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 Child survival
Many parts of Sub-Saharan Africa have limited access to TV, the internet, and sometimes even to radio. The ubiquity of mobile phones, in even the most remote places, could be part of the solution. Videos have the potential to “go viral” if shared between phones, using Bluetooth or SD cards. But how does a public health video stand out from the millions of other videos on the internet?
The objectives of this study were to (1) investigate whether short health promotion films in local languages – languages in which no films had ever been made – distributed via mobile phones, could “go viral”, and (2) to see whether the films, if shared, improved parents’ knowledge of appropriate treatment seeking for diarrhoea, malaria, and pneumonia.
Child survival – Promoting the importance of handwashing with soap and supporting parents to seek treatment for children with symptoms of malaria, pneumonia or diarrhoea.
Eight x 3-minute videos shared with 80 local ‘distributors’ to be distributed via Bluetooth and SD card sharing.
The intervention ran in nine villages in Burkina Faso’s Gaoua region from November 2014 to October 2015.
In 2014, we tested our hypothesis in the Gaoua region of Burkina Faso, an area with very low traditional media penetration. At the time, only 20% of women in the region regularly listened to the radio (in the last week) and 6% had watched TV. Household radio ownership was 34% and TV ownership was 5%. However, mobile phone access was surprisingly high, with 81% of women reporting access to a mobile phone in their home or compound and 34% owning their own phone.
We randomly selected nine villages in the region for our intervention arm and selected another 10 villages to act as controls, where no distribution took place. To evaluate the reach and impact of the mobile video intervention, our research team surveyed 708 mothers across all villages before the intervention and 728 mothers and 726 men one year later, once the videos had been distributed.
We produced eight entertaining dramas in the Lobiri language reflecting rural Burkinabe life and targeting primary caregivers of children under 5. To our knowledge, no other films had ever been produced in this language. The films promoted preventative child health behaviours: washing your hands with soap, giving oral rehydration salts to children with diarrhoea, seeking treatment for children with symptoms of fever (malaria) and seeking treatment for children with fast or difficult breathing (pneumonia). We selected behaviours which our modeling (using the Lives Saved Tool) predicted will save the most under-5 lives.
We loaded 356 memory cards with our eight films. 80 local distributors – including mechanics, store vendors, and other members of the business community – across the nine intervention villages were given these cards and encouraged to distribute them via Bluetooth or direct memory (SD) card transfer.
Results showed that at the end of the 12-month trial, nearly one third of the population in intervention zones had seen the videos (compared to ≤2% in the control arm). 50% of women who had seen the videos didn’t own a mobile phone – a hugely promising result.
Although the primary objective of this study was to test whether people would share films in their local language via mobile phones, we also measured whether there were any improvements in knowledge and behaviours related to the health behaviours promoted in the eight films.
Improvements in knowledge include:
We also recorded behaviour changes in our intervention areas compared to controls, particularly relating to handwashing. This includes: a 3 percentage point increase in handwashing with soap, a 7 percentage point increase in handwashing after defecation and an 18 percentage point increase in women reporting they washed their hands before feeding a child.
We are grateful to the Bill & Melinda Gates Foundation and Grand Challenges Canada for funding this campaign.
There are over 2,000 languages in Africa, most of which have never had professional films made in them. Our ‘viral videos’ approach has real potential to deliver impact in remote areas with limited access to mass media. We therefore aim to continue to test and scale up our ‘viral videos’ approach.