Roy Head. “Media Strategies to Reduce Mortality.” (English) Presentations to the Second Stakeholders Meeting on Implementing the Recommendations of the Commission on Information and Accountability for Women's and Children's Health, Ottawa. Session 4A: Advocacy and Outreach (Global Actions) 21-22 November 2011

1. Media Strategies to Reduce Mortality
Roy Head
Managing Director
Development Media International
www.developmentmedia.net

2. Impact on behaviour (Cambodia)
A dose response
Parents reporting washing their childrens' hands to
prevent diarrhoea
100
90
80
70
60 No
50
40 Yes
30
20
21.7 25.2 28.4
10
10
0
Baseline (2004) Low exposure Medium High exposure
(2006) exposure (2006) (2006)

3. Impact on service uptake (ANC care, Cambodia)
A dose response
Pregnant women only

4. Impact on observed behaviours (Ethiopia)
Trachoma/hygiene campaigns conducted in Ethiopia, LSHTM published
survey
Baseline Endline
(2002) (2005)
Observed impact: dirty hands 73.7 26.0
observed impact: dirty scalp or hair 47.3 21.8
Trachoma prevalence (in areas receiving no antibiotics) 72.0 51.6
Ocular discharge (no antibiotics) 50.8 16.0
* 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

5. Moving away from verticality
January: Malaria
February: Diarrhoea
March: Pneumonia
April: Breastfeeding
May: Immunisation
June: Nutrition
July: Ante-natal care
etc

6. But can we reduce mortality?
Original Research:
DMI + Prof. Simon Cousens (LSHTM), Anne Mills (LSHTM)
Based on statistical models created for
The Lancet’s 2003 and 2005 series.

7. The model’s predictions
Child deaths Media Lives saved Reduction in
Country Cost/DALY
(pa) penetration (pa) mortality
Bangladesh 183,000 67.3 36,517 13.2% $2.88
Ethiopia 321,000 28.1 26,787 6.9% $3.43
Ghana 55,000 86.0 13,228 15.7% $8.00
Kenya 189,000 85.1 31,286 17.9% $3.50
Malawi 56,000 77.8 9,591 14.1% $9.59
Mozambique 110,000 63.8 17,039 14.4% $5.92
Tanzania 175,000 68.8 27,161 14.4% $3.41
[1] Total number of under-five deaths in 2008. Source: Countdown to 2015.
[2] Percentage of men and women (averaged) who listen to the radio or watch television at least once a week. Source: DHS (year varies by country).
[3] Number of child (under-five) lives we expect to save each year by running a campaign, from the third year of a campaign onwards. Source: DMI.
[4] Reduction in under-five mortality rate from the third year of a campaign onwards. Source: DMI.
[5] Cost per disability-adjusted life year. Source: DMI.

8. A scientific trial (Burkina Faso)

9. Media for information and accountability
1. Media for behaviour change as part of health systems:
(Save 1.1 million lives by implementing campaigns in 10 countries)
2. Media to promote services and entitlements (eg. civil registration, ANC)
3. Media to promote accountability:
Phone-ins (“In the hot seat”)
Culture of health as political issue
Holy grail of media economics…
www.developmentmedia.net