SBCC Summit 2016 CommTalk: Can Mass Media Interventions Reduce Child Mortality?

This CommTalk took place at the First International SBCC (Social and Behaviour Change Communication) Summit in February 2016 in Addis Ababa, Ethiopia. The CommTalks at the Summit were 10-minute "TED Talk" like presentations that focused on experiences from the field, and presented an opportunity for organisations to share their innovations, successes, challenges, and lessons learned. In this recording of one of the CommTalks,  Joanna Murray, head of research at London-based Development Media International (DMI), described DMI's  clustered randomised controlled trial (RCT) in Burkina Faso to show the impact of a mass media campaign of social and behaviour change communication (SBCC) on care seeking health behaviours. Her talk is entitled, "Can Mass Media Interventions Reduce Child Mortality?"

Murray addressed the challenge of reducing child mortality as described in MDGs 4 and 5. She stated that, practices like exclusive breastfeeding and treatment seeking for febrile illness or diarrhoea, among others, were simple behaviours which could save children’s lives. However, coverage rates of proven interventions have stagnated, particularly in parts of Africa. She believes that mass media has a role in increasing demand for behaviour change through SBCC campaigning. However, due to a lack of strong evidence, there is a disconnect in funding for these campaigns. For that reason, DMI developed an RCT in partnership with the London School of Hygiene and Tropical Medicine (LSHTM), funded by the Wellcome Trust and the Planet Wheeler Foundation.
 
DMI chose Burkina Faso because of the unique media landscape, with the dominance of local FM radio stations. They were able to identify and randomise 7 intervention zones and 7 non-overlapping control radio station zones. They developed 60 second radio spots on child health themes and broadcast 10 times a day for 35 months in the local language of each station. In addition, they developed regular evening radio dramas, acted out live by local actors at each station.
 
At midpoint in the intervention, LSHTM interviewed 5,000 women in the intervention and control zones and produced the data Murray displayed on a bar graph. It shows the difference in: percentage change in behaviours in the intervention zones, minus the change that occurred in the control zones. A chart shows the changes in 10 of the key behaviours that were targeted.
 
DMI found that it had most impact on episodic care seeking behaviours (such as telling mothers about when to seek treatment for fever).  A dose response analysis showed there was approximately a 1% change in behaviours for every week of broadcasting on a given topic. More powerful health facility data also showed an increase in care seeking. GSHP Journal has the full article. Endline results are still being analysed but seem to be showing statistically significant increases in care seeking too. This RCT is the first of its kind to provide evidence that the saturation plus approach to mass media can change behaviours. The theory of saturation plus is centred around broadcasting at high intensity.
 
Murray concludes by recommending quasi experimental methods for evaluating impact, using the saturation plus approach for mass media campaigns including using research to help create engaging dramas and stories that resonate with intended audiences. In order to have SBCC become a mainstream component of health policy, she states that a much stronger evidence base needs to be created.