• G20 health and finance ministers urged to bring about the necessary marriage between the wealth and the health of nations

DMI has been named in the G20 Health & Development Partnership’s (GHDP) 2019 report outlining recommendations to G20 heads of government and finance and health ministers to adopt more cross-sectional approaches towards global public health engagement. One of the six recommendations by the report emphasises the need to scope the health technology horizon for gaps that need to be filled in order to lessen inequalities in health and to fulfil SDG3 commitments. In light of this, DMI’s vision and methodology, and in particular the results of our child and maternal health RCT were published in the report to showcase DMI’s evidence-based approach as a means of reaching the global goal of increased health security.
 
The G20 Health and Development Partnership – representing a coalition of 21 leading global organisations and more than 1000 collaborators – will launch in UK parliament today, 5th March 2019, urging G20 heads of government and finance ministers to join health ministers in addressing the growing disease burden before it is too late. Coming from an understanding that global health is an issue intimately linked to politics, development and economic growth, the report calls for sustaining and increasing innovation at the intersection of these fields. DMI is thus very honoured to be recognised by and be part of such a powerful coalition of organisations sharing a vision of more holistic global and national public health strategies towards a healthier, wealthier world.
 
The partnership is presenting the report to the heads of government and finance and health ministers in advance of the joint G20 health and finance ministers meeting in Japan this June.
 
You can access the report in full here. 

DMI has been working with UNFPA on the Sahel Women’s Empowerment and Demographic Dividend (SWEDD) initiative, which seeks to reduce gender inequality and promote family planning in Mauritania, Mali, Burkina Faso, Cote D’Ivoire, Niger and Chad.
 
As part of this project, we were delighted to work with award winning Ivorian graphic novelist and filmmaker Marguerite Abouet on a series of one minute animations following the life story of Nya, a young woman with ambitions for a better life. The films have Marguerite’s characteristic blend of wit and authenticity in dealing with powerful topics and will be shown over the next few months on TV5 Monde, Canal Plus and other regional TV stations. The films and associated content will also be on social media.

In the first episode, thirteen-year-old Nya’s father is about to forcibly marry her to a man three times her age, so she and her mother come up with an ingenious plan to make him change his mind.
 
The first film on how Nya avoids early marriage has already had an excellent response on Facebook, generating 730,000 views, over 10,000 shares and lively and highly engaged dialogue in the comments section.
 
You can follow the SWEDD Facebook page here, and watch the film below: 

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; they were covered by over 150 press outlets including Reuters, CNN and the BBC. 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.

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.