various radio programs aired in ethnic languages. Radio is most popular among those in Phongsaly, among men, among the older age group, and among Lao Tai. Potential beneficiaries are spending about two hours listening to radio, most possibly over FM bandwidth (49.5 percent), with only 3.0 percent on AM, while the rest are unsure. The top radio station listened to is FM 99.7 (39.0 percent). Prime-time radio runs from 7:30 am to 9:30 am. Popular genres of programs include news, music, politics, and lifestyle. 4.1.3. Mobile Phones Mobile phones are widely used to access information among those in Phongsaly, males, the younger age groups, and among Akha and Hmong. It must be noted that while almost all the target audience (86 percent) uses a mobile phone to access information, only 30 percent have smartphones. As such, making and receiving calls and sending and receiving text messages are the main activities on their mobile phones. The top three mobile phone applications used by those with smartphones are YouTube, WhatsApp, and Line. Almost all mobile phone users (83 percent) are willing to receive information, advertisements, and promotions on their mobile phones, and they are likely to read (if they are able to) and listen to them. 4.1.4. Out-of-Home Media Out-of-home media are widely available in all four provinces except Huaphanh. Men are more exposed than women, and younger age groups are more exposed than older ones, as they are more mobile, traveling outside the village more often. The most common forms of OOH media seen by respondents are posters displayed in village offices and billboards shown in general public places. Out of every 10 respondents, 6 reported they had seen various types of this medium within the village, while 4 in every 10 see them within the district. Therefore, these are the areas where OOH media must be posted for better reach. 41 4.1.5. The Internet Internet is popular among those in Phongsaly, among men, and among the younger age cohorts. Lao Tai are the most exposed to online media. All internet users reported they access online media from their mobile phones. About 3 in 10 either access the internet three to four times a week or every day. Engagement is from one to three hours daily. Downloading and exchange of music and photos, and watching videos are the top two activities done online on mobile devices. Respondents also mostly search materials for entertainment and information about Technology and Vocational Education and Training (TVET) and news. Therefore, the program team can leverage these activities to disseminate audiovisual communication materials. Facebook As expected, Facebook is popular among the younger age cohorts. It is also more popular among males, among those in Xiengkhuang, and among the Lao Tai. About a fourth access their Facebook account four to five times a day, with a total of about an hour engagement on a daily basis. 4.1.6. Newspaper Newspaper is popular among middle-age men, among Khmu, and among those in Oudomxay. Potential beneficiaries read newspapers one to two times a week and spend up to half an hour per reading, mostly during the start of the week (e.g., Monday). The top newspaper titles are Pasaxon and Pathet Lao. Aside from the local and international news, readers also look at newspapers’ business section. The potential effectiveness of these communication channels in transmitting health and nutrition–related messages needs to be viewed in terms of preferences, satisfaction, and trust. Village loudspeakers, television, and mobile phones are the three most preferred media channels among the target population. In terms of satisfaction, villagers are most satisfied with village loudspeakers, online, and mobile phone channels. Finally, in terms of trust, village loudspeakers are the most trusted channel, distantly followed by all other media. Findings from this MA show that village announcements through loudspeakers are the most preferred, have the most satisfied users, and are the most trusted source of information in all villages. However, given the “audit” nature and scope of this study, it was not possible to ascertain why exactly this was the case, nor which messages village announcements have been the most effective in conveying. Therefore, a more focused study is required to address these gaps in knowledge and whether and how this channel can be coupled with other “modern” media channels such as radios, phones, and OOH to deliver health and nutrition–focused SBCC. Mobile phones follow village announcements in terms of reach. Nonetheless, it must be noted that only text messages and calls are likely to work effectively since 70 percent of phones used in target areas are either dumb phones or feature phones. However, given the low literacy rates in these communities, reading these texts could be a major constraint. Televisions reach 50 to 70 percent of the target areas. However, to increase penetration of SBCC messages into these rural and largely remote communities, audiovisual information materials may need to be run on satellite televisions that have higher and wider coverage. However, it should also be noted that as close to half of television channels airing in the target villages are Thai channels, controlling the airing of these messages and/or the cost of this approach would be a major hindrance. 42 Out-of-home media have potential for reaching a large segment of the target populations. The content and placement of banners at suitable locations would need careful consideration to increase their reach and message consumption. Other practical communication methods that may warrant further exploration include pocket projectors and fun fairs, stage performances, puppet theaters, and non-spoken drama in the villages. For all communication and information materials, several points must be considered. First, it is important to use simple messages, given the low levels of literacy in these communities. Second, as much as possible, messages should be conveyed in local or ethnic languages. It is noteworthy, however, that the use of local language may only be effective through audio and audiovisual materials, since not all local and ethnic minority languages have written scripts. Third, audiovisual materials such as comics and cartoons should be used because a significant proportion of the constituents are not able to read. Finally, messages would need to be highly segmented, catering to the dynamics of sex, age, and ethnic differences. 43 APPENDIX A. SUMMARY OF KEY INFORMANT INTERVIEWS Development partners Private sector Methods for program information dissemination and campaign implementation • Communication is done via an integrated • Fun fairs are conducted in the village, similar approach by directly interacting with the to the fun days implemented by NGOs; beneficiaries in rural areas. This is done booths for games, consultations, and other through interpersonal communication, village activities are set up in the village in a caravan meetings and activities, and village fairs or fashion. Basically, these are village visits. No “fun days” done by village volunteers directly television or radios are used. with household members. These efforts use a counseling rather than education approach, refraining from theoretical discussions and providing practical guidelines. • Mixture of television, radio, and posters. • National broadcasts will be used with some province-specific contents through regional or local radio. • Main message is maintained nationwide, while province-specific messages are delivered by Social and Behavior Change Communication (SBCC) task force. Methods specifically targeting rural areas • More face-to-face interactions with • Fun fair in the villages: beneficiaries, rather than through a media o With simple mechanics campaign. o Local people facilitating because • Potential use of the following technologies: language is important • Home visits o Smartphone and access to • School tours communication through mobile phones • No television or radio despite rather low electricity coverage • No online for rural areas, only for cities, o Pocket projectors for village chiefs for especially Facebook use during meetings with villagers, 44 featuring clips on nutrition, handwashing, and sanitation Target beneficiaries • Mostly parents • Household heads • Other adults in the household • Target market of commercial brands Strategies by gender • Gender-specific messaging • Difference in topics of programs to reach • Difference mainly on best time to reach them: them: o Sports and news on television, radio, o Women in the early morning and late and in print for men evening o Talk show (“Women Talk”) among o Men during most of the day women Strategies by age • Age-segmented communication • Digital for younger people, such as Facebook • Find out what works by age cohorts in the • Illustrated visuals in local and ethnic village languages for the older age group Foreseen barriers • Connectivity via mobile devices driven by low • Literacy and comprehension of rural electricity coverage constituency • Cost of airtime for television • Cost, so communication is channeled through village volunteers 45 Recommendations for effective SBCC for rural program areas • Radio over television • Use of local people during implementation • Use of mobile phones (video clips on • Language considerations Facebook, YouTube), using the same contents on different platforms • No value of print (due to low literacy) • Carefully crafted formative research to understand what works among different segments of the target beneficiary and which media touchpoint is more cost-effective 46 APPENDIX B. FIGURE 3.4 AND FIGURE 3.10 SUMMARY DATA Table B.1. Ten Most Watched Television Channels and Television Channel Repertoire (for Figure 3.4) TV channel Most Repertoire Number watched (%) of (%) viewers Others 6 26 155,852 MV Lao 2 13 73,040 Now 26 2 9 50,863 Lao PS TV 7 19 127,225 Lao TV 3 9 26 170,178 Lao TV 1 9 22 151,828 Lao Star 21 30 246,428 Thai channel 8 2 18 96,818 Thai channel 3 3 65 317,903 Thai channel 7 39 49 427,458 Source: Findings of the media consumption survey conducted as part of this study Table B.2. Five Most-Listened-to Radio Stations and Station Repertoire (for Figure 3.10) Station Most Repertoire Number listened to (%) of (%) listeners FM 99.7 25 14 46,305 FM 90.5 12 14 16,908 FM 97.3 9 10 11,437 FM 98.8 4 7 8,523 FM 93.3 4 5 5,968 Source: Findings of the media consumption survey conducted as part of this study 47 APPENDIX C. SURVEY OF HOUSEHOLDS QUESTIONNAIRE MEDIA CONSUMPTION SURVEY 2018 (HGNDP) Indochina Research Laos Questionnaire ID: _____________________ 282/17 Phontong Savath, Chathabouly District Interviewer name: ____________________ Tel: (855-21) 562 881Œ-4 Interviewer no.: ______________________ Fax: (855-21) 562 880 Vientiane, Lao PDR Respondent name: _____________________________ Contact Phone No.:____________________ Ethnic group/code of household head Sino-Tibetan–Akha, Phong... 01 Province name/Code: _______________ Mon-Khmer-Khmu ................ 02 Hmong-Mien ......................... 03 District name/Code: ________________ Lao Tai .................................. 04 Village name/Code: _________________ Others ................................... 05 Locale Day of the Week Urban .................................... 01 Monday ................................. 01 Rural with road...................... 02 Tuesday................................. 02 Rural without road................. 03 Wednesday ........................... 03 Thursday .............................. 04 Friday .................................... 05 Saturday ................................ 06 Sunday .................................. 07 RESULTS 48 Household visit #1 Household visit #2 Household visit #3 Day Month Year Day Month Year Day Month Year 2 0 1 9 2 0 1 9 2 0 1 9 Start time : Start time : Start time : End time : End time : End time : Total time mins. Total time mins Total time mins Complete . 1 Complete. 