Results from the first randomised controlled trial to show that mass media can change behaviours were published in two papers in BMJ Global Health on Tuesday 17/07/18. The first paper shows the impact of the campaign on treatment-seeking behaviours and models its impact on mortality. The second paper indicates that this is one of the most cost-effective ways to save children’s lives. The trial was run by DMI and evaluated by the London School of Hygiene and Tropical Medicine.
The campaign was broadcast on seven radio stations (with a radii of approx. 50km), shown in blue, between 2012-2015. Seven other radio station areas acted as control zones, shown in red. The campaign used DMI’s ‘Saturation+’ methodology, broadcasting radio spots 10 times a day, 365 days a year. It promoted health-seeking behaviours, including ante-natal care attendance, health facility deliveries and primary care consultations for malaria, pneumonia and diarrhoea.
Routine data from health facilities were analysed for evidence of changes in treatment-seeking. Year 1 of the campaign saw increases in children with malaria, pneumonia and diarrhoea taken to health facilities of 56%, 39% and 73% respectively, compared to control zones (all p<0.001).
Lives Saved Tool (LiST) calculations showed that this corresponded to a mortality reduction of 9.7% in year 1, and that approximately 3,000 lives were saved over the course of the three year campaign.
Overall, data from over 600,000 consultations was evaluated and there were no intervention effects on any categories for which there was no campaigning (e.g. coughs and colds).
Mortality predictions for Burkina Faso and other countries were used to calculate the cost-effectiveness of these interventions. Using Disability-Adjusted Life Years (DALYs) as the metric (equivalent to the cost of one year of healthy life added), the results show that mass media campaigns based on Saturation+ principles are among the most cost-effective methods available for saving children’s lives.
The authors calculated that scaling up campaigns in Burkina Faso, Burundi, Niger, Malawi and Mozambique would cost between $7 to $27 per DALY in 2018-20. (For reference, $7-$27 per DALY equates to approximately $196-$756 per life saved.)
The authoritative source for cost-effectiveness comparisons, the Disease Control Priorities, Third Edition, compares the relative magnitudes of the cost-effectiveness estimates for all health interventions. For reproductive, mother and child health interventions the cost per DALY ranges from $2,900 down to $5. Saturation-based media campaigns are among the most cost-effective interventions available.
Roy Head of DMI who designed and led the study in partnership with LSHTM says: “What this study shows is that using mass media to drive people to health centres is actually more cost-effective than almost anything on earth in terms of saving children’s lives. And that makes sense – it reaches millions of people at a time – but this is the first time it has been shown in a scientific trial.”
Professor Simon Cousens, of LSHTM who led the evaluation adds: “Pneumonia, malaria, and diarrhoea are three of the biggest killers of children in Sub-Saharan Africa. Ensuring that these children get appropriate treatment is a global priority. This research provides evidence that mass media has an important role to play in persuading parents to seek life-saving treatment for children.”
The study was jointly funded by Wellcome and the Planet Wheeler Foundation. On Tuesday we celebrated the publication of the results at an event at the Wellcome Collection. Thank you for all the guests who joined us, many of whom this RCT would not have happened without.
Watch an animation of our RCT results, and the story of Mariéta, whose life was saved by the campaign.
Learn more about the results in the news, in Reuters, the New York Times, or our CEO's interview with the BBC World Service (starting at 36:52). More details are also available on our website.
In December we posted a story about our animation, Neighbours, which reached over 97,000 Facebook views in DRC's capital, Kinshasa. Our second animation was even more successful, attracting 114,000 Facebook views and over 13,000 likes in just four days.
We recently launched our first ever social media campaign in Kinshasa, using a series of animations, created by award winning artist Yoni Goodman, as part of our family planning campaign.
Vizinha, vizinha… ‘Neighbour, neighbour, why is your little one looking so healthy?’ – ‘Because of his mother’s milk…’ This is the start to one of the first spots on nutrition education produced by community radio stations in Mozambique’s Manica province. The production forms part of a two year capacity building programme on nutrition campaigns in Manica, implemented by DMI and funded by the World Food Programme. The main aim of the programme is to enable community radio stations to develop and run effective behaviour change campaigns.
DMI’s creative teams have been working hard to craft our first set of long-format radio shows for our family planning randomised controlled trial (RCT). As of this week, all of our eight radio stations selected for the RCT are on air with the new programme. The long-format radio show, in combination with our short entertaining spots, aims to stimulate debate about some of the existing misconceptions and create awareness about the contraceptive options available in Burkina Faso.
In 2015, DMI ran a one-year radio campaign (with eight months of broadcasting) on behaviours linked to child survival in eight provinces of the Democratic Republic of Congo. The campaign, funded by UNICEF, IMA World Health (with DFID funding) and Save the Children, aimed to reduce child mortality by promoting healthy behaviours through radio adverts broadcast on 33 community radio stations. The campaign failed to achieve its main objective (changing behaviours linked to child survival), although it did have an impact on knowledge related to most of the target behaviours.
DMI has received a $400,000 award from the US Agency for International Development (USAID) to test whether a mass media family planning campaign increases contraceptive use among men and women of reproductive age living in rural areas of Burkina Faso, using a randomised controlled trial (RCT). The funds are being provided as stage two funding from USAID’s Development Innovation Ventures (DIV) programme.
DMI is seeking funds to launch INTENSAÚDE, a planned health mass media campaign supported by the Ministry of Health in Mozambique. The campaign will build on the recent results of a randomised controlled trial in Burkina Faso, conducted by DMI and evaluated by the London School of Hygiene & Tropical Medicine. This showed that a radio campaign had a significant impact on several target behaviours, notably treatment-seeking for children with symptoms of pneumonia, diarrhoea and malaria.
DMI recently launched a four-year randomised control trial in Burkina Faso to evaluate the impact and cost-effectiveness of a mass media campaign on family planning. To target our campaign effectively, we sent our scriptwriters to live in a rural village for a week. Here is why.
The World Food Programme is funding DMI to run a capacity strengthening project in Manica province of Mozambique, which will help community radio stations to design and run behaviour change campaigns to improve outcomes related to nutrition.