MML | Media Million Lives
Media Million Lives is an ambitious initiative launched by Development Media International (DMI) to create integrated radio, TV and mobile phone campaigns that will promote key maternal and child health behaviours in ten African countries for five years each, with the objective of saving a million lives.
media,radio,television,TV,mobile phones,mHealth,health,mass media,behaviour,behavior,behaviour change,behavior change,C4D,M4D,BCC,IEC,demand,million,lives
2
home,page,page-id-2,page-template-default,ajax_updown,page_not_loaded,,

MEDIA MILLION LIVES

WHY

 

19,000 children die needlessly every day.

In 2011 one in nine children in sub-Saharan Africa died before their fifth birthday. Almost two-thirds of these deaths could be avoided by increasing coverage of simple, existing and affordable health interventions, such as exclusive breastfeeding and handwashing.

HOW

 

Radio and TV can save one in five of them.

Radio and TV campaigns that encourage healthy behaviours in mothers and children can reduce the number of child deaths by up to 23%, more cheaply than any other intervention. We design and deliver campaigns that improve health outcomes and save lives in Africa.

WHAT

 

Introducing Media Million Lives.

Media Million Lives is a new initiative from Development Media International. It is raising funds to create integrated radio, TV and mobile phone campaigns to promote key maternal and child health behaviours in ten African countries, with the objective of saving a million lives.

 

Jump to a section: Media | Health | Behaviours | Impact | Cost | Action | Contact

 

English | Français

MEDIA

Radio, TV and mobile phones are ALL growing fast in Africa.

Mobile phones are now common in Africa (49% of people own one; 20% more can access one). But radio and TV audiences are also growing fast. Radio and TV sets continue to drop in price, and the relaxation of media laws has led to a boom in non-state channels (the number of community radio stations in Africa increased by 1,386% from 2000 to 2006). Radio dominates in rural, off-grid areas. As a result, radio is the main source of information for rural audiences in Africa, while television is increasingly popular in towns and cities. All three media have an important role to play in reaching African audiences. Often, they reach the same people in different ways. When used together, they combine national reach, locally tailored content and interactivity in a way that none can achieve alone.

59%Radio
20%Television
49%Mobile phone
5%Computer

 

Household ownership of consumer electronics in Africa

Data sources: Demographic and Health Surveys (radio/television/computer) and GSMA (mobile phones)

HEALTH

Unhealthy behaviours cause many unnecessary childhood deaths.

Two in three of the 7 million children who die every year before their fifth birthday can be saved by increasing the coverage rates of simple, existing interventions. These include exclusive breastfeeding of children under six months, reducing the risk of malaria by sleeping under treated bednets, giving children antibiotics when they have pneumonia, or giving them oral rehydration salts (ORS) for diarrhoea. However, coverage rates for these interventions in sub-Saharan Africa remain low. Many children die simply because their parents do not take these simple steps. For example, only one in three children are exclusively breastfed for the first six months.

33%Exclusive breastfeeding
30%Insecticide-treated nets
37%Antibiotics for pneumonia
28%Oral rehydration for diarrhoea

 

Coverage rates of key child health interventions in Africa and Asia

Data source: Countdown to 2015 (2012 report)

 

View a map showing the locations and causes of child deaths around the world

BEHAVIOURS

Effective media campaigns change those behaviours.

There is strong evidence that radio and TV campaigns alone can convince families to adopt behaviours that will save children’s lives. For example, a TV campaign in India changed the attitudes to leprosy of 172 million people and led to 200,000 people being treated (see more examples from around the world). We can also document a direct impact on health outcomes. A radio campaign targeting trachoma in Ethiopia achieved significant reductions in the prevalence of dirty hands, ocular discharge and trachoma, all without the use of antibiotics:

 

 

  • Before

  • After

 

Health outcomes before and after a radio campaign in Ethiopia

Data source: Edwards et al, Ophthalmology. 2006 Apr;113(4):548-55, and Tropical Medicine and International Health, Vol.13, no.4 pp556-565, sample size 2008, P-values calculated, ranging from p<0.001 to p=0.17

We are running a randomised controlled trial in West Africa to to measure directly the effect of a radio campaign on child survival.