1 Complete .1 Outcome Outcome Outcome Call back .. 2 Call back . 2 Call back ..2 A2. Difficulty of respondent in answering questions: A3. Was translation used? No difficulty ....................................1 Yes, all, or most ................................. 1 Some difficulty ...............................2 Yes, some .......................................... 2 Much difficulty ...............................3 No ....................................................... 3 COMMENTS 49 SCREENING AND RECRUITMENT Good morning/afternoon. We are carrying out a household survey on media and lifestyle habits, and we would be grateful if you could spare some time to answer some questions? We need to talk to an adult family member over 15 years old who currently has children five years old and below OR to any household (HH) members who are main caregivers of a child or children five years old and below. Sa. Do you have household members who fall under these criteria? Yes.............................1 Continue No ..............................2 Proceed to next sample household Sb. How many members of your households fall under these criteria? NOTE TO INTERVIEWER: If the father and the mother are in the household, this means more than one is present, we will select the one who is taking care of the youngest child in the household. Review scenarios based on training. More than one………….1 Select the one who is taking care of the youngest child in the HH Only one………………..2 GO TO S1 S1. Record gender Male ........................................................................ 1 Female ........................................................................ 2 S2. Please tell me your age. Record actual: ____ _____ (And code below) 15–25 years .................................................... 2 Check quota 26–35 years .................................................... 3 Check quota 36–45 years .................................................... 4 Check quota 46 years and up .............................................. 6 Check quota Note to Interviewer: Check quota of age by province Age Phongsaly Oudomxay Huaphanh Xiengkhuang Total 15–25 33 32 32 33 130 50 26–35 33 33 32 32 130 36–45 32 33 33 32 130 46 and up 32 32 33 33 130 Total 130 130 130 130 520 S3. Which of the following ethnicities do you belong to? (SHOW CARD) Sino-Tibetan–Akha, Phong .......................... 01 Mon-Khmer-Khmu ........................................ 02 Hmong Mien ................................................. 03 Lao Tai .......................................................... 04 Other ............................................................. 05 Note to Interviewer: Check quota of ethnicity by province Ethnicity Phongsal Oudomxa Huaphan Xiengkhuang y y h Sino-Tibetan–Akha, Phong 53 29 0 0 Mon-Khmer-Khmu 29 48 20 18 Hmong Mien 14 29 61 42 Lao Tai 0 0 16 35 Other 34 25 34 35 Total 130 131 131 130 S4. Which of the following best describes your reading ability (SHOW CARD)? This is just to help us understand levels of literacy around Lao PDR. SA I can read everything ...................................... 1 I can read most things .................................... 2 I can read only a little ..................................... 3 I cannot read................................................... 4 Refuse ............................................................ 5 51 ---------------------------------------------------------------------------------------------------------------------- MEDIA ACCESS, PREFERENCE, SATISFACTION, AND TRUST OBJECTIVE 1a: Reach (access) Q1. I have here a list of media channels that people use to get or receive information (SHOW CARD), could you tell me which of these media channels you have used over the past three months to get information? (MR) OBJECTIVE 1b: Preference Q2. Among those media channels you have used over the past three months (programmer to answer according to answer in Q1) to get or receive information, could you please tell me which channel you prefer the most? (SA) Q1. Q2. Used in Prefer the P3M Most A. Television 1 1 B. Radio 2 2 C. Print (including daily newspapers, other press and printed media options) 3 3 D. Out-of-home media (including, billboards, posters, video walls, and other 4 4 OOH channels) E. Mobile phones (information received via SMS, voice messaging) 5 5 F. Village announcements (loudspeakers) 6 6 G. Online (internet activities over a mobile phone, tablet, or laptop) 7 7 H. Facebook 8 8 I. Social media (all other social media apps and platforms aside from 9 9 Facebook) OBJECTIVE 1c: Level of satisfaction Q3. Among those media channels you have used over the past three months (programmer to filter topics according to answer in Q1) to get or receive information, could you please tell me your level of satisfaction for each? Can’t Very Somewhat Somewhat Very say/ satisfied satisfied Undecided dissatisfied dissatisfied Refused A. Television 1 2 3 4 5 9 B. Radio 1 2 3 4 5 9 C. Print (including daily newspapers, other press 1 2 3 4 5 9 and printed media options) D. Out-of-home media (including, billboards, 1 2 3 4 5 9 posters, video walls, other OOH channels) E. Mobile phones (information 1 2 3 4 5 9 received via SMS) F. Village announcements 1 2 3 4 5 9 (loudspeakers) G. Online (internet activities over a mobile phone, tablet, 1 2 3 4 5 9 or laptop) H. Facebook 1 2 3 4 5 9 52 I. Social media (all other social media apps and 1 2 3 4 5 9 platforms aside from Facebook) OBJECTIVE 1d: Trust Q4. Among those media channels you have used over the past three months (programmer to filter topics according to answer in Q1) to get or receive information, could you please tell me which channel you trust the most? (SA) Q1. Used in past A. Television 1 B. Radio 2 C. Print (including, daily newspapers, other press and printed media options) 3 D. Out-of-home media (including, billboards, posters, video walls, and other OOH 4 channels) E. Mobile phones (information received via SMS) 5 F. Village announcements (loudspeakers) 6 G. Online (internet activities they do over a mobile phone, tablet, or laptop) 7 H. Facebook 8 I. Social media (all other social media apps and platforms aside from Facebook) 9 TV MODULE OBJECTIVE 2i. TV Interviewer: Ask only among those who mentioned TV in Q1 T1. How frequently do you watch TV? (SHOW CARD. Record SA) 53 Less than once a week................................................... 1 1–2 times a week ........................................................... 2 3–4 times a week ........................................................... 3 Nearly every day, 5–6 times a week .............................. 4 Every day........................................................................ 5 T2. When you watch TV, how long do you watch? (SHOW CARD. Record SA) Less than 1 hour per day................................................ 1 1–2 hours per day .......................................................... 2 2–3 hours per day .......................................................... 3 3–4 hours per day .......................................................... 4 More than 4 hours per day ............................................. 5 T3. Which of the following do you currently have that is working at home? (SHOW CARD. Record MA) Cable/Digital TV.............................................................. 1 Satellite TV ..................................................................... 2 Free to air TV.................................................................. 3 None of the above .......................................................... 4 T4. Which TV station do you watch most often? (SHOW CARD. Record SA) T5. Which other TV stations do you watch occasionally? (SHOW CARD, Record MA) T4 T5 Stations Most often watched Occasionally watched Lao TV 1 1 1 Lao TV 3 2 2 54 Lao PS TV 3 3 Lao Star 4 4 MV Loa 5 5 Sabaidee TV 6 6 Thai channel 3 7 7 Thai channel 5 8 8 Thai channel 7 9 9 Thai channel 9 10 10 Thai NBT 11 11 Thai PBS 12 12 Thai channel 1 13 13 GMM channel 25 14 14 Workpoint channel 15 15 Thai channel 8 16 16 Other (specify) _________________________ ( ) ( ) T6. Did you watch TV yesterday? Yes.................................................................................. 1 CONTINUE No ................................................................................... 2 GO TO T8 T7. What time did you watch television yesterday? Please specify channel watched for every time slot. Channel name From: 55 05:01– 1 05:30 AM 1 1 1 1 1 1 1 1 1 1 1 1 1 05:31– 2 06:00 AM 2 2 2 2 2 2 2 2 2 2 2 2 2 06:01– 3 06:30 AM 3 3 3 3 3 3 3 3 3 3 3 3 3 06:31– 4 07:00 AM 4 4 4 4 4 4 4 4 4 4 4 4 4 07:01– 5 07:30 AM 5 5 5 5 5 5 5 5 5 5 5 5 5 07:31– 6 08:00 AM 6 6 6 6 6 6 6 6 6 6 6 6 6 08:01– 7 08:30 AM 7 7 7 7 7 7 7 7 7 7 7 7 7 08:31– 8 09:00 AM 8 8 8 8 8 8 8 8 8 8 8 8 8 09:01– 9 09:30 AM 9 9 9 9 9 9 9 9 9 9 9 9 9 09:31– 10 10:00 AM 10 10 10 10 10 10 10 10 10 10 10 10 10 10:01– 11 10:30 AM 11 11 11 11 11 11 11 11 11 11 11 11 11 10:31– 12 11:00 AM 12 12 12 12 12 12 12 12 12 12 12 12 12 11:01– 13 11:30 AM 13 13 13 13 13 13 13 13 13 13 13 13 13 11:31– 14 12:00 AM 14 14 14 14 14 14 14 14 14 14 14 14 14 12:01– 15 12:30 PM 15 15 15 15 15 15 15 15 15 15 15 15 15 12:31– 16 01:00 PM 16 16 16 16 16 16 16 16 16 16 16 16 16 01:01– 17 01:30 PM 17 17 17 17 17 17 17 17 17 17 17 17 17 01:31– 18 02:00 PM 18 18 18 18 18 18 18 18 18 18 18 18 18 02:01– 19 02:30 PM 19 19 19 19 19 19 19 19 19 19 19 19 19 56 02:31– 20 03:00 PM 20 20 20 20 20 20 20 20 20 20 20 20 20 03:01– 21 03:30 PM 21 21 21 21 21 21 21 21 21 21 21 21 21 03:31– 22 04:00 PM 22 22 22 22 22 22 22 22 22 22 22 22 22 04:01– 23 04:30 PM 23 23 23 23 23 23 23 23 23 23 23 23 23 04:31– 24 05:00 PM 24 24 24 24 24 24 24 24 24 24 24 24 24 05:01– 25 05:30 PM 25 25 25 25 25 25 25 25 25 25 25 25 25 05:31– 26 06:00 PM 26 26 26 26 26 26 26 26 26 26 26 26 26 06:01– 27 06:30 PM 27 27 27 27 27 27 27 27 27 27 27 27 27 06:31– 28 07:00 PM 28 28 28 28 28 28 28 28 28 28 28 28 28 07:01– 29 07:30 PM 29 29 29 29 29 29 29 29 29 29 29 29 29 07:31– 30 08:00 PM 30 30 30 30 30 30 30 30 30 30 30 30 30 08:01– 31 08:30 PM 31 31 31 31 31 31 31 31 31 31 31 31 31 08:31– 32 09:00 PM 32 32 32 32 32 32 32 32 32 32 32 32 32 09:01– 33 09:30 PM 33 33 33 33 33 33 33 33 33 33 33 33 33 09:31– 34 10:00 PM 34 34 34 34 34 34 34 34 34 34 34 34 34 10:01– 35 10:30 PM 35 35 35 35 35 35 35 35 35 35 35 35 35 10:31– 36 11:00 PM 36 36 36 36 36 36 36 36 36 36 36 36 36 11:01– 37 11:30 PM 37 37 37 37 37 37 37 37 37 37 37 37 37 11:31– 38 12:00 PM 38 38 38 38 38 38 38 38 38 38 38 38 38 57 12:01– 39 12:30 PM 39 39 39 39 39 39 39 39 39 39 39 39 39 12:31– 40 01:00 AM 40 40 40 40 40 40 40 40 40 40 40 40 40 01:01– 41 01:30 AM 41 41 41 41 41 41 41 41 41 41 41 41 41 01:31– 42 02:00 AM 42 42 42 42 42 42 42 42 42 42 42 42 42 02:01– 43 02:30 AM 43 43 43 43 43 43 43 43 43 43 43 43 43 02:31– 44 03:00 AM 44 44 44 44 44 44 44 44 44 44 44 44 44 03:01– 45 03:30 AM 45 45 45 45 45 45 45 45 45 45 45 45 45 03:31– 46 04:00 AM 46 46 46 46 46 46 46 46 46 46 46 46 46 04:01– 47 04:30 AM 47 47 47 47 47 47 47 47 47 47 47 47 47 04:31– 48 05:00 AM 48 48 48 48 48 48 48 48 48 48 48 48 48 T8. Which type of TV programs do you watch most often? (SHOW CARD. Record SA) T9. Which other types of TV programs do you watch occasionally? (SHOW CARD, Record MA) T8 T9 Program type Most often watched Occasionally watched A. Breaking news 1 1 B. News (local, international) 2 2 C. Economics/Business/ Finance 3 3 D. Series/Soap opera 4 4 E. Movies 5 5 F. Sport (news, live, etc.) 6 6 58 G. Entertainment (concert, comedy, night shows, etc.) 7 7 H. Documentary 8 8 I. Education 9 9 J. Game show 10 10 K. Reality show 11 11 L. Lifestyle (health, religion, culture, etc.) 12 12 M. Other (specify) _________________________ ( ) ( ) RADIO MODULE OBJECTIVE 2ii. Radio Interviewer: Ask only those who mentioned radio in Q1 R1. How frequently do you listen to the radio? (SHOW CARD. Record SA) Less than once a week................................................... 1 1–2 times a week ........................................................... 