The potential of education and its various media is primarily a function of (a) target populations where socio-economic conditions would permit reasonable people to change their behavior with the receipt of information about family planning and (b) the adequate development of the substantive motivating context of the message. While dramatic limitations in the availability of any family planning related message are most severe in rural areas of developing countries, even more serious gaps exist in the understanding of the implicit incentives in the system for large families and the potential of the informational message to alter those conditions.

Nevertheless, progress in the technology for mass media communications has led to the suggestion that the priority need might lie in the utilization of this technology, particularly with large and illiterate rural populations. While there are on-going efforts they have not yet reached their full potential. Nor have the principal U.S. agencies concerned yet integrated or given sufficient priority to family planning information and population programs generally.

Yet A.I.D.'s work suggests that radio, posters, printed material, and various types of personal contacts by health/family planning workers tend to be more cost-effective than television except in those areas (generally urban) where a TV system is already in place which reaches more than just the middle and upper classes. There is great scope for use of mass media, particularly in the initial stages of making people aware of the benefits of family planning and of services available; in this way mass media can effectively complement necessary interpersonal communications.

In almost every country of the world there are channels of communication (media) available, such, as print media, radio, posters, and personal contacts, which already reach the vast majority of the population. For example, studies in India - with only 30% literacy, show that most of the population is aware of the government's family planning program. If response is low it is not because of lack of media to transmit information.

A.I.D. believes that the best bet in media strategy is to encourage intensive use of media already available, or available at relatively low cost. For example, radio is a medium which in some countries already reaches a sizeable percentage of the rural population; a recent A.I.D. financed study by Stanford indicates that radio is as effective as television, costs one-fifth as much, and offers more opportunities for programming for local needs and for local feedback.

Recommendations:

USAID and USIA should encourage other population donors and organizations to develop comprehensive information and educational programs dealing with population and family planning consistent with the geographic and functional population emphasis discussed in other sections. Such programs should make use of the results of AID's extensive experience in this field and should include consideration of social, cultural and economic factors in population control as well as strictly technical and educational ones.

2. Use of U.S. broadcast satellites for dissemination of family planning and health information to key LDC countries

Discussion:

One key factor in the effective use of existing contraceptive techniques has been the problem of education. In particular, this problem is most severe in rural areas of the developing countries. There is need to develop a cost-effective communications system designed for rural areas which, together with local direct governmental efforts, can provide comprehensive health information and in particular, family planning guidance. One new supporting technology which has been under development is the broadcast satellite. NASA and Fairchild have now developed an ATS (Applied Technology Satellite), now in orbit, which has the capability of beaming educational television programs to isolated areas via small inexpensive community receivers.

NASA's sixth Applications Technology Satellite was launched into geosynchronous orbit over the Galapagos Islands on May 30, 1974. It will be utilized for a year in that position to deliver health and educational services to millions of Americans in remote regions of the Rocky Mountain States, Alaska and Appalachia. During this period it will be made available for a short time to Brazil in order to demonstrate how such a broadcast satellite may be used to provide signals to 500 schools in their existing educational television network 1400 miles northeast of Rio de Janeiro in Rio Grande do Norte.

In mid-1975, ATS-6 will be moved to a point over the Indian Ocean to begin beaming educational television to India. India is now developing its broadcast program materials. Signals picked up from one of two Indian ground transmitters will be rebroadcast to individual stations in 2500 villages and to ground relay installations serving networks comprising 3000 more. This operation over India will last one year, after which time India hopes to have its own broadcast satellite in preparation.

Eventually it will be possible to broadcast directly to individual TV sets in remote rural areas. Such a "direct broadcast satellite," which is still under development, could one day go directly into individual TV receivers. At present, broadcast satellite signals go to ground receiving stations and are relayed to individual television sets on a local or regional basis. The latter can be used in towns, villages and schools.

The hope is that these new technologies will provide a substantial input in family planning programs, where the primary constraint lies in informational services. The fact, however, is that information and education does not appear to be the primary constraint in the development of effective family planning programs. AID itself has learned from costly intensive inputs that a supply oriented approach to family planning is not and cannot be fully effective until the demand side - incentives and motivations are both understood and accounted for.

Leaving this vast problem aside, AID has much relevant experience in the numerous problems encountered in the use of modern communications media for mass rural education. First, there is widespread LDC sensitivity to satellite broadcast, expressed most vigorously in the Outer Space Committee of the UN. Many countries don't want broadcasts of neighboring countries over their own territory and fear unwanted propaganda and subversion by hostile broadcasters. NASA experience suggests that the U.S. must tread very softly when discussing assistance in program content. International restrictions may be placed on the types of proposed broadcasts and it remains technically difficult to restrict broadcast area coverage to national boundaries. To the extent programs are developed jointly and are appreciated and wanted by receiving countries, some relaxation in their position might occur.

Agreement is nearly universal among practitioners of educational technology that the technology is years ahead of software or content development. Thus cost per person reached tend to be very high. In addition, given the current technology, audiences are limited to those who are willing to walk to the village TV set and listen to public service messages and studies show declining audiences over time with large audiences primarily for popular entertainment. In addition, keeping village receivers in repair is a difficult problem. The high cost of program development remains a serious constraint, particularly since there is so little experience in validifying program content for wide general audiences.

With these factors it is clear that one needs to proceed slowly in utilization of this technology for the LDCs in the population field.

Recommendations:

1. The work of existing networks on population, education, ITV, and broadcast satellites should be brought together to better consolidate relative priorities for research, experimentation and programming in family planning. Wider distribution of the broad AID experience in these areas would probably be justified. This is particularly true since specific studies have already been done on the experimental ATS-6 programs in the U.S., Brazil, and India and each clearly documents the very experimental character and high costs of the effort. Thus at this point it is clearly inconsistent with U.S. or LDC population goals to allocate large additional sums for a technology which is experimental.

2. Limited donor and recipient family planning funds available for education/motivation must be allocated on a cost-effectiveness basis. Satellite TV may have opportunities for cost-effectiveness primarily where the decision has already been taken on other than family planning grounds to undertake very large-scale rural TV systems. Where applicable in such countries satellite technology should be used when cost-effective. Research should give special attention to costs and efficiency relative to alternative media.

3. Where the need for education is established and an effective format has been developed, we recommend more effective exploitation of existing and conventional media: radio, printed material, posters, etc., as discussed under part I above.