TV Globo, the largest television network in Brazil, produced and broadcast a 203-episode telenovela (soap opera) titled Paginas da Vida ("Pages of Life") which completed broadcast on March 2 2007. Communicate, Population Media Center (PMC)'s partner in Brazil, worked with TV Globo to incorporate social messages into the telenovela about Down Syndrome and family planning.

At the conclusion of the programme, Comunicarte and PMC engaged a team from BEMFAM (Civil Society for the Welfare of the Brazilian Family) to conduct an evaluation of the impact of Paginas da Vida on health-seeking behaviours, including attending BEMFAM family planning clinics. A total of 474 women were interviewed.

In 2006, PMC engaged Dr. Arvind Singhal to conduct impact research to measure the effects of Paginas da Vida. Dr. Singhal traveled to Brazil in September 2006 to train Comunicarte staff on participatory research techniques. This participatory research was conducted in November 2006. The main objective of this phase of the research was to use focus groups to evaluate the changes in viewers' knowledge, attitudes and practices regarding people living with Down Syndrome. The focus groups also completed a participatory sketching exercise to provoke expression of opinions, experiences, and emotions through means of visual communication.

83.3% of women interviewed watched Paginas da Vida at least twice per week.

For part of the research, a questionnaire was sent to those affiliated with FUNLAR (the Brazilian National Down syndrome Association). They found that 82.8% watched the drama at least sometimes.

There was more than a 50% increase in knowledge among women interviewed with regard to various reproductive health issues such as: contraceptive methods, family planning, maternal health, maternity/paternity, unwanted pregnancy, adolescent pregnancy, and HIV/AIDS.

72.6% respondents reported that their knowledge of Down Syndrome increased markedly through watching Páginas da Vida.

The evaluation found that 65.4% of women interviewed said that the telenovela influenced them to be more careful to prevent unwanted pregnancy.

60% of women, age 18-24, said that scenes in Paginas da Vida served as a stimulus for them to seek a health service.

"Because of the way in which the writers developed the storyline of a Down Syndrome baby born to a teenage mother, it is also likely that the Down Syndrome content motivated adolescent viewers to seek family planning services in order to avoid having a Down Syndrome baby."

Participants in the focus groups (qualitative study) were given drawing materials and asked to document what they learned from the drama. They explained the significance of their sketches to the research team. The following sketch and narrative is illustrative: "I drew a flower pot, with three pretty flowers, but one of the petals is a little atrophied (smaller). The messages about Down syndrome and other disabilities in telenovelas are increasing and causing more and more debate, generating opinions etc. However, it is necessary still to create a bigger base and more solid vehicle for these messages. Because of this, I did not I finish the table in the drawing. The subject still can be better explored with regard to socializing the information. The flowers are different, as we are, and, like the flowers, everybody has their own beauty."

PMC e-news [PDF], June 2007; PMC website; and Report to the Weeden Foundation on the Social Merchandising Project in Brazil to incorporate Reproductive Health Issues into Prime-Time Programs of TV Globo, April 2006 - March 2007 [PDF].