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DMI
DEVELOPMENT	MEDIA	INTERNATIONAL
Changing	behaviours.
Building	evidence.
Going	to	scale.
TOD	IM	20.	JAHRHUNDERT
34%	Kinder	U5	sterben	an	drei	behandelbaren Infektionskrankheiten	
– Lungenentzündung	(14%),	
– Durchfallerkrankungen	(10%)	
– Malaria	(10%)
1	mio	Kinder	unter	5	/	Jahr	
<	50%	der	Kinder	werden	rechtzeitig	in	die	Klinik	gebracht
– Lungenentzündung	46%
– Durchfallerkrankung	39%
– Malaria	43%	
DIE	HERAUSFORDERUNG
LEITFRAGEN	DES	EFFEKTIVEN	ALTRUISMUS
1. WIRKUNG	- How	many	people	benefit	and	by	
how	much?	
2. EFFIZIENZ	- Is	this	the	most	effective	thing	
you	can	do?						
3. VERGLEICHBARKEIT	- What	are	the	chances	
of	success	and	how	good	would	success	be?
HOW	MANY	PEOPLE	BENEFIT	
I.	Wirkung schätzen
II.	Wirkung messen
III.	Wirkung erzielen
Kommunikationsforschung
I.	WIRKUNG	SCHÄTZEN
Massenmedien	sind	durch	ihre	Reichweite kosten-effizient
Kampagnendesign ist	ausschlaggebend	(e.g.	Intensität)	
Vergleich	von	16	Kommunikationsprogrammen	(Hornik	et	al.	2001)	 		
Erfolg	von	Programmen	mit	geringer	Intensitaet		 28%	
Erfolg	von	Programmen	mit	hoher	Intensitaet	 82%	
	
Channel	 %	Exposed	(a)		 Effect	of	Exposure	(b)*		 Channel	Effect	(a	x	b)		
Clinic	 22%	 18%	 4%	
Outreach	 16%	 20%	 3%	
Radio		 60%	 14%	 8%	
*	Unstandardized	Regression	Coefficient	
	
	
Sources:	Hornik	(1989),	Naugle	and	Hornik		(2014),	Hornik	et	al	(2001)
Praxisbeispiele
India	|	Leprosy
%	who	believe	leprosy	is	hereditary
56%
32%
19%
0%
10%
20%
30%
40%
50%
60%
Baseline Phase	1 Phase	2
Ethiopia	|	Trachoma
74% 72%
26%
52%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Baseline
Endline
Handwashing
Trachoma	
prevalence
I.	WIRKUNG	SCHÄTZEN
Mathematisches Modell	
Assumptions	(Lives	Saved	Tool)	
%	current	coverage	(Baseline)
%	Target	coverage
II.	WIRKUNG	SCHÄTZEN
Assumptions	(DMI)																				
%	predicted	behaviour	change
%	service	coverage	
%	media	penetration
%	Child	mortality
%	Child	survival
%	change	in	coverage
(1-current	coverage	)*	predicted	change	in	coverage
Number	of	lives	saved	and	%	mortality	reduction
Predictions	- 16-23%	reduction	in	child	mortality
HOW	MANY	PEOPLE	BENEFIT	
I.	Wirkung schätzen
II.	Wirkung messen
III.	Wirkung erzielen
Measuring	Impact	– Burkina	Faso	RCTII.	WIRKUNG	- MESSEN
HOW	MANY	PEOPLE	BENEFIT	
I.	Wirkung schätzen
II.	Wirkung messen
III.	Wirkung erzielen
WIRKUNG	ERZIELEN	– SATURATION+
1	|	Saturation
Broadcast	spots		8-12	
times	per	day	(radio),	or	
3	times	(TV),	and	daily	
longer	formats
Broadcast	in	languages	
which	at	least	75%	of	the	
target	population	can	
understand	well
Broadcast	on	stations	
viewed	or	heard	at	least	
weekly	by	at	least	75%	of	
the	target	population
2	|	Science
Use	mathematical	
modelling	to	estimate	
impact of	each	message
Allocate	airtime	to	each	
message	based	primarily	
on	predicted	impact
Measure	and	attribute	
impacts	using	robust	
evaluations
3 |	Stories
Integrate	formative	
research	findings	into	the	
creative	process
Ensure	emotional	climax	
of	dramas	reflect	barriers	
to	behaviour	change
Test	all	materials	before	
and	after	broadcast	with	
the	target	audience
Saturation
Achieveing	Saturation
III.	WIRKUNG	ERZIELEN	– SATURATION
REICHWEITE
VERSTÄNDLICHKEIT
INTENSITÄT
(Exposure)
13	Szenaristen	
6	Sprachen	(Djoula,	Moore,	Fulfulde,	...)
140	Spots	(1‘)
10	mal	am	Tag
75,000	Wiederholungen	
15,000	Stunden	Live-Radio
Medienkanäle	die	75%	der	Bevölkerung	erreichen
Tabelle	-	Kostenbeispiel	(1-jaehrige	Kampagne	in	Tanzania)		
	
	
	
Kanal	 Frequenz	 Sendekosten	/	Jahr	 Erreichte	Personen	 Kosten/Person	
Radio		 (5	spots/Tag)	 $150,000	 33.5mio	 $0.004	
TV	 (3	spots/Tag)	 $280,000	 15mio	 $0.019	
SMS		 (1	sms/day)	 $2.8	mio	 100,000	 $28	($0.078	per	SMS)	
	