2 3–4 times a week ........................................................... 3 Nearly every day, 5–6 times a week .............................. 4 Every day........................................................................ 5 R2. When you listen to the radio, how long do you listen? (SHOW CARD. Record SA) Less than 1 hour per day................................................ 1 1–2 hours per day .......................................................... 2 59 2–3 hours per day .......................................................... 3 3–4 hours per day .......................................................... 4 More than 4 hours per day ............................................. 5 R3. Which radio bandwidth do you listen to most often? FM radio ......................................................................... 1 AM radio ......................................................................... 2 Don’t know ...................................................................... 3 R4. Which radio station do you listen to most often? (SHOW CARD. Record SA) R5. Which other radio stations do you listen to occasionally? (SHOW CARD. Record MA) R4 R5 STATIONS Most often listen to Occasionally listen to FM 90.5 1 1 FM 92.5 2 2 FM 93.3 3 3 FM 95.0 4 4 FM 95.5 5 5 FM 96.0 6 6 FM 97.3 7 7 FM 98.8 8 8 FM 101.5 9 9 FM 103.7 10 10 FM 105.5 11 11 CRI FM 93.5 12 12 60 AM Station 1 (specify)______ 13 13 AM Station 2 (specify)______ 14 14 AM Station 3 (specify)______ 15 15 Other (specify) _________________________ ( ) ( ) R6. Did you listen to the radio yesterday? Yes.................................................................................. 1 CONTINUE No ................................................................................... 2 GO TO R8 R7. What time did you listen to the radio yesterday? FM 101.5 FM 103.7 FM 105.5 FM 90.5 FM 92.5 FM 93.3 FM 95.0 FM 95.5 FM 96.0 FM 97.3 FM 98.8 CRI FM Other Station name From: 05:01– A 1 05:30 M 1 1 1 1 1 1 1 1 1 1 1 1 1 05:31– A 2 06:00 M 2 2 2 2 2 2 2 2 2 2 2 2 2 06:01– A 3 06:30 M 3 3 3 3 3 3 3 3 3 3 3 3 3 06:31– A 4 07:00 M 4 4 4 4 4 4 4 4 4 4 4 4 4 07:01– A 5 07:30 M 5 5 5 5 5 5 5 5 5 5 5 5 5 07:31– A 6 08:00 M 6 6 6 6 6 6 6 6 6 6 6 6 6 08:01– A 7 08:30 M 7 7 7 7 7 7 7 7 7 7 7 7 7 08:31– A 8 09:00 M 8 8 8 8 8 8 8 8 8 8 8 8 8 09:01– A 9 09:30 M 9 9 9 9 9 9 9 9 9 9 9 9 9 61 09:31– A 10 10:00 M 10 10 10 10 10 10 10 10 10 10 10 10 10 10:01– A 11 10:30 M 11 11 11 11 11 11 11 11 11 11 11 11 11 10:31– A 12 11:00 M 12 12 12 12 12 12 12 12 12 12 12 12 12 11:01– A 13 11:30 M 13 13 13 13 13 13 13 13 13 13 13 13 13 11:31– A 14 12:00 M 14 14 14 14 14 14 14 14 14 14 14 14 14 12:01– P 15 12:30 M 15 15 15 15 15 15 15 15 15 15 15 15 15 12:31– P 16 01:00 M 16 16 16 16 16 16 16 16 16 16 16 16 16 01:01– P 17 01:30 M 17 17 17 17 17 17 17 17 17 17 17 17 17 01:31– P 18 02:00 M 18 18 18 18 18 18 18 18 18 18 18 18 18 02:01– P 19 02:30 M 19 19 19 19 19 19 19 19 19 19 19 19 19 02:31– P 20 03:00 M 20 20 20 20 20 20 20 20 20 20 20 20 20 03:01– P 21 03:30 M 21 21 21 21 21 21 21 21 21 21 21 21 21 03:31– P 22 04:00 M 22 22 22 22 22 22 22 22 22 22 22 22 22 04:01– P 23 04:30 M 23 23 23 23 23 23 23 23 23 23 23 23 23 04:31– P 24 05:00 M 24 24 24 24 24 24 24 24 24 24 24 24 24 05:01– P 25 05:30 M 25 25 25 25 25 25 25 25 25 25 25 25 25 05:31– P 26 06:00 M 26 26 26 26 26 26 26 26 26 26 26 26 26 06:01– P 27 06:30 M 27 27 27 27 27 27 27 27 27 27 27 27 27 06:31– P 28 07:00 M 28 28 28 28 28 28 28 28 28 28 28 28 28 62 07:01– P 29 07:30 M 29 29 29 29 29 29 29 29 29 29 29 29 29 07:31– P 30 08:00 M 30 30 30 30 30 30 30 30 30 30 30 30 30 08:01– P 31 08:30 M 31 31 31 31 31 31 31 31 31 31 31 31 31 08:31– P 32 09:00 M 32 32 32 32 32 32 32 32 32 32 32 32 32 09:01– P 33 09:30 M 33 33 33 33 33 33 33 33 33 33 33 33 33 09:31– P 34 10:00 M 34 34 34 34 34 34 34 34 34 34 34 34 34 10:01– P 35 10:30 M 35 35 35 35 35 35 35 35 35 35 35 35 35 10:31– P 36 11:00 M 36 36 36 36 36 36 36 36 36 36 36 36 36 11:01– P 37 11:30 M 37 37 37 37 37 37 37 37 37 37 37 37 37 11:31– P 38 12:00 M 38 38 38 38 38 38 38 38 38 38 38 38 38 12:01– P 39 12:30 M 39 39 39 39 39 39 39 39 39 39 39 39 39 12:31– A 40 01:00 M 40 40 40 40 40 40 40 40 40 40 40 40 40 01:01– A 41 01:30 M 41 41 41 41 41 41 41 41 41 41 41 41 41 01:31– A 42 02:00 M 42 42 42 42 42 42 42 42 42 42 42 42 42 02:01– A 43 02:30 M 43 43 43 43 43 43 43 43 43 43 43 43 43 02:31– A 44 03:00 M 44 44 44 44 44 44 44 44 44 44 44 44 44 03:01– A 45 03:30 M 45 45 45 45 45 45 45 45 45 45 45 45 45 03:31– A 46 04:00 M 46 46 46 46 46 46 46 46 46 46 46 46 46 04:01– A 47 04:30 M 47 47 47 47 47 47 47 47 47 47 47 47 47 63 04:31– A 48 05:00 M 48 48 48 48 48 48 48 48 48 48 48 48 48 R8. Which type of radio programs do you listen to most often? (SHOW CARD. Record SA) R9. Which other types of radio programs do you listen to occasionally? (SHOW CARD. Record MA) R8 R9 Program type Most often listen to Occasionally listen to A. Hot news 1 1 B. News (local/international) 2 2 C. Economics/Business/ Finance 3 3 D. Politics 4 4 E. Movie reviews 5 5 F. Song requests 6 6 G. Sports (news, commentary, and live) 7 7 H. General music 8 8 I. Documentary 9 9 J. Education 10 10 K. Entertainment 11 11 L. Lifestyle (health, religion, culture, etc.) 12 12 M. Talk back 13 13 N. Other (specify) ( ) ( ) 64 _________________________ Can’t remember 99 99 MOBILE PHONE MODULE OBJECTIVE 2iii. Mobile phones Interviewer: Ask only those who mentioned mobile phones in Q1 Now I would like to talk to you about mobile phones that you have access to, regardless of whether you own them or not. M1. Do you personally own a mobile phone? Yes.................................................................................. 1 No ................................................................................... 2 M2. What type of mobile phone do you currently use to access information? (SHOW CARD, Pictures) Basic phone .................................................................... 1 Feature phone ................................................................ 2 (can access internet and store and play music but lacks the advanced functionality of a smartphone) Smartphone Android ...................................................................... 3 iOS ............................................................................. 4 Windows .................................................................... 5 I don’t know .................................................................... 6 M3. Generally, how often do you use these services? (SHOW CARD. Record SA for each) Several times a a a a Once a month Once a week times times times Once a day Never 4–6 2–3 2–3 Read out the following attributes: A. Make and receive calls 1 2 3 4 5 6 7 8 B. Send and receive SMS (text message on mobile phone) 1 2 3 4 5 6 7 8 C. Send or receive MMS (multimedia message on a mobile phone) 1 2 3 4 5 6 7 8 D. Voicemail 1 2 3 4 5 6 7 8 E. Instant messaging (using app) 1 2 3 4 5 6 7 8 65 F. Video messaging (e.g., FaceTime or 1 2 3 4 5 6 7 8 Skype) G. Social networking or sharing content online 1 2 3 4 5 6 7 8 H. Check e-mail 1 2 3 4 5 6 7 8 I. Browse the internet 1 2 3 4 5 6 7 8 J. Internet banking 1 2 3 4 5 6 7 8 K. Use location-based (GPS) apps 1 2 3 4 5 6 7 8 L. Watch TV 1 2 3 4 5 6 7 8 M. Play games 1 2 3 4 5 6 7 8 N. Download ringtones 1 2 3 4 5 6 7 8 M4. Excluding Facebook, which of the following apps do you use on your phone, if any? (SHOW CARD, Record MA) WhatsApp ....................................................................... 1 Viber ............................................................................... 2 Skype .............................................................................. 3 Instagram........................................................................ 4 LINE ................................................................................ 5 LinkedIn .......................................................................... 6 YouTube ......................................................................... 7 Twitter ............................................................................. 8 Other (specify: ______________)............................ ( ) I don’t use any of these ................................................ 99 M5. Mobile advertising: Have you ever received advertising, promotion, or information campaign on your mobile (SMS advertising or ads in mobile social networks, mobile video streaming, or mobile games)? (Record SA) Yes.................................................................................. 1 CONTINUE No ................................................................................... 2 GO TO M10 M6. What kinds of advertising, promotion, or information campaigns did you receive or participate in on your mobile phone over the past month? (SHOW CARD, Pictures. Record MA) Calls received for advertisements ................................ 1 In app advertising/Promotion ....................................... 2 Text to receive something for free................................ 3 Text to receive free content (news, songs, etc.) .......... 4 Text to vote for promotion ........................................... 5 Text to join a survey ..................................................... 6 Text to join a raffle ........................................................ 7 Text to send feedback (radio) ...................................... 8 Text to send feedback (TV show) ................................ 9 Text about health warning ......................................... 10 Text about crop and animal prices ............................. 11 Other (specify:______________)........................... ( ) 66 M7. How often do you receive mobile advertising, promotions, or information campaigns? 2–3 times in a day .......................................................... 1 Once a day ..................................................................... 2 Several times in a week ................................................. 3 Several times in a month ................................................ 4 Rarely ............................................................................. 5 Don’t know/Not sure ....................................................... 6 M8. Would you like to receive advertisements, promotions, or information campaigns on the mobile phone in the future? Yes.................................................................................. 1 No ................................................................................... 2 Don’t Know/Not sure ...................................................... 3 M9. A. In which language would you prefer to receive mobile advertising, promotions, or information campaigns on the mobile in the future? (Record SA) B. In which language would you prefer to receive mobile advertising, promotions, or information campaigns on the mobile in the future? (Record SA) M9A. M9B. Primary Secondary Lao ............................................................. 1.................. 1 English ....................................................... 2.................. 2 Karaoke (Lao in English) ........................... 3.................. 3 Thai ............................................................ 4.................. 4 Akha........................................................... 5.................. 5 Phong ........................................................ 6.................. 6 Khamu ....................................................... 7.................. 7 Hmong ....................................................... 8.................. 9 Other (specify:______________)…………………………( ) M10. How likely are you to read mobile advertising, promotions, or information campaigns that you receive on your mobile phone in the future? (SHOW CARD. Record SA) M11. How likely are you to listen to mobile advertising, promotions, or information campaigns that you receive on your mobile phone in the future? (SHOW CARD. Record SA) MD10 MD11 Very unlikely .......................................1 ......................... 