DMI

Location Child survival

Scaling Up Lives Saved in Mozambique

Objective

Scaling Up Lives Saved in Mozambique was a two-year project which promoted treatment-seeking for young children displaying symptoms of malaria, pneumonia and diarrhoea, which are among the biggest killers of children under-5. This was a 2-year expansion and extension of Intensaúde, our previous national child survival campaign in Mozambique.

Locations

Mozambique

Themes

Child survival and maternal health – Encouraging parents to seek treatment for children with symptoms of malaria, pneumonia or diarrhoea. Encouraging bed net use and antenatal care attendance.

Formats

26 x 1-minute radio spots, produced in 12 languages

5 x 1-minute live action films

1 x 6 minute film for community health workers

Scope

Our radio campaign was broadcast from November 2020 to September 2022 on 66 radio stations including the national broadcaster, Radio Moçambique. Our live action audio-visual outputs were broadcast on a national TV station and distributed through SD cards, and the ‘UpScale’ app via community health workers.

Reach

Over 10.5 million people

Project at a glance

8,500
Lives saved
Modelling using the well-established Lives Saved Tool (LiST) indicates that this three-year campaign will have saved over 8,500 under five lives and over 90 maternal lives.

Our Approach

Science

Optimising our campaign design

Modelling from our child survival RCT indicated that a national scale up of our child survival radio campaign in Mozambique could save thousands of lives of children under-5 by encouraging their parents to recognise the symptoms of malaria, pneumonia and diarrhoea and to seek treatment at a health facility. Intensaúde, our preceding child survival campaign in Mozambique set out to achieve just that. Saving Lives Mozambique was a 2-year extension of that campaign, integrating key learnings from Intensaúde to ensure greater reach and impact.

We created spots that encouraged bed net use and malaria prevention as well as antenatal care attendance for pregnant mothers. We also created audio-visual content to convey more complex messages and distributed them to hard-to-reach communities outside the range of radio. And finally, following an in-depth exposure analysis of Intensaúde, we increased our community radio broadcasting to multiply our reach and impact in each province.

Stories

Engaging, high-impact content

We conducted focus group discussions with families in Gaza, Manica, Tete, Nampula and Zambezia provinces to understand the barriers to care-seeking for malaria, pneumonia and diarrhoea as well as malaria prevention and antenatal care attendance for pregnant mothers. These barriers included a lack of awareness of symptoms, use of traditional medicine, distance to health centre, and uncertainty about how urgently they should act. Based on these insights, our team in Mozambique wrote 24 scripts covering key behaviours that parents can adopt to fight these diseases. We also conducted focus group discussions to help us write 20 scripts promoting antenatal care and maternal health. We worked with Radio Moçambique to record each of these scripts in the 12 most widely spoken languages in the country, producing a total of 312 radio spots.

A man in a recording studio demonstrating DMI producing radio spots for this campaign
A radio demonstrating the distribution mechanism used in this campaign

Saturation

18 months, over 50 radio stations, 12 languages

We pretested our spots in five provinces to ensure they resonated with our target audience, adjusting our spots where necessary. We broadcast for 18 months on 66 radio stations, including Radio Moçambique’s (RM) national antenna, 11 RM provincial stations with high listenership. We also conducted post-broadcast feedback research to gather audience reactions. These findings will be incorporated into our scriptwriting when writing more spots.

Outputs

Project impact

Our Impact

Project Impact

We surveyed over 3,000 male (75%) and female (25%) caregivers at baseline and endline, gathering data on exposure to our campaign as well as on knowledge, attitudes and behaviours related to child survival and treatment-seeking for malaria, pneumonia and diarrhoea. We found that maternal health care-seeking and malaria prevention behaviours were significantly higher in those exposed to the campaign compared to those who were not.

Compared to those who were not exposed to DMI’s campaign, female caregivers exposed to the campaign were significantly more likely to report the presence of a skilled birth attendant at the time of delivery (89% versus 77%, p<0.001) and delivering the baby in a health facility (81% versus 69%, p=0.03).

Our findings showed that the uptake of three or more doses of intermittent preventative treatment for malaria in pregnancy (IPTp-Sulfadoxine Pyrimethamine) was significantly higher among female caregivers exposed to the campaign than those who were unexposed (52% versus 29%, p=0.04).

Women who were exposed to the campaign were significantly more likely to report having attended four or more ANC visits during their recent pregnancy than those who were unexposed (74% versus 63%, p=0.04).

Malaria prevention knowledge was higher among caregivers who were exposed to the campaign, indicating that campaign exposure increased the likelihood of agreement with statements such as:

  • Children should sleep under ITN every night in dry season (p<.0001, p<.001)
  • Children should sleep under ITN every night in hot/wet season (p<.001, p<.001)
  • Sleeping under a mosquito net every night can prevent malaria (p<.02, p<.001)

Moreover, both male and female caregivers who were exposed to the campaign were more likely to report that household members slept under a mosquito net last night than those who were not exposed to DMI’s campaign (82% in exposed vs 59% in unexposed males, p<.001; 87% in exposed vs 68% in unexposed females, p<.002).

Partners & Funders

We are grateful to the Light Foundation for funding this project.

What Next

Scale Up Plans

We are delivering a similar national campaign in Burkina Faso and are actively seeking to expand our child survival programming in priority countries.