This paper explores the relationship between quality improvements in family planning delivery sites and increased contraceptive use among target populations.

Context: Sub-Saharan Africa has a considerable unmet need for contraception. In 1998–1999,the Gold Circle campaign—a regional initiative to promote and improve family planning servicedelivery sites—was launched in Cameroon. Methods: During the last quarter of 1999, 571 women who had been interviewed during the1998 Cameroon Demographic and Health Survey were reinterviewed regarding their exposureto the Gold Circle campaign and their perceptions on and use of contraceptives. The impact ofthe campaign was evaluated by assessing the panel data and by using an ideation model of behaviorchange. In addition, service statistics from Gold Circle and non-Gold Circle family planningdelivery sites were contrasted to assess the effects of the campaign on clinic performance. Results: More than one-third of the women surveyed reported exposure to the Gold Circle campaign,52% of whom mentioned being exposed to the campaign through television. Those withprimary or postprimary education were four and six times as likely, respectively, as those withno education to have been exposed to the campaign. Exposure was associated with a significantincrease in the level of family planning ideation, as well as with an increased likelihood ofusing a modern contraceptive method (80%). The service statistics indicate that the campaignled to a significant increase in the demand for family planning services at Gold Circle clinics,with the number of new clients more than doubling immediately after the campaign launch. Conclusions: The Gold Circle campaign had appreciable success in promoting family planningin Cameroon. The campaign had a considerable positive influence on both family planning ideationand contraceptive use.