1 Unlikely ...............................................2 ......................... 2 Likely...................................................3 ......................... 3 Very likely ...........................................4 ......................... 4 67 Don’t know/Can’t say..........................5 ......................... 5 OUT-OF-HOME MODULE OBJECTIVE 2iv. Out-of-home media Interviewer: Ask only those who mentioned OOH in Q1 Now let’s talk about outdoor advertisements. These can be in the form of billboards, loudspeakers, screens in shops, bulletin boards, and posters in health centers and/or community buildings. OO1. Please, can you tell me how often you usually see any outdoor advertising? Every day................................................... …… 1 6 days a week............................................ …… 2 4–5 days a week ....................................... …… 3 2–3 days a week ....................................... …… 4 One day a week......................................... …… 5 Once every 2 weeks .................................. …… 6 Once a month ............................................ …… 7 Once every 3 months ................................ …… 8 Once every 6 months ................................ …… 9 Less often .................................................. …… 10 Don’t know/Can’t recall.............................. …… 99 OO2. Over the past three months, which of the following forms of outdoor advertising did you see? (Record MA) OO3. Over the past three months, which of the following forms of outdoor advertising did you see last time? (Record SA) OOH media OO2 OO3 Seen over P3M (MA) See last time (SA) Billboard 1 1 68 Poster (heath center, market, 2 2 road) Banner 3 3 Video/Screen in shops 4 4 Bulletin board within the village 5 5 Loudspeakers 6 6 Other (specify)___________ ( ) ( ) Other (specify)___________ ( ) ( ) Other (specify)___________ ( ) ( ) OO4. Could you tell me where you saw the advertisement? Note to interviewer: Probe for specifics. If, for example, respondent mentions a market, ask whether it’s within the village or otherwise, and use precodes below to record response. Within the village ....................................... …… 1 Outside the village, within the district ............... 2 Outside the district, within the province ........... 3 Outside the province ........................................ 4 ONLINE (INTERNET) MODULE OBJECTIVE 2v. Online (internet) Interviewer: Ask only those who mentioned online (internet) in Q1 Now I would like to talk about your internet activities. I1. From which device do you access the internet? (Record MA) Mobile phone .................................................. 1 Tablet .............................................................. 2 Laptop ............................................................. 3 Desktop at home or elsewhere ...................... 4 I2. Generally, how often do you go on or access the internet? (SHOW CARD) 69 Less than once a week................................................... 1 1–2 times a week ........................................................... 2 3–4 times a week ........................................................... 3 Nearly every day, 5–6 times a week .............................. 4 Every day........................................................................ 5 I3. In a day, how many hours do you use the internet? Less than an hour........................................................... 1 Between 1–3 hours ........................................................ 2 More than 3 hours .......................................................... 3 I4. What are the activities that you usually do on the internet? (SHOW CARD. Record MA) E-mail ............................................................................. 1 Surf for info/search engine ............................................. 2 Chat/IM ........................................................................... 3 Visit and use websites .................................................... 4 Visit and use blogs ......................................................... 5 Play online games .......................................................... 6 Download and exchange music, photos ........................ 7 Watch videos for entertainment (such as movies) ......... 8 ` Watch videos for education purposes (such as documentaries and infomercials) ................... 9 Interactive learning tool/educational games................. 10 Use webcam ................................................................. 11 Click on banner/pop-up ads ......................................... 12 Shop/buy/sell products ................................................. 13 Listen to radio station ................................................... 14 Read newspaper .......................................................... 15 Read magazines .......................................................... 16 70 Download software ....................................................... 17 Check and do bank service .......................................... 18 SMS to friends .............................................................. 19 Make telephone call using voice-over-internet protocol.20 Download ringtone ....................................................... 21 Other (specify:_________________) ....................... ( ) I5. What are the three websites from which you get or access information? 1. ________________________________________________________ ( ) 2. ________________________________________________________ ( ) 3. ________________________________________________________ ( ) I6. What is the most important topic or information that you are looking for over the internet, if there is any? Note to Interviewer: Probe for specifics and use precodes below to record response. Information about health................................................. 1 Information about education/TVET ................................ 2 Information about job vacancies/livelihood .................... 3 Price information for crops ............................................. 4 Other (specify: ______________________________)……5 Now let’s talk about Facebook. I7. How often do you open Facebook? Every hour in a day ........................................................ 1 4–5 times a day .............................................................. 2 Once a day ..................................................................... 3 4–6 times a week ........................................................... 4 2–3 times a week ........................................................... 5 Once a week................................................................... 6 2–3 times a month .......................................................... 7 Less than once a month ................................................. 8 Other (specify: ______________).................................. 9 71 I don't have a Facebook account ................................. 10 I8. Please can you tell me how many hours, during a typical day, you usually spend time online on days you usually use the internet? We do not mean time spent using the internet for sending or receiving e-mails but for visiting websites. (Please include your use at work and at home.) Less than 15 minutes ..................................................... 1 Between 15 minutes and half an hour ........................... 2 More than half an hour to 1 hour .................................... 3 More than 1 hour to 2 hours ........................................... 4 More than 2 hours to 3 hours ......................................... 5 More than 3 hours to 4 hours ......................................... 6 More than 4 hours to 5 hours ......................................... 7 5 hours or more .............................................................. 8 Don’t know/Can’t say...................................................... 9 I9. Which day of the week do you use the internet the most? Monday ........................................................................ 01 Tuesday ........................................................................ 02 Wednesday................................................................... 03 Thursday ...................................................................... 04 Friday ............................................................................ 05 Saturday ....................................................................... 06 Sunday ......................................................................... 07 I20. With whom do you usually access the internet? With a friend ................................................................... 1 With a household member ............................................. 2 With a relative ................................................................. 3 72 With peers at work.......................................................... 4 With no one; I access it alone ........................................ 5 PRINT MODULE OBJECTIVE 2vi. Print Interviewer: Ask only those who mentioned print media in Q1 Thank you for your continued engagement in the interview. At this time, we will talk about print media and newspapers. P1. How often do you read the newspaper? (SHOW CARD. Record SA) Less than once a week................................................... 1 1–2 times a week ........................................................... 2 3–4 times a week ........................................................... 3 Nearly every day, 5–6 times a week .............................. 4 Every day........................................................................ 5 P2. Did you read the newspaper yesterday? Yes.................................................................................. 1 CONTINUE No ................................................................................... 2 GO TO P4 P3. Which newspaper did you read yesterday? (SHOW CARD. Record MA) P4. Which newspaper do you usually read? Which else? (SHOW CARD. Record MA) P3 P4 Pasaxon.........................................................1 .............. 1 Vientiane Mai .................................................2 .............. 2 Pathet Lao .....................................................3 .............. 3 Kampuchea Thmey Daily ..............................4 .............. 4 Vientiane Times .............................................5 .............. 5 KPL News ......................................................6 .............. 6 Sunday News ................................................7 .............. 7 Sports News ..................................................8 .............. 8 73 Lao Women ...................................................9 .............. 9 Lao Army .....................................................10 ............ 10 Renovator ....................................................11 ............ 11 Thai newspapers .........................................12 ............ 12 Other (specify:_____________).............. ( ) ........ ( ) P5. Please, can you tell me how many hours you usually spend reading the newspaper on a typical day you read the newspaper? Less than 15 minutes ..................................................... 1 Between 15 minutes and half an hour ........................... 2 More than half an hour to 1 hour .................................... 3 More than 1 hour to 2 hours ........................................... 4 More than 2 hours to 3 hours ......................................... 5 More than 3 hours to 4 hours ......................................... 6 More than 4 hours to 5 hours ......................................... 7 5 hours or more .............................................................. 8 Don’t know ...................................................................... 