Kostenbeispiel
III.	WIRKUNG	ERZIELEN	– SATURATION
Science
Medienanalyse	– Wirkungsanalyse	– Verhaltensanalyse	– Pretesting	
III.	WIRKUNG	ERZIELEN	– SCIENCE
Campaign	
Design
Media	
Analysis
Impact	prediction MessageI.
Behaviour	Analysis Message	Brief Script	
Pretesting
Production
II.
Stories
Ergebnisse
So…	HOW	MANY	PEOPLE	DID	BENEFIT?
FIRST	RCT	TO	SHOW	IMPACT	OF	MEDIA	ON	BEHAVIOURS
20,1
25,3
18,2
15,7
17,5
10,2
4,7
8,0
9,3
13,4
7,7
0,9
5,6
9,4
13,6
8,3
-1,4
17,0
10,6
4,6
Diarrhoea	treatment-seeking
ORS/liquids	for	diarrhoea
Antibiotics	for	pneumonia
Malaria	treatment-seeking
Bed	nets
Latrines
Early	breastfeeding
Exclusive	breastfeeding
Birth	in	health	facility
Saving	money	for	pregnancy
Intervention Control
Fig.	%	change	in	behaviours
DOSE	RESPONSE
Each	additional	week	of	broadcasting	adds	0.9%	change
IS	THIS	THE	MOST	EFFECTIVE	THING	
YOU	CAN	DO?	
I.	Kosteneffizienz messen (DALYs)
II.	Kosteneffizienz im Vergleich
I.	KOSTENEFFIZIENZ	MESSEN
Kostenanalyse	anhand	von	Disability	Adjusted	Life	Years	(DALYs)
Kostenanalyse	anhand	von	Disability	Adjusted	Life	Years	(DALYs)
II.	KOSTENEFFIZIENZ	IM	VERGLEICH
Cost	effectiveness	–	How	does	our	intervention	compare?	
	 Intervention	 Cost	 per	 DALY	
averted		
	 	 	
Treatment	
uptake	
Treatment-seeking	behavioural	campaign	(DMI)		 $20	-	$50		
	 	 	
Vaccines	 Rotavirus	and	Japanese	encephalitis	in	high-burden	countries		 <	$50		
	 Hepatitis	B,	Rotavirus	Vaccines	 $60	-	$350		
	 Polio	Vaccines	 $1,000	-	$3,000		
	 	 	
Community-
based	
interventions	
Outreach	and	community-based	child	health	interventions	(various)		
The	 impact	 of	 such	 interventions	 varies	 and	 their	 cost-effectiveness	
remains	largely	unknown.			
<	$100		
	 	 	
Sanitation			 Household-level	water	treatment	in	rural	areas		 $180	-	$200	
	 Rural	sanitation,	piped	water	and	cholera	vaccine	 $2,000		
	
Nutrition	 Micro-nutrients,	education	and	supplementary	feeding	 $240	-	$340
DEVELOPMENT	MEDIA	INTERNATIONAL
Changing	behaviours.
Building	evidence.
Going	to	scale.	
HOW	GOOD	WOULD	SUCCESS	BE?
Intervention	 Mortality	Reduction	 Cost	per	life	saved	
Scaling	 up	 treatment-seeking	
behavioural	campaigns	
7-8%	reduction	in	mortality	 $660		
	
	
Scaling	up	midwifery	services	and	
obstetrics		 		
34%	 reduction	 in	 maternal,	 foetal	 and	 neo-
natal	mortality	
$2,200		
	
	
Bis	2030	werden	81%	der	Kinder	unter	5	Jahren	in	Ländern	südlich	der	Sahara	leben
Radiokampagnen	in	8	Ländern	könnten	bis	2020	150,000	Leben	retten	
zu	Kosten	von	<	$50	pro	DALY,	oder	$660	pro	gerettetem	Leben.	
Damit	wären	wir	eine	der	kosteneffizientesten	Interventionen	zur	Reduktion	der	
Sterblichkeitsrate	auf	Bevölkerungsebene.		
VERGLEICHBARKEIT
Vielen Dank	fuer Ihre Aufmerksamkeit
...	NOCH	FRAGEN?	
KONTAKT	
clara.straimer@developmentmedia.net
LITERATUR	
• Head	R,	Murray	J,	Sarrassat S,	Snell	W,	Meda N,	Ouedraogo	M,	et	al.	Can	mass	media	interventions	reduce	
child	mortality?	The	Lancet.	2015	Jul;386(9988):97–100.
• Naugle DA,	Hornik RC.	Systematic	Review	of	the	Effectiveness	of	Mass	Media	Interventions	for	Child	
Survival	in	Low- and	Middle-Income	Countries.	J	Health	Commun.	2014;19(sup1):190–215.	
• Hornik RC,	McDivitt J,	Zimicki S,	Yoder,	PS,	Contreras-Budge	E,	McDowell	J,	Rasmuson M.	2001.	
Communication	in	Support	of	Child	Survival:	Evidence	and	Explanations	From	Eight	Countries;	in	Hornik RC	
(ed.)	Public	Health	Communication:	Evidence	for	Behavior Change.	2001.	New	York:	Routledge,	pp.	219-
250
• Horton	S,	Levin	C.	Cost-Effectiveness	of	Interventions	for	Reproductive,	Maternal,	Neonatal,	and	Child	
Health.	Disease	Control	Priorities.	2016;	Available	from:	http://dcp-
3.org/sites/default/files/chapters/DCP3%20RMNCH%20Ch