Issues

The main issues that we focus on are health and education. Within health, we have a strong focus on maternal and child survival (including nutrition, hygiene and sanitation) and family planning. We have also worked on other health issues, including neglected tropical diseases, tuberculosis and HIV/AIDS. Within education, we work on early childhood development. We are also exploring other areas, including gender equality, agriculture and livelihoods. 

 


Maternal and child survival

In 2014 one in 12 children in sub-Saharan Africa died before their fifth birthday (see an interactive map of child deaths around the world). Meanwhile, maternal mortality rates remain stubbornly high in many countries. Many of the health interventions that can reduce maternal and child mortality (such as exclusive breastfeeding, treatment of diarrhoea, malaria and pneumonia, and giving birth in a health facility) are highly dependent on the actions of parents and other members of the community. Mass media campaigns that can change behaviours can help millions of people to provide or access these interventions, thus saving many thousands of lives. We work along the ‘continuum of care’ for mothers and children, from pre-pregnancy to delivery, the immediate postnatal period, and childhood. This includes a focus on nutrition, hygiene and sanitation (and links to reproductive health, below, including family planning and child marriage). 

We recently concluded a randomised controlled trial of a child survival radio campaign in Burkina Faso. We are running a child survival behaviour change campaign in Burkina Faso and have just completed a similar campaign in DRC. We are looking for partners and funders for similar campaigns in other countries (especially Mozambique) through our Media Million Lives initiative.  

 


Family planning

Contraception saves mother’s lives by avoiding high-risk pregnancies (too early, too late, too close, too many). If all women who wanted contraception could access it, over 100,000 fewer women would die as a result of giving birth every year. It also saves children’s lives: ‘birth spacing’ (leaving 2-3 years between having each child) will save the lives of over a million children under five every year. However, the current rate of contraceptive use among sexually active women in sub-Saharan Africa is just 22% (compared to 75% in developed countries). According to a 2011 World Health Organisation (WHO) Bulletin, the largest barriers to contraception use are a lack of information and awareness among women and fears about possible side-effects. So there is an urgent need to increase demand for family planning among women and girls by raising awareness and changing behaviours. 

We are currently running a family planning behaviour change campaign in DRC. We recently launched a randomised controlled trial of a family planning radio campaign in Burkina Faso.

 


Early childhood development

The first year of life presents a crucial opportunity for parents to develop the cognitive abilities of their children, simply by talking to them, a great deal, and in the right way. Children who have good spoken language skills (understanding, vocabulary and beginning to put words together) at the age of two enjoy much greater success at school (and in later life). However, few parents talk very much to their children before they themselves start talking. This is a huge missed opportunity, yet it is straightforward to persuade parents to talk to their babies by pointing out the benefits (immediate joyful interaction, and increased cognitive capabilities and future success).

We have produced two sets of training films to encourage parents in the Caribbean and in Jamaica, Peru and Bangladesh to talk to and play with their young children. We are now raising funds to bring a proven and cost-effective ECD intervention to national scale in Tanzania through a radio campaign.

 


Nutrition

Over 200 million children under the age of five suffer from the consequences of malnutrition, and are either stunted (too short) or wasted (too thin). In addition, obesity is rapidly rising across the globe, with 44% of countries now facing the double burden of both undernutrition and obesity. These high levels of malnutrition have wide-ranging consequences for both children's and adults' lives. In the early years, inappropriate nutrition and feeding practices can weaken a child’s immune system and obstruct cognitive and motor development, reducing chances of survival and success in later life. In adulthood, malnutrition and obesity can trigger a range of non-communicable diseases such as diabetes and heart disease, reducing the quality of life of adults and increasing health risks. Nutrition interventions therefore need to help people understand how to eat appropriate amounts and a sufficient variety of nutritious foods at each stage of life.

DMI is currently conducting campaigns on mother and child nutrition in sub-Saharan Africa. We have run campaigns to promote exclusive breastfeeding and complementary feeding in Burkina Faso, and we are launching nutrition campaigns in Mozambique and Tanzania.

 


Neglected tropical diseases

Neglected tropical diseases (NTDs) are a group of parasitic and bacterial infections that affect about one billion people worldwide. They are ‘neglected’ because they persist exclusively in the poorest and the most marginalised populations, who live in remote areas with limited access to effective health care. NTDs can cause malnutrition, anaemia, serious or permanent disability (including blindness), illness and death. ‘Mass drug administration’ (MDA) campaigns are distributing drugs to entire populations, irrespective of disease status, in order to treat and, where possible, eradicate certain diseases. However, compliance rates vary, and can be low in areas where people believe that MDA is an experiment rather than a treatment, are confused as to why asymptomatic individuals are treated, or are afraid of side-effects. Behaviour change campaigns that are run alongside MDA programmes can increase understanding and compliance, by raising awareness of the profound effects of NTDs on morbidity and quality of life, and reassuring people that the drugs used are effective, safe and without serious side-effects. 

We have previously run campaigns on leprosy and trachoma. We are interested in running campaigns focused on other NTDs such as schistosomiasis and lymphatic filariasis. 

 


Gender equality

Girls and young women in sub-Saharan Africa (especially in the Sahel region) are generally less educated, less healthy, and less free than their male peers. In the Sahel region, there are particularly strong linkages between gender inequality, low educational attainment of girls, high fertility rates and high maternal and infant mortality. Women here are 470 times more likely to die from pregnancy and childbirth complications than women in the global north. Tackling the social norms that underpin this inequality is a huge undertaking. However, if it can be achieved, it will have huge and lasting impacts not only on health outcomes, but also on educational attainment, productivity and prosperity in some of the poorest countries in the world. Mass media can play a much bigger role in supporting this change than it does; however, we recognise that, where social norms are concerned, community-level efforts are also crucial. 

We are currently scoping mass media campaigns focused on gender equality and on maternal and child health in several countries in the Sahel (in particular Mali and Niger).