DMI

Location Early childhood development, Nutrition

ASTUTE

Objective

Tanzania has one of the world’s highest rates of chronic malnutrition, with an estimated 2.7 million undernourished children. The FCDO-funded ASTUTE programme set out to address child stunting and contribute to the evidence base for what works in Tanzania. We ran a radio and TV campaign to improve child and maternal nutrition and encourage early childhood development (ECD) practices.

Locations

Tanzania

Themes

Nutrition – reducing stunting by encouraging early and exclusive breastfeeding, complementary feeding, handwashing, and maternal nutrition.

Early childhood development – encouraging positive parent-child interactions such as talking, praising and playing with your child.

Formats

150 x 1-minute radio spots and four short live action films.

Scope

Our campaign ran from June 2017 – March 2020 on 17 community and regional radio stations and one national station in the Lake Zone and Southern Highlands in Tanzania. From May 2019 to March 2020, we broadcast our films 1198 times on three TV stations.

Reach

60% of women and 70% of men in the intervention zones heard our campaign

Project at a glance

32pp
increase in mothers engaging with their child's learning
13pp
increase in pregnant women eating a healthier diet
17pp
increase in fathers engaging with their child's learning

Our Approach

Science

Preventing stunting in Tanzania’s Lake Zone

In Tanzania, an estimated 32% of children under five suffer from stunting. Stunting before age two predicts poor cognitive and educational outcomes in later childhood and adolescence and has important educational and economic consequences for households and communities. The Lake Zone of Tanzania has a population of 10.2 million people, including over 750,000 children who are stunted.

For ASTUTE , we developed, implemented and evaluated a radio and TV campaign to address stunting in five regions of the Lake Zone. We conducted extensive desk research and qualitative formative research before, during and at the end of the campaign. We surveyed over 21,000 men and women with children under two across three timepoints, to understand whether they were exposed to the campaign and to measure any shifts in nutrition and early child development behaviours. Owing to the success of the project and at the request of the donor, we expanded our campaign to four regions of the Southern Highlands.

Stories

Engaging radio and audiovisual content

We ran focus groups and interviews with key local stakeholders and identified six key themes which shaped the messaging of our campaign: maternal health and nutrition; exclusive breastfeeding for children 0-6 months; complementary feeding for children 6-23 months; talking, singing and playing with children right from birth; water, sanitation and hygiene practices; and diarrhoea treatment.

Our scriptwriters and social and behaviour change specialists in Tanzania created short, dramatic radio and TV spots relevant to the Tanzanian context. In each 60-second spot, the crux of the drama relates to one of the barriers identified in the formative research. We tested audience reactions to the spots before broadcast to ensure engagement and accuracy.

A TV in the corner of a room demonstrating the distribution mechanism used by DMI in this campaign

Saturation

34 months, over 70,000 broadcasts

We broadcast 140 different radio spots on 17 radio stations (community, regional, and one national).

We broadcast our television spots on the ITV and Star TV channels right before and during the evening Swahili news. To ensure best value for money, we worked with UBONGO Kids (which airs an edutainment cartoon programme for children) to also air spots on TBC1.

Outputs

Project impact

Our Impact

Significant Increases in Nutrition and Early Childhood Development Behaviours

Our evaluation of this campaign shows that 60% of female and 70% of male participants heard our messaging either on the radio or on TV, and that significant improvements were observed for nearly all of the behaviours we addressed. The main impacts and outcomes of ASTUTE are summarised in the below tabs.

Additionally, we recorded that men’s engagement with their young children, including playing and speaking to them, increased substantially over time and by exposure to the campaign. The men who heard or saw a campaign spot were also more likely to know that a woman needs to breastfeed more frequently if she thinks she does not have enough breastmilk. Given men are often important decision makers, influencing their understanding of maternal health and child development will have important long-term effects on the health of their families.

The number of mothers who ate more foods during their last pregnancy increased by 12.6 percentage points (pp), from 7.1% at baseline to 19.7% at endline. Additionally, mothers who heard our radio campaign were more likely to have a diverse diet during pregnancy (+6.9pp) compared to mothers who did not.

The number of mothers who engaged with their children in at least four (of seven suggested) early childhood development activities such as drawing, signing and naming objects increased by 32.5 percentage points (pp), from 46.7% at baseline to 79.2% at endline. Mothers who heard our campaign were more likely to engage in these activities (+5.5pp) than those who did not hear our campaign.

The number of fathers who engaged with their children by talking and playing with them in the last week increased by 17.2 percentage points (pp), from 51.3% at baseline to 68.5% at endline. Fathers who heard our campaign were more likely to engage in these activities (+10.6pp) than those who did not hear our campaign.

The number of mothers who correctly identified at least two critical time points for handwashing increased by 9.8 percentage points (pp), from 84.3% at baseline to 94.1% at endline. Mothers who heard our campaign were more likely to identify these timepoints (+5.4pp) than those who did not.

Partners & Funders

This project was delivered in partnership with IMA World Health, the Partnership for Nutrition in Tanzania and Cornell University’s Division of Nutritional Sciences. It was funded by the United Kingdom’s Foreign, Commonwealth & Development Office (FCDO).

IMA World Health logo
Man holding radio field Burkina Faso representing DMIs method of communication for this campaign

What Next

Scale Up Plans

The ASTUTE programme received an A+ rating in the Programme Completion Report from the Foreign, Commonwealth & Development Office (FCDO). Following the encouraging results from the impact evaluation of this campaign, we hope to take it to national scale in Tanzania in order to multiply our impact and cost-effectiveness.