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Frequently asked questions
Q: How do you know that the deaths that you have prevented would not have happened anyway, given that child mortality is falling in most African countries?
A: The only way to test this is through a ‘concurrent comparison’ design that overcomes the limitations of a ‘before and after’ survey. This is why we are running a randomised controlled trial in Burkina Faso.
Q: Isn’t the effectiveness of your campaigns depending on the availability of healthcare services?
A: To some extent, but the model takes account of the limited availability of healthcare services in each country, and around 60% of our impact is through the promotion of ‘household behaviours’ such as breastfeeding or improved hygiene, which are not dependent on service provision.
Q: How can you change behaviours through knowledge alone, when so many of the barriers to behaviour change are cultural?
A: We address whatever the barriers are to a particular behaviour change in a given country; if cultural issues are important, as they often are, then we will tackle these alongside simply imparting knowledge. Formative research is a key part of this process.
Q: Doesn’t focusing on multiple health issues rather than a single issue during a media campaign undermine your impact on each issue by diluting the focus?
A: The evidence that we have collated suggests that there is only a small reduction of impact on each issue, and because adding an extra issue to a campaign only marginally increases the cost, the cost-effectiveness is much greater.
Q: How long does a population-wide behaviour change last after the end of a campaign focused on it?
A: This varies depending on the issues, the country and the nature of the campaign. Evidence from previous campaigns suggests that there is a strong sustained behaviour change. For example, a two-year leprosy campaign in Sri Lanka reduced the prevalence of the belief that the disease was a curse of the gods from 70% to 30%; two years after the campaign had ended, this had risen again, but only to 45%. Our goal is to work in a single country for 2-5 years, and in that time to equip that country’s government and media institutions with both the ability to run, and the motivation to fund, campaigns for years after we have left.
Q: What makes you different from an advertising agency?
A: Advertising agencies pick up on the zeitgeist and desires of their (generally urban, affluent) target audience in order to persuade them to buy more of an existing product, or to switch brand, or to try out a new product. We research the deep-rooted beliefs and attitudes of our (generally rural, poor) target audience in order to change some of their fundamental behaviours (such as washing hands, or breastfeeding). We also work with broadcasters to build their capacity to produce their own materials in the long term, rather than asking external funders to pay for both the production and broadcast of those materials indefinitely.