Life-saving radio

Two men recording a pre-recorded spot for the radio show.

Can mass media save lives? Marta Tufet on the first randomized control trial of this in Burkina Faso.

A farmer in Burkina Faso turns on the radio and finds himself immediately captivated by a heated debate about why the Burkinabe football team is not doing well in the league. The team is losing all its matches, it is disastrous! The radio presenters are blaming the tactics, the coach, the training, the heat, infinite reasons are thrown in the air. The farmer, now surrounded by a bunch of his neighbours, calls the programme to add their contribution: it’s simple, the players are just not strong enough! The radio host is quick to introduce an interesting twist to the debate: how can these players, who are well fed and sporty adults, be so weak? Could it be related to their health as children?  Were they malnourished? And more importantly were these players exclusively breastfed for at least 6 months as babies? The phone lines ring incessantly…

This is just a snapshot of the many creative programmes that are being broadcasted live on radio stations across Burkina Faso, in partnership with the NGO Development Media International (DMI) and public health experts at the London School of Tropical Medicine (LSHTM), in a study that hopes to answer a question that could have wide implications: can mass media campaigns save lives?

Funded in partnership by the Planet Wheeler Foundation (founders of the Lonely Planet Travel guides) and the Wellcome Trust, this study is the first randomised control trial of a mass media intervention with a mortality outcome to take place in the developing world. The campaign comprises 60-second pre-recorded creative radio spots delivered 10 times a day, and 2-hour live interactive call-in programmes delivered once a day that will encourage potentially life-saving practices, such as families washing their hands to avoid infection, using mosquito nets to prevent malaria, mothers to breastfeed exclusively for 6 months etc. Radio messaging was chosen over television as in Burkina Faso, a low-income country with high rates of child mortality, television does not reach many in rural communities but the country has encouraged the development of independent FM radio, and listenership reaches 80% in many regions.

Live radio broadcast

Prior to launching the campaign, epidemiologists at the LSHTM surveyed the population in 14 regions in Burkina to estimate the current mortality rate in children under 5. Seven of these regions (or clusters) have been randomly assigned to the intervention and the other seven will act as controls. At the end of the 2.5 year project they will do another mortality survey to calculate the impact that the campaign has really had.

The potential is huge: their modelling predicts that the campaign could potentially cut mortality rates by 15-20% and could be almost as cost-effective as vaccinations. Roy Head, DMI Director is clearly excited: “If this works, and if we can do this in 10 countries for 5 years each, we can save a million children’s lives,” a huge leap towards reaching the Millennium Development Goals.

But what is so special about this particular campaign? Well, we know that health messages can change knowledge, but whether this results in behaviour change is still questionable. A message from the Ministry of Health telling you to wash your hands to avoid the spread of germs will gift you with that knowledge, but how likely is it that you will immediately adopt such behaviour? You may be more inclined to do so, however, when your neighbour (or even a fictional neighbour) tells you in tears that he has just lost his pregnant wife after contracting an infection due to poor hygiene at delivery of the baby. The team at DMI believe that creative storytelling is a much more powerful tool to changing the way people think and make decisions. Indeed, Hollywood movies like The Matrix or The Truman Show have got thousands of people questioning the reality in which they live in. Million Dollar Baby reignited the taboo debate on euthanasia at many conservative dinner tables and bestsellers like The Da Vinci Code got Christians questioning their religion. It seems that when we are touched emotionally our decision-making is challenged, and only then will deeply engrained beliefs begin to be broken down.

When visiting the team in Burkina Faso a couple of weeks ago I was privileged to experience the radio programmes being broadcast live, and was even allowed into the studio to see first-hand how the spots are recorded. It then became incredibly clear what their strength was:  a vibrant environment of young creative Burkinabe scriptwriters with real-life experience of the communities being addressed and who know how to tackle cultural barriers. With support from actors and public health experts, they write, test, record and deliver new creative scripts on a daily basis in 7 different languages. Roy Head says “We need to keep refreshing the creative content as the intensity of the messaging is key.  We use drama, comedy and testimonials, using every creative device we can think to both entertain them and motivate them”.

Another major asset has been the robust relationships that have been built with the radio stations. The radio presenters, many of them young mothers, have truly embraced their new roles as health promoters within their own communities.  Mathew Lavoie, DMI Country Director, says that the key to their success has been the establishment of equitable partnerships. “We help them strengthen their capacity to deliver radio programmes, and they help us reach out to the communities.” This has gone as far as establishing solar panels to power the radio station in Sapouy, a town where electricity is yet to come.

A pleasant surprise for me was hearing the sound of a baby’s innocent laughter at the end of each pre-recorded spot rather than a tagline along the lines of “this is a message brought to you by DMI and LSTMH”. I am told that this laughter, now a DMI classic, has become famous across much of Burkina.

Marta Tufet, Wellcome Trust, International Activities Adviser

Marta and the team in Burkina Faso