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By arranging for people in Burkina Faso to call a radio football phone-in show and argue the merits of breastfeeding as a way to raise children to be top players, Roy Head was able to spread messages about healthy practices far beyond those who might normally listen.
Mr Head is a former radio and television journalist who now runs Development Media International, a consultancy. He has focused on how to disseminate the findings of scientific research, including an innovative attempt to spread health messages and carefully track their impact on outcomes.
The project began with a conversation with Simon Cousens at the London School of Hygiene and Tropical Medicine in 2007, who had just presented an academic paper. “I asked whether he had given any thought to how to pass on the findings to the people who actually count: not the health workers, professionals or others reading the Lancet, but the mothers themselves,” Mr Head says.
“To his credit, he not only conceded the point but got involved,” he adds, in a reference to a pioneering health project on which they worked together — the outcomes of which have recently been published in the Lancet.
The media is sometimes blamed for a negative influence on health. In 2016, three years after the BMJ, formerly the British Medical Journal, published research questioning the value of cholesterol-lowering statins, a follow-up study found an 11 to 12 per cent drop in their use by existing patients after popular media coverage of the article.
But Mr Head says media campaigns can be helpful. “What you need is the skill of a broadcaster combined with the strategy of an epidemiologist,” he says.
Running a UN radio station in Cambodia in the early 1990s, he had seen its power in persuading people to vote. “Where the army had taken their voting cards away, we could broadcast to them within 15 minutes with the message that they could turn up and vote anyway and their voice would be counted,” he says.
Trying to repeat the exercise with a UN television station in the former Yugoslavia to promote peace was less easy. “While mass media is quite good at fomenting conflict, it’s very poor at stopping it. Ordinary people don’t have the power in a war,” Mr Head says.
But he saw greater potential in using broadcasting to promote health messages, where individual mothers could make a difference to children’s lives.
He took his vision to the BBC World Service Trust and persuaded it to create a health division, using its reach at the turn of the millennium to broadcast campaigns on how to treat leprosy and tackle HIV. But after a few years, he felt tension between his “propaganda” campaigns designed to save lives and the broadcaster’s focus on journalism.
Media stories are likely to have an important role in influencing funders and policymakers to adopt scientific findings — albeit it is difficult to track, and the few studies on the subject largely focus on perceptions of impact.
Once policies have been agreed, a different approach is needed to have them widely adopted by the public.
“People in the media first want to make documentaries about international aid, and when they find it’s hard they make them for aid agencies,” says Mr Head. “But documentaries are a complete waste of time. They have no effect on [individuals’] behaviour.
“A well-crafted discussion with experts that goes out once will not work. You have to entertain but you also need volume and saturation to hit them with the message over and over again.”
By pairing with Prof Cousens, he was able to run a rigorous randomised control trial to highlight the specific contribution of a media campaign.
In Burkina Faso, fragmented regions with different languages meant most people listened only to local radio. That meant it was possible to test the campaigns’ impact without the confounding effect of national broadcasts. The team planned short bulletins and longer programmes with call-ins every day over three years to reinforce the value of 17 health interventions for mothers.
In fact, the findings published in the Lancet were mixed: at a time of other programmes to improve health, it was not possible to identify a measurable impact on under-five mortality in the districts where the radio campaign ran. Even so, with a relatively modest budget for broadcasting, the number of medical consultations, deliveries in healthcare facilities and antenatal visits rose relative to those in other areas.
That has not dissuaded Mr Head from adapting and expanding his approach to other health programmes in Africa, Asia and Latin America, including for malaria and family planning.
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