Our preferred channels are radio, television and mobile phones. We use these media to reach our target audience, rather than print media, social media or community-level approaches (such as street theatre), because they enable us to reach the largest possible number of people within that target audience at the lowest cost. In some countries, we might work exclusively with radio, while in others television is sufficiently popular to be an additional channel. The increasing popularity, availability and affordability of mobile phones offers new opportunities for us to integrate 'top-down' mass media approaches with campaigns that are more personalised and interactive.


The advantages of mass media

The most cost-effective way of achieving large-scale, population-wide behaviour change is through the use of mass media. This generic term refers to any type of media that is 'one-to-many'. It encompasses broadcast media (primarily TV, film and radio), and print media (newspapers, magazines, books, leaflets and posters). Online media (websites, and especially social media such as Facebook and Twitter) are becoming increasingly important, as are mobile phones (which can be used in many ways beyond the simple passing on of SMS or voice messages).

By contrast, interpersonal media works on a 'one-to-one' or 'one-to-few' basis. In developing countries this includes techniques such as community theatre and presentations to small groups in schools or other public buildings. These techniques have advantages, but because of their small scale they are significantly more expensive in terms of cost per person reached than mass media. On average, it is between 100 and 1,000 times more cost-effective to use radio and television than interpersonal media. For example, an HIV/AIDS campaign in India reached 43 million people on television (at a cost of $0.01 per person reached), while the same campaign was watched by 348,000 people on video vans (at a cost of $1.43 per person reached).

There is also plenty of evidence that mass media campaigns are at least as effective in causing behaviour change as more expensive interpersonal campaigns. After a leprosy campaign in India using both mass media (TV and radio) and community media, we surveyed the number of people who still believed that leprosy was a curse of the gods. Among those who had only seen or heard the mass media campaign, just 17% still believed this to be the case. Among those who had only seen the community media campaign, 30% of people still believed it.

Mass media is cost-effective in developing countries because the vast majority of people consume some form of mass media on a regular basis, even in the poorest countries. In most developing countries, over 75% of people regularly listen to the radio or watch television.

A 2010 article in the Lancet written by Professor Bob Hornik (one of our board members) discusses the use of mass media in health behaviour campaigns in more detail.


Different types of mass media

When we talk about mass media at DMI we are normally referring to radio and TV, which are the most effective media in developing countries because they have by far the greatest reach. In most countries in sub-Saharan Africa, the most popular media is radio, because of its lower cost and portability: for example, in Uganda, 74% of the population listen to the radio at least once per week (compared to 11% for TV).

Radio is an important and trusted source of health information, particularly in sub-Saharan Africa. Even people in the most remote rural communities generally have access to a radio (sometimes through radio listening clubs) or have regular contact with others who listen to it. Research commissioned by the BBC in 2006 found that the number of community radio stations in Africa had grown by 1,386 per cent during the previous six years. This renaissance in radio in many countries is partly due to liberalised broadcasting environments but also to the availability of cheap radio sets which, unlike TVs, do not require access to the electricity grid.

Television is less pervasive in rural communities, but is extremely popular in urban areas and is growing rapidly in many countries across Africa and Asia (it is already dominant in Latin America). The chart below shows the percentage of households that own a radio or a television set respectively, in a range of African countries.


The increasing popularity, availability and affordability of mobile phones offers new opportunities for us to integrate 'top-down' mass media approaches with campaigns that are more personalised and interactive. We have recently received seed funding from the Bill & Melinda Gates Foundation (through its Grand Challenges Exploration scheme) to pilot a project in Burkina Faso that will promote maternal and child health using short entertaining films that can be watched on mobile phones. We hope to be able to use the lessons learned from this pilot project to be able to scale up an innovative approach to integrating mobile phones with 'conventional' mass media.


Film: Radio Partners

Why do we form such close partnerships with radio stations? Why don't we just pay for airtime? This film, set in Burkina Faso, answers those questions and explores what local radio stations have to gain from the partnership.