9 P6. Which day of the week do you read the newspaper the most? Monday ........................................................................ 01 Tuesday ........................................................................ 02 Wednesday................................................................... 03 Thursday ...................................................................... 04 Friday ............................................................................ 05 Saturday ....................................................................... 06 Sunday ......................................................................... 07 P7. What type of news do you like to read in the newspaper the most? (SHOW CARD. Record SA) Lao news ........................................................................ 1 74 International news .......................................................... 2 Local/Provincial news ..................................................... 3 Editorial opinion section ................................................. 4 Business section ............................................................ 5 Sports section ................................................................. 6 Entertainment section..................................................... 7 Classified advertising ..................................................... 8 Other (please specify:__________) ............................... 9 SALIENT COMMUNICATION ON THE TOPIC OBJECTIVE 3. Salient communication on the topic Interviewer: Ask all SC1. Could you please tell me if you have ever heard, read, or seen any information in any media regarding maternal and child health and nutrition, sanitation, personal and environmental hygiene, and/or other information on health and nutrition as well as immunization? Yes, I have heard, read, or seen any information related to those topics .......................... 1 CONTINUE No, I have not heard, read, or seen any information related to those topics .......................... 2 GO TO SC3 I don’t know about those topics ...................................... 3 GO TO SC3 I’m not sure/Can’t recall.................................................. 4 GO TO SC3 Interviewer: Ask only if code 1 in SC1 SC2. Could you please tell me when you last remember hearing, reading, or seeing information regarding maternal and child health and nutrition in the media. Yesterday ....................................................................... 1 Over the past week ........................................................ 2 75 Over the past few weeks ................................................ 3 Last month ...................................................................... 4 More than 3 months ago ................................................ 5 More than 6 months ago ................................................ 6 More than a year ago ..................................................... 7 Long time ago ................................................................. 8 SC3. As far as you can remember, could you tell me what information you have heard, read, or seen related to these topics? (probe for specifics)? __________________________________________________ __________________________________________________ __________________________________________________( ) Provision of prenatal care. ............................................. 1 Provision of postnatal care ............................................. 2 Provision for childbirth .................................................... 3 Vaccination ..................................................................... 4 Feeding programs .......................................................... 5 Personal hygiene guidelines/Information ....................... 6 Clean and green drives .................................................. 7 SC4. Could you please tell me in which of the following media channels (programmer to filter answers by answers in Q1) you have heard, read, or seen this information? A. TV ............................................................................ 1 B. Radio ...................................................................... 2 C. Print (including, daily newspapers, other press and printed media options) ............................................ 3 D. Out-of-home media (including billboards, posters, video walls, and other OOH channels) ................. 4 E. Mobile phones (information received via SMS) .... 5 76 F. Village announcements (loudspeakers) ................ 6 G. Online (internet activities they do over a mobile phone, tablet, or laptop) .......................... 7 H. Facebook ................................................................ 8 I. Social media (all other social media apps and platforms aside from Facebook)............................. 9 DEMOGRAPHICS OBJECTIVE 4. Sociodemographic and classification variables Interviewer: Ask all D1. Could you tell me which statement best applies to you? I’m a mother of a child or children age (choose all that apply among codes 1 to 3): Child 0–5 months ...................................................... 1 Child 6–23 months .................................................... 2 Child 24–59 months ................................................. 3 I’m a father of a child or children age (choose all that apply among codes 4 to 6): Child 0–5 months ...................................................... 4 Child 6–23 months .................................................... 5 Child 24–59 months ................................................. 6 I’m a guardian or main caregiver of a child or children age (choose all that apply among codes 7 to 9): Child 0–5 months ...................................................... 7 Child 6–23 months .................................................... 8 Child 24–59 months ................................................. 9 D2. How many people live at your house? (Include all those sleeping in the dwelling for at least three of the last twelve months including children, adult relatives, and domestic servants for whom you have a financial responsibility.) Actual number: ___ ___ D3. What best describes your current status? (SHOW CARD) Government employee ................................................... 1 Employee in a private company ..................................... 2 77 Self-employed/Own business......................................... 3 Work for agriculture Farm own land (upland): hed hai ....................................................................... 4 Farm own land (lowland): hed na xeng and na pee ............................................ 5 Day laborer on other peoples’ land ............................ 6 House work/Housewife................................................... 7 Student ........................................................................... 8 Retired/Old age .............................................................. 9 Not working/Unemployed ............................................. 10 Other (specify:_____________)................................... 11 D4. What is your educational status? (SHOW CARD) No formal schooling........................................................ 1 Primary school ................................................................ 2 Lower secondary ............................................................ 3 Upper secondary ............................................................ 4 Technical/Vocational ...................................................... 5 University (undergraduate) ............................................. 6 Postgraduate .................................................................. 7 Other (specify:____________)....................................... 8 D5. Could you please tell me which category on this card best describes your household income and expenditures? (SHOW CARD) Monthly Monthly income expenditure Less than 500,000 kip 1 1 500,001–1,500,000 kip 2 2 1,500,001–2,500,000 3 3 kip 78 2,500,001–3,500,000 4 4 kip 3,500,001–4,500,000 5 5 kip 4,500,001–5,500,000 6 6 kip 5,500,001–6,500,000 7 7 kip 6,500,00 –7,500,000 kip 8 8 7,500,001–8,500,000 9 9 kip Above 8,500,001 kip 10 10 Don’t know 11 11 D6. Could you please tell me which category on this card best describes your personal situation in terms of income and expenditures? (SHOW CARD) Monthly Monthly income expenditure Less than 500,000 kip 1 1 500,001–1,500,000 kip 2 2 1,500,001–2,500,000 3 3 kip 2,500,001–3,500,000 4 4 kip 3,500,001–4,500,000 5 5 kip 4,500,001–5,500,000 6 6 kip 5,500,001–6,500,000 7 7 kip 6,500,001–7,500,000 8 8 kip 7,500,001–8,500,000 9 9 kip Above 8,500,001 kip 10 10 Don’t know 11 11 79 D7. For each of the items listed on this card, can you please tell me how many of each item your household owns? (Record each item owned.) Own Quantity Television ....................................................................... 1 ........ __ __ Personal computer ......................................................... 3 ........ __ __ Fixed-line telephone ....................................................... 4 ........ __ __ Mobile telephone ............................................................ 5 ........ __ __ Tablet .............................................................................. 6 ........ __ __ Motorcycle ...................................................................... 6 ........ __ __ Car .................................................................................. 7 ........ __ __ Radio set ........................................................................ 8 ........ __ __ D8. And can you tell me which of the following statements applies to your household? (Record each item owned.) Yes No Own house ..................................................................... 1 ................2 Own property/land .......................................................... 1 ................2 Have access to electricity (municipal) ............................ 1 ................2 Have access to electricity (other, e.g., generators) ....... 1 ................2 Have access to municipal water..................................... 1 ................2 Have internet at home (nonmobile) ................................ 1 ................2 Motorbike ........................................................................ 1 ................2 Refrigerator..................................................................... 1 ................2 D9. Do you currently have a personal bank account with an available ATM? Again, please remember this is confidential, and we do not need details. We just want to find out how many people have bank accounts. Yes.................................................................................. 1 No ................................................................................... 2 Refused to say................................................................ 9 Thank the respondent and give token! 80 .o0O0o. 81 APPENDIX D. SURVEY OF VILLAGE HEADS QUESTIONNAIRE MEDIA CONSUMPTION SURVEY 2018 (HGNDP) Indochina Research Laos Questionnaire ID: _____________________ 282/17 Phontong Savath, Chathabouly District Interviewer name: _______________ Tel: (855-21) 562 8814 Interviewer no.: ______________________ Fax: (855-21) 562 880 Vientiane, Lao PDR Respondent name: _________________________ Contact phone no.:____________________ Ethnic group/Code of village head Sino-Tibetan–Akha, Phong . 01 Province name/Code: _____________ Mon-Khmer-Khmu .............. 02 District name/Code: ______________ Hmong Mien-Hmong .......... 03 Lao Tai ............................... 04 Village name/Code: ______________ Others ................................ 05 Locale Day of the week Urban ................................. 01 Monday ............................. 01 Rural with road ................... 02 Tuesday ............................. 02 Rural without road .............. 03 Wednesday ........................ 