We are running a five-year randomised controlled trial in Burkina Faso, funded by the Wellcome Trust and Planet Wheeler Foundation, to test the proposition that a radio campaign focused on child health can reduce under-five mortality. This is the most rigorous trial ever conducted of a mass media health intervention.

The trial uses radio broadcasts to change behaviours in order to improve child survival, covering a range of health issues, and is the largest, most rigorous evaluation ever conducted of a mass media intervention. It will generate a substantial body of further evidence for the impact of mass media campaigns on a range of behaviours, including those linked to demand for healthcare services, and on child mortality.

The trial involves fourteen geographical areas that were randomised and equally divided into an intervention group and a control group. Messages are being broadcast for 2.5 years in the seven geographical areas of the intervention group, but not in the control group. We predict that in Burkina Faso, where 101,000 children under five die every year, we will reduce under-five mortality by 15.7% at a cost per DALY of $8.49.

A controlled trial using radio would not normally work, due to the risk that people in ‘control’ areas would listen to radio stations broadcasting from ‘intervention’ areas. However, Burkina Faso has a very localised, radio-dominated media environment, so we can use local FM radio stations to broadcast our messages to intervention areas without ‘leaking’ into the control areas.

For 30 months we are broadcasting 60-second advertisements at least 10 times per day on seven radio stations (one in each intervention zone), in six languages. In addition, we are broadcasting two hours per night, five nights per week on each station. This represents a total of 70 hours per week of live radio.

The evaluation, led by LSHTM and Centre Muraz, includes a baseline mortality survey of 50,000 children under 5 years (with a two-year recall period), and a baseline behaviour survey of 5,000 households, before radio broadcasts began in March 2012. Broadcasts will stop in January 2015, and full results, based on an endline mortality survey of 100,000 children (with a one-year recall period), will be available in mid- to late-2015.

In April 2014 we published our midline results on behaviour change (based on a survey of 5,000 households). The results show that behaviours in the intervention zones have all improved (ranging from 9.3% to 25.5%). When changes in the control zones are subtracted from these results, the difference in difference is substantial (in the 8.5% to 23.3% range) in 6 out of 10 cases. This represents, even at this preliminary stage, the first randomised controlled trial to demonstrate that mass media can cause behaviour change. We expect the endline results to be stronger still.

IMPACT

Radio and television campaigns in Africa can save a million lives.

We have worked with epidemiologists at the London School of Hygiene & Tropical Medicine to develop a mathematical model that predicts and measures how many lives can be saved by mass media campaigns. It predicts that a multi-issue campaign in a typical sub-Saharan African country will reduce child deaths by 16-23%, neonatal deaths by 5-21% and maternal deaths by 2-20%, and that running campaigns in ten African countries for five years each will save a million lives. Most lives are saved by increasing prevention and treatment of three key diseases (malaria, diarrhoea and pneumonia) and encouraging women to give birth in a health facility.

 

DRC

Lives saved per year

43200

Mali

Lives saved per year

16400

Mozambique

Lives saved per year

14600

Zambia

Lives saved per year

11200

 

Lives saved by disease type

  • Diarrhoea

  • Malaria

  • Pneumonia

  • Neonatal

Lives saved by disease type

  • Diarrhoea

  • Malaria

  • Pneumonia

  • Neonatal

Lives saved by disease type

  • Diarrhoea

  • Malaria

  • Pneumonia

  • Neonatal

Lives saved by disease type

  • Diarrhoea

  • Malaria

  • Pneumonia

  • Neonatal

 

Data source: DMI-LSHTM model

 

COST

They are as cost-effective as the cheapest health interventions.

