This website uses cookies to ensure you get the best experience on our website. Learn more
Learn how we use evidence-based behaviour change campaigns to improve and save lives in low-income countries.
Learn about how DMI brings together two different worlds: demonstrable scientific practice and creative storytelling.
Location Tuberculosis
In 2018, Mozambique had the fourth highest incidence of tuberculosis (TB) in the world, at 551 per 100,000 people (WHO, 2018). This meant that each year 22,000 people died of TB. This was largely because people didn’t promptly get tested and start their treatment course. To address this, we piloted a radio campaign in Zambezia province to increase TB case-detection.
Mozambique
Tuberculosis – encouraging testing and symptom recognition.
12 x 1-minute radio spots in three languages.
The radio campaign broadcast for 6 months from September 2020 to March 2021 on 12 radio stations in Mozambique’s Zambezia province.
2.5 million people
Science
Despite the high incidence rate of the disease (368 TB cases per 100,000 people in 2020), a large proportion of TB cases in Mozambique remain undetected (WHO, 2021). To address this, we ran a radio campaign to improve tuberculosis case-detection in Zambezia, with intensified broadcasting in high-burden districts. We measured exposure to our campaign and collected health centre data on TB consultations and testing in Zambezia, and compared this to data from Tete province which acted as a control area.
Stories
We conducted desk-based research and interviews with community members and health workers in Zambezia to understand local knowledge, attitudes, and practices relating to TB in Zambezia. Barriers to behaviour change included misconceptions about the disease – for example beliefs that TB is caused by witchcraft, that the symptoms aren’t serious and that treatment is expensive – and stigmatisation of those who have it. Our radio campaign addressed these barriers, helped people recognise symptoms of the disease and encouraged them to get tested, either in a health centre or by seeking out community health workers. Our spots also emphasised gender-specific factors that negatively affect TB case detection, such as lack of decision-making power to access health services for women.
Saturation
We produced 12 radio spots for this campaign, each in Portuguese and the two most widely spoken local languages in Zambezia, Elomwe and Echwabu. We worked with Radio Moçambique and their regional broadcaster in Zambezia as well as 11 community radio stations to broadcast these spots 10 times a day, every day, for 6 months.
Listen to the spot
Machamba
Our Impact
We collected health centre data to compare TB testing and diagnoses in Zambezia, our intervention province, and Tete, our control province. We have carried out qualitative research to understand exposure to our campaign as well as knowledge and intentions about TB amongst our target audience. We also ran an efficacy randomised controlled trial to measure the impact of our campaign messages on individuals’ knowledge and behaviours.
Our evaluation of this campaign shows that health education through radio programming can enhance TB testing and case detection. During this campaign, there was a higher increase in TB testing in the intervention province (57%) compared to the control province (48%).
In this same period, the increase in TB case notifications was similar in both provinces, but the increase in bacteriologically positive TB case notifications was higher in the intervention province (38%) than the control province (22%). This suggests that exposure to DMI’s campaign helped people to correctly identify their symptoms as TB.
Concurrent community campaigns to increase case detection in both provinces could in part explain the overall increase in TB testing and case notifications. Evidence suggests that DMI’s radio campaign contributed to increasing overall testing and the identification of bacteriologically positive cases in the broadcast zone.
This graph shows the differences in outcomes between the control and intervention zones. Data from Mozambique’s National Tuberculosis Centre.
Resources
Read our published papers to explore our findings.
This project was funded by the Stop TB Partnership and was implemented with support from the Mozambique Ministry of Health’s National Tuberculosis Programme and local NGO Ajuda de Desenvolvimento de Povo para o Povo (ADPP).