03 Thursday ........................... 04 Age of village head Friday ................................. 05 ______ Actual age Saturday ............................ 06 Sunday............................... 07 82 RESULTS Household visit #1 Household visit #2 Household visit #3 Day Month Year Day Month Year Day Month Year 2 0 1 9 2 0 1 9 2 0 1 9 Start time : Start time : Start time : End time : End time : End time : Total time mins. Total time mins Total time mins Complete 1 Complete 1 Complete 1 Outcome Outcome Outcome Call back . 2 Call back 2 Call back 2 A2. Difficulty of respondent in answering A3. Was translation used? questions: Yes, all or most............................... 1 No difficulty ............................... 1 Yes, some ...................................... 2 Some difficulty ........................... 2 No .................................................. 3 Much difficulty ........................... 3 COMMENTS 83 VILLAGE INFORMATION Good morning/afternoon. We are carrying out a household survey on media and lifestyle habits, and we would be grateful if you could spare some time to answer some questions. We are talking to adult family members over 15 years old who currently have children five years old and below OR to any household member who are main caregivers of a child or children five years old and below in your village. NUMBER OF HOUSEHOLDS Sa. Based on the most recent data you have, how many households are there in your village currently? ______________ Number of households Sb. Based on your best estimate as a percentage, how many households in your village have household members falling under the criteria we have mentioned above? ______________ % VIALLGE LOCATION Sc. Programmer to force capture GPS of Naiban office as location indicator for the village. ______________ GPS coordinates POVERTY INDICATOR Sd. Do you have information on the poverty level or classification of your village? This may be any poverty classification index that you may have, be it officially from the government or from any source. Yes ..................................................................................... 01 Poverty indicator: _____________ (Get verbatim) Source: ______________________ (Get verbatim) No poverty level/classification information ................... 02 ETHNICITY Se. Which of the following ethnicities would you say is predominant in your village? (SHOW CARD) Sino-Tibetan–Akha, Phong ...................... 01 Mon-Khmer-Khmu ................................... 02 Hmong Mien-Hmong ................................ 03 Lao Tai..................................................... 04 Other ....................................................... 05 84 MEDIA ACCESS, PREFERENCE, SATISFACTION, AND TRUST We would like to understand about several media channels. OBJECTIVE 1a: Reach (access) Q5. I have here a list of media channels that people could use to get or receive information (SHOW CARD). Could you tell me which of these media channels are available and have been used by households in your village during the past three months to get information? (MR) OBJECTIVE 1b: Preference Q6. Among those media channels that have been used by households in your village over the past three months (programmer to filter answer according to answer in Q1) to get or receive information, could you please tell me which channel is the most preferred by households in your village? (SA) Q7. In your opinion, do you think men and women have different preferences for the media channels they use? Yes .......................................................................... 1 CONTINUE No ............................................................................ 2 GO TO Q4 Q3a. (Programmer to filter answer according to response in Q1) Which channel do you think is most preferred by adult MEN in your village? (SA) Q3b. (Programmer to filter answer according to answer in Q1) What about adult WOMEN in your village? (SA) Q8. In your opinion, do you think younger and older adults have different preferences for the media channels they access? Yes .......................................................................... 1 CONTINUE No ............................................................................ 2 GO TO Q5 Q4a. (Programmer to filter answer according to answer in Q1) Which channel do you think is most preferred by YOUNGER adults in your village? (SA) Q4b. (Programmer to filter answer according to answer in Q1) What about OLDER adults in your village? (SA) 85 Q9. Finally, among the media channels that have been used by households in your village over the past three months (programmer to filter answer according to answer in Q1) to get or receive information, could you please tell me which channel in your opinion is the most effective channel to reach a wide majority of adults in your village? (SA) Q1. Q2. Used Prefer Q3a. Q3b. Q4a. Q4b. Q5. in the Adult Adult Younger Older Most P3M most men women adults adults effective A. TV 1 1 1 1 1 1 1 B. Radio 2 2 2 2 2 2 2 C. Print (including, daily newspapers, and other 3 3 3 3 3 3 3 press and printed media options) D. Out-of-home media (including, billboards, posters, video walls, 4 4 4 4 4 4 4 and other OOH channels) E. Mobile phones (information received 5 5 5 5 5 5 5 via SMS, voice messaging) F. Village announcements 6 6 6 6 6 6 6 (loudspeakers) G. Online (internet activities they do over 7 7 7 7 7 7 7 a mobile phone, tablet, or laptop) H. Facebook 8 8 8 8 8 8 8 I. Social media (all other social media apps and 9 9 9 9 9 9 9 platforms aside from Facebook) OBJECTIVE 1d: Trust Q10. In terms of trust, among those media channels you have used over the past three months (programmer to filter topics according to answer in Q1) to get or receive information, could you please tell me which channel is most trusted by households in your village in general? (SA) Q1. Used in past A. TV 1 B. Radio 2 C. Print (including daily newspapers, other press and printed media options) 3 86 D. Out-of-home media (including, billboards, posters, video walls, and other 4 OOH channels) E. Mobile phones (information received via SMS) 5 F. Village announcements (loudspeakers) 6 G. Online (internet activities they do over a mobile phone, tablet, or laptop) 7 H. Facebook 8 I. Social media (all other social media apps and platforms aside from 9 Facebook) TV MODULE OBJECTIVE 2i. TV Interviewer: Ask only those who mentioned TV in Q1 T10. Which TV stations are available in your village? (SHOW CARD. Record MA) T1 Stations Most often watched Lao TV 1 1 Lao TV 3 2 Lao PS TV 3 Lao Star 4 MV Loa 5 Sabaidee TV 6 Thai channel 3 7 Thai channel 5 8 Thai channel 7 9 87 Thai channel 9 10 Thai NBT 11 Thai PBS 12 Thai channel 1 13 GMM channel 25 14 Workpoint channel 15 Thai channel 8 16 Others (specify) _________________________ ( ) T11. Which type of TV programs do majority of households in your village watch most often? (SHOW CARD. Record SA) T2 Program type Most often watched A. Breaking news 1 B. News (local, international) 2 C. Economics/Business/Finance 3 D. Series/Soap opera 4 E. Movies 5 F. Sports (news, live, etc.) 6 G. Entertainment (concert, comedy, night shows, etc.) 7 H. Documentary 8 I. Education 9 J. Game show 10 K. Reality show 11 88 L. Lifestyle (health, religion, culture, etc.) 12 M.Other (specify) _________________________ ( ) T12. In general, do you see any difference between the viewing habits of adult men versus adult women? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ T13. How about younger adults versus older adults? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ T14. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai)? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ T15. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through television? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ T16. Could you mention any recommendations that you may have to effectively reach our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below) through TV? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ RADIO MODULE OBJECTIVE 2ii. Radio Interviewer: Ask only those who mentioned radio in Q1 R10. Which radio stations are available in your village? (SHOW CARD. Record MA) 89 Stations R1 FM 90.5 1 FM 92.5 2 FM 93.3 3 FM 95.0 4 FM 95.5 5 FM 96.0 6 FM 97.3 7 FM 98.8 8 FM 101.5 9 FM 103.7 10 FM 105.5 11 CRI FM 93.5 12 AM Station 1 (specify)______ 13 AM Station 2 (specify)______ 14 AM Station 3 (specify)______ 15 Others (specify) _________________________ ( ) R11. Which type of radio programs, in your opinion, is listened to most often? (SHOW CARD. Record SA) R2 Program type 90 Most often listened to A. Hot news 1 B. News (local/international) 2 C. Economics/Business/Finance 3 D. Politics 4 E. Movie reviews 5 F. Song requests 6 G. Sports (news, commentary, and live) 7 H. General music 8 I. Documentary 9 J. Education 10 K. Entertainment 11 L. Lifestyle (health, religion, culture, etc.) 12 M.Talk back 13 N. Other (specify) _________________________ ( ) Can’t remember 99 R12. In general, have you observed any differences between the radio-listening habits of adult men versus adult women? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ R13. How about younger adults versus older adults? Could you explain why? 91 ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ R14. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai)? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ R15. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through radio? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ R16. Could you mention any recommendations you may have to effectively reach our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below) through radio? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ MOBILE PHONE MODULE OBJECTIVE 2iii. Mobile phones Interviewer: Ask only those who mentioned mobile phones in Q1 M1. Which of the following activities can be done on mobile phones in your village? (SHOW CARD. Record MA) Read out the following attributes A. Make and receive calls 1 B. Send and receive SMS (text message on a mobile phone) 2 C. Send or receive MMS (multimedia message on a mobile phone) 3 D. Voicemail 4 E. Instant messaging (using app) 5 F. Video messaging (e.g., FaceTime or Skype) 6 G. Social networking or sharing content online 7 92 H. E-mail 8 M2. Excluding Facebook, which of the following apps is used by households in the village, if any? (SHOW CARD. Record MA) WhatsApp ................................................................ 1 Viber ........................................................................ 2 Skype ...................................................................... 3 Instagram................................................................. 4 LINE ........................................................................ 5 LinkedIn ................................................................... 6 YouTube .................................................................. 7 Twitter ...................................................................... 8 Other (specify: _____________________) ...... ( ) I don’t use any of these .......................................... 99 M3. In general, do you see any difference between the telephone usage habits of adult men versus adult women? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ M4. How about younger adults versus older adults? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ M5. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ M6. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through telephone? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ M7. Could you mention any recommendations that you may have to effectively reach our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below) through telephone? 