The model predicts that mass media campaigns are as cost-effective (at $2-10 per disability-adjusted life year) as the cheapest health interventions that are available, including treated bednets ($2-24) and child vaccines ($1-8). This would suggest that in many African countries, mass media campaigns are one of the cheapest ways of saving lives. Integrating inexpensive mHealth (mobile phone-based) components can make radio and TV even more cost-effective.

 
 

With $1,000, you can save 42 children with insecticide-treated bednets:

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Or you can save 125 children with comprehensive vaccinations:

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

But you can save 167 children through Saturation+ mass media campaigns:

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

Data sources: DMI analysis and Disease Control Priorities (2nd Edition)

To achieve these results, we use an approach called Saturation+.

Broadcast media messages several times per day

 

Our evidence base suggests a strong correlation between message frequency and impact. We broadcast radio and TV spots at least three times per day. This is particularly important when the target audience is not consuming media throughout the day at regular times. We also broadcast daily dramas, as well as using ‘concept placement’ to insert key health messages into existing, popular radio and TV programmes.

 

Use radio/TV networks that reach the target audience

 

Audience figures for radio and TV networks at national level are weak in many African countries. Sophisticated modelling is needed to generate a best estimate of audience numbers by network, especially in rural areas. A strategy that includes community radio stations will ensure strong rural coverage, but other networks often generate a higher return on investment.

Use modelling to maximise health impacts

 

Our mathematical model predicts the impact on child and maternal mortality of each media message in each country. In most African countries, a multi-issue radio/TV campaign can reduce under-five mortality by 16-23% and maternal mortality by 2-20%, at a cost of $2-10 per DALY. We can predict lives saved by disease, by behaviour, by message and by province. By focusing on the behaviours that are easiest to change and that also have the greatest impact on lives saved, we can maximise health impacts.

 

Measure outcomes and health impacts robustly

 

We can translate behaviour change outcomes into health impacts using our model, but first we need to measure behaviour change outcomes reliably, and to attribute them to our activities. We have developed quasi-experimental evaluation techniques that are rigorous, but can be feasibly integrated into a complex media campaign. These include dose-response analysis, triangulation of survey data with external data sources, time-series analysis and non-randomised control areas.

Understand the audience using qualitative research

 

We need to understand the values and motivations of our target audience. We send teams of researchers to conduct formative research (identifying barriers to behaviour change), to pre-test outputs for clarity and appeal with focus groups, and to conduct detailed post-broadcast feedback research (asking whether, how and why people who heard our messages changed their behaviours).

 

Generate content that changes behaviours effectively

 

Content that really changes behaviours must be simple, funny, and engaging, rather than didactic. We use drama to maximise emotional impact. Short, realistic dramas (including spots) work well if repeated often. We hire the best local talent using open competitions, and we use a proven creative and editorial process to generate ideas and select the best for broadcast.

ACTION

We want to save a million lives by running behaviour change mass media campaigns in ten African countries.

Media Million Lives is an ambitious initiative to create integrated radio, TV and mobile phone campaigns that will promote key maternal and child health behaviours in ten African countries for five years each, with the objective of saving a million lives. This will be one of the most ambitious behaviour change programmes yet run in Africa. We are currently seeking partners to help us to scale up our programme globally in order to reach this target, and we welcome conversations with national Ministries of Health, public and private funders, and private sector and NGO partners.

 

 

 

Take action

Download a PDF in English or French

Watch some short films about us

Sign up for email updates

Contact us to find out more or get involved

Media Million Lives supports the following global maternal and child health initiatives:

 

every_woman_every_child_logo_ok
APromiseRenewed_Logo_EN
Campaign-on-Accelerated-Reduction-of-Maternal-Mortality-in-Africa-CARMMA
CONTACT

 

Media Million Lives is an initiative of Development Media International, which runs radio and TV campaigns to change behaviours and save lives in developing countries.