93 ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________ OUT-OF-HOME MEDIA MODULE OBJECTIVE 2iv. Out-of-home media Interviewer: Ask only those who mentioned OOH in Q1 Now let’s talk about outdoor advertisements. These can be in the form of billboards, loudspeakers, screens in shops, and bulletin boards and posters in health centers and/or community buildings. OO4. Over the past three months, which of the following forms of outdoor advertising did you use to pass information to village members? (Record MA) OO5. Over the past three months, which of the following forms of outdoor advertising did you use last time to pass information to village members? (Record SA) OOH media OO1 OO2 Use over P3M (MA) Use last time (SA) Billboard 1 1 Poster (heath center, market, 2 2 roadside) Banner 3 3 Video/Screen in shops 4 4 Bulletin board within the village 5 5 Loudspeakers 6 6 Other (specify)___________ ( ) ( ) Other (specify)___________ ( ) ( ) Other (specify)___________ ( ) ( ) OO6. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through outdoor advertisements? 94 ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ OO7. Could you mention any recommendations you may have to effectively reach our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below) through outdoor advertisements? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ ONLINE (INTERNET) MODULE OBJECTIVE 2v. Online (internet) Interviewer: Ask only those who mentioned online (internet) in Q1 I10. What kind of internet-based services do households in your village access/use? (SHOW CARD. Record MA) E-mail ..................................................................... 1 Chat/IM .................................................................... 2 Websites .................................................................. 3 Blogs ....................................................................... 4 Interactive learning tool/educational games ............. 5 Webcam .................................................................. 6 SMS......................................................................... 7 Make telephone calls using voice-over-internet protocol...................................... 8 Watch videos for entertainment ............................... 9 Watch videos for educational purposes.................. 10 Other (specify:_________________) ................... ( ) I11. In general, do you see any difference between the internet usage habits of adult men versus adult women? Could you explain why? 95 ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ I12. How about younger adults versus older adults? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ I13. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ I14. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through the internet? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ I15. Could you mention any recommendations that you may have to effectively reach our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below) through the internet? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________ PRINT MODULE OBJECTIVE 2vi. Print Interviewer: Ask only those who mentioned print media in Q1 P8. Which newspaper/print media are available and used by most households in your village? (SHOW CARD. Record MA) P1 Pasaxon....................................................1 Vientiane Mai ............................................2 Pathet Lao ................................................3 Kampuchea Thmey Daily ..........................4 96 Vientiane Times ........................................5 KPL News .................................................6 Sunday News............................................7 Sports News .............................................8 Lao Women ..............................................9 Lao Army ................................................10 Renovator ...............................................11 Thai newspapers ....................................12 Other (specify: _____________) ......... ( ) P9. In general, do you see any difference between readership habits of adult men versus adult women? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ P10. How about younger adults versus older adults? Could you explain why? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ P11. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ P12. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through print media? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ _________ P13. Could you mention any recommendations that you may have to effectively reach our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below) through print media? ________________________________________________________________________ ________________________________________________________________________ 97 ________________________________________________________________________ _____ SALIENT COMMUNICATION ON THE TOPIC OBJECTIVE 3. Salient communication on the topic Interviewer: Ask all SC5. Could you please tell me if you have ever heard, read, or seen any information in any media regarding maternal and child health and nutrition, sanitation, personal and environmental hygiene, and/or other information on health and nutrition as well as immunization? Yes, I have heard, read, or seen ............................. 1 CONTINUE any information related to those topics No, I have not heard, read, or seen ......................... 2 GO TO SC3 any information related to those topics I don’t know about those topics ................................ 3 GO TO SC3 I’m not sure/Can’t recall ........................................... 4 GO TO SC3 Interviewer: Ask only if code 1 in SC1 SC6. Could you please tell me when was the last time you can remember hearing, reading, or seeing in the media information regarding maternal and child health and nutrition? Yesterday ................................................................ 1 Over the past week .................................................. 2 Over the past few weeks .......................................... 3 Last month ............................................................... 4 More than 3 months ago .......................................... 5 More than 6 months ago .......................................... 6 More than a year ago ............................................... 7 Long time ago .......................................................... 8 SC7. As far as you can remember, could you tell me what information you have heard, read, or seen related to these topics? (probe for specifics.) __________________________________________________ 98 __________________________________________________ __________________________________________________( ) Provision of prenatal care. ....................................... 1 Provision of postnatal care ....................................... 2 Provision for childbirth.............................................. 3 Vaccination .............................................................. 4 Feeding programs .................................................... 5 Personal hygiene guidelines/information .................. 6 Clean and green drives ............................................ 7 Growth monitoring (weighing) and promotion ........... 8 SC8. Could you please let me know from which of the following media channels (programmer to filter answers according to answers in Q1) you have heard, read, or seen this information? A. TV..................................................................... 1 B. Radio ............................................................... 2 C. Print (including daily newspapers, other press and printed media options)...................................... 3 D. Out-of-home media (including, billboards, posters, video walls, and other OOH channels) ............ 4 E. Mobile phones (information received via SMS) 5 F. Village announcements (loudspeakers) .......... 6 G. Online (internet activities they do over a mobile phone, tablet, or laptop) ..................... 7 Ga. Use of special applications (apps) for health and nutrition ...................................... 8 Gb. Playing videos on a device accessed through an SD card or any memory medium. ................ 9 H. Facebook ....................................................... 10 I. Social media (all other social media apps and platforms aside from Facebook) ..................... 11 99 SC9. In your opinion, which media channel would be the best channel to effectively pass information regarding maternal and child health and nutrition, sanitation, personal and environmental hygiene, and/or other information on health and nutrition as well as immunization to our target audience (who are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below)? A. TV 1 B. Radio 2 C. Print (including daily newspapers, other press and printed media options) 3 D. Out-of-home media (including, billboards, posters, video walls, and other 4 OOH channels) E. Mobile phones (information received via SMS, voice messaging) 5 F. Village announcements (loudspeakers) 6 G. Online (internet activities over a mobile phone, tablet, or laptop) 7 Ga. Use of special applications (apps) for health and nutrition 8 Gb. Playing videos on a device accessed through an SD card or any memory 9 medium H. Facebook 10 I. Social media (all other social media apps and platforms aside from Facebook) 11 DEMOGRAPHICS OBJECTIVE 4. Sociodemographic and classification variables Interviewer: Ask all D10. What best describes your current status? (SHOW CARD) Government employee............................................. 1 Employee in a private company ............................... 2 Self-employed/Own business................................... 3 Work for agriculture Farm own land (upland): hed hai ............................................................ 4 Farm own land (lowland): hed na xeng and na pee ................................. 5 Day laborer on other peoples’ land ...................... 6 House work/Housewife ............................................ 7 Student .................................................................... 8 Retired/Old age........................................................ 9 Not working/Unemployed ....................................... 10 Other (specify:_____________) ............................. 11 100 D11. What is your educational status? (SHOW CARD) No formal schooling ................................................. 1 Primary school ......................................................... 2 Lower secondary ..................................................... 3 Upper secondary ..................................................... 4 Technical/Vocational ................................................ 5 University (undergraduate)....................................... 6 Postgraduate ........................................................... 7 Other (specify:____________) ................................. 8 Thank the respondent and give token! .o0O0o. 101 APPENDIX E. QUALITATIVE FIELD INSTRUMENTS E.1. OBJECTIVES The project development objective of the Health Governance and Nutrition Development Project (HGNDP) is to increase coverage and quality of reproductive, maternal and child health, and nutrition services in target areas. The objective of the survey is to enable the identification of a potential media mix that could be used by the government of Lao PDR and concerned stakeholders to transmit or deliver health and nutrition messages to the target audience to ensure maximum reach and uptake for a given level of communication expenditure. This activity is important in light of the ongoing nutrition-related activities supported under the HGNDP and to be continued under the new Health and Nutrition Service Access Project (HANSA). The study will help inform the development and production of mass media advocacy and communication tools and materials with a focus on maternal and child health and nutrition, sanitation, personal and environmental hygiene, and/or other determinants of health and nutrition as well as immunization. E.2. INTERVIEW QUESTIONS AND GUIDELINES Initial Overall Questions for All Respondents (Establishing Rapport) Q1.Could you please introduce yourself? How long have you been with the organization? Your position, designation, and tasks/responsibilities? Q2.Could you please tell me about your organization? When was it established? What does your organization do? (Then proceed to ask information relevant to particular groups.) For Development Partner Key informant: Q1. Could you please introduce yourself? How long have you been with the organization? Your position, designation, and tasks/responsibilities? Q2. Could you please tell me about your organization? When was it established? What does your organization do? 1. We are interested in how your communication campaigns reach your beneficiaries. In all your development projects, and in general, how do you go about disseminating information for your campaigns? 2. Can you tell me the coverage of your programs on a nationwide scope? Do you have coverage/programs in all provinces or some provinces only? If some provinces only, which provinces do you have programs in? 3. Probe if not mentioned: How about in the provinces of Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh? 4. Could you let me know the scope of your programs in these provinces? Which districts? 5. Would you say you are reaching the entire rural area, a huge part of rural areas, some of the rural areas, only a little, or none of the rural areas in these provinces? 102 6. How about reaching your target beneficiaries in rural areas? Do you have any stories you can share about how you successfully reach most, if not all, of them? Which media do you use, if any? 7. Could you let us know who are your program’s target beneficiaries? 8. In general, do you see any difference between reaching adult men versus adult women as regards the media channels you use? Could you explain why? 9. How about younger adults versus older adults? Could you explain why? 10. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through the channel(s) that you used/are using? 11. Could you mention any recommendations you may have for us to effectively reach our target audience through radio, television, print, and other media? 12. Do you have any reports from your campaigns or campaign evaluations you are able to share with us? For Media Department, Ministry of Information, Culture, and Tourism Q1. Could you please introduce yourself? How long have you been with the organization? Your position, designation, and tasks/responsibilities? Q2. Could you please tell me about your organization? When was it established? What does your organization do? For Television 1. Can you tell me the coverage of television on a nationwide scope? Are television signals available in all provinces or some provinces only? 2. Probe if not mentioned: How about in the provinces of Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh? 3. Could you let me know the coverage of television signals in these provinces? 4. Would you say television channels are reaching the entire rural area, a huge part of rural areas, some of the rural areas, only a little, or none of the rural areas in these provinces? Do you have data in percentage per province? I. In which districts do you have coverage, and what percentage of the districts currently have access to television signals? II. Could you mention which television stations have signals too? 5. The target audience for future communication of the project is adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below. The main objective of this research is to identify a potential media mix that could be used by the MOH and concerned stakeholders to transmit/deliver health and nutrition messages to the target audience. Having the target audience in mind, could you tell me about their television-viewing habits? 103 I. What programs do you think they watch most often? II. What days of the week are these programs aired? 6. In general, do you see any difference between viewing habits of adult men versus adult women? Could you explain why? 7. How about younger adults versus older adults? Could you explain why? 8. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai)? 9. How much time do rural villagers spend watching television per day? 10. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through television? 11. What television programs, if you have an idea, would Laotians in villages like to watch most? Any specific examples? 12. Could you mention any recommendations to effectively reach our target audience through television? 13. Have you done any surveys about television coverage and consumption? If yes, can you share the reports with us? For Radio 1. Can you tell me the coverage of radio stations on a nationwide scope? Do radio stations have signals in all provinces or some provinces only? 2. Probe if not mentioned: How about in the provinces of Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh? 3. Could you let me know the coverage of radio stations in these provinces? 4. Would you say radio stations are reaching the entire rural area, a huge part of rural areas, some of the rural areas, only a little, or none of the rural areas in these provinces? Do you have data in percentage per province? I. In which districts do you have coverage, and what percentage of the districts’ people currently have access to radio signal? II. Could you mention which radio stations have signals too? 5. The target audience for future communication of the project is adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below. The main objective of this research is to identify a potential media mix that could be used by the MOH and concerned stakeholders to transmit/deliver health and nutrition messages to the target audience. Having the target audience in mind, could you tell me about their radio-listening habits? I. What programs do you think they listen to most often? II. What days of the week are these programs aired? 6. In general, do you see any difference between listening habits of adult men versus adult women? Could you explain why? 104 7. How about younger adults versus older adults? Could you explain why? 8. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai)? 9. How much time do rural villagers spend listening to the radio per day? 10. May I ask what, in your opinion, are the key barriers to more effective media coverage/consumption through radio? 11. What radio programs, if you have an idea, would Laotians in villages like to listen to most? Any specific examples? 12. Could you mention any recommendations that you may have or use to effectively reach our target audience through radio? 13. Have you done any surveys about radio coverage and consumption? If yes, can you share the report with us? For Print Media 1. Can you tell me the circulation of newspapers/journals/magazines nationwide? 2. Does the print media have circulation in all provinces or only in some provinces? 3. Which provinces have circulation? 4. Probe if not mentioned: How about in the provinces of Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh? 5. Could you let me know the circulation of newspapers/journals/magazines in these provinces? 6. Would you say the print media is reaching the entire rural area, a huge part of the rural areas, some of the rural areas, only a little, or none of the rural areas in these provinces? Do you have data in percentage per province? I. Which districts have circulation, and what percentage of the districts is the print media reaching? II. What kind of print media reach those districts? 7. The target audience for future communication of the project are adult men and women age 15 years and above who have children OR are main caregivers of children age five years and below. The main objective of this research is to identify a potential media mix that could be used by the MOH and concerned stakeholders to transmit/deliver health and nutrition messages to the target audience. Having the target audience in mind, could you tell me about their print media readership habits? I. What newspapers/journals/magazines do you think they read most often? II. What days of the week are these newspapers/journals/magazines circulated? III. Do you have a newspaper/journal/magazine in the current lineup of publications, specifically catering to this target audience? Could you explain about this newspaper/journal/magazine? 105 8. In general, do you see any difference between the readership habits of adult men versus adult women? Could you explain why? 9. How about younger adults versus older adults? Could you explain why? 10. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai)? 11. How much time do rural villagers spend reading print media per day? 12. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through print media? 13. What newspaper/journal/magazine, if you have an idea, would Laotians in villages like to read most? Any specific examples? 14. Could you mention any recommendations that you may have or use to effectively reach our target audience through print media? 15. Have you done any surveys about print media coverage and consumption? If yes, can you share the report with us? For Telecommunications Department, Ministry of Posts and Telecommunications Q1. Could you please introduce yourself? How long have you been with the organization? Your position, designation, and tasks/responsibilities? Q2. Could you please tell me about your organization? When was it established? What does your organization do? 1. Can you tell me the coverage of telephone signals nationwide? Are telephone signals available in all provinces or only some provinces? 2. Which provinces have transmission? 3. Probe if not mentioned: How about in the provinces of Phongsaly, Oudomxay, Xiengkhuang, and Huaphanh? 4. Could you let me know the coverage of telephone signals in these provinces? 5. Would you say telephone signals are reaching the entire rural area, a huge part of rural areas, some of the rural areas, only a little, or none of the rural areas in these provinces? Do you have data in percentage per province? I. In which districts do you have coverage, and what percentage of the districts currently have access to a telephone signal? II. Could you mention which telephone networks have signals too? 6. In general, do you see any difference between telephone usage habits of adult men versus adult women? Could you explain why? 7. How about younger adults versus older adults? Could you explain why? 8. How about differences among different ethnic groups (say, for example, Khamu, Hmong, Akha, or Lao Tai)? 9. How much time do rural villagers spend on the telephone per day? 106 10. May I ask what, in your opinion, are the key barriers for more effective media coverage/consumption through telephone? 11. Could you mention any recommendations you may have to effectively reach our target audience through telephone? 12. Have you done any surveys about telephone coverage and consumption? If yes, can you share the report with us? REFERENCES Choudhury, Payel Sen. 2011. “Media in Development Communication.” Global Media Journal, Indian ed. 2 (2). Lao Statistics Bureau. 2018. Lao Social Indicator Survey II 2017, Survey Findings Report. Vientiane, Lao PDR: Lao Statistics Bureau and UNICEF. 107 The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition–related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition. ABOUT THIS SERIES: This series is produced by the Health, Nutrition, and Population Global Practice of the World Bank. The papers in this series aim to provide a vehicle for publishing preliminary results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual author/s whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Editor Martin Lutalo (mlutalo@ worldbank.org) or HNP Advisory Service (askhnp@worldbank.org, tel 202 473- 2256). For more information, see also www.worldbank.org/hnppublications. 1818 H Street, NW Washington, DC USA 20433 Telephone: 202 473 1000 Facsimile: 202 477 6391 Internet: www.worldbank.org E-mail: feedback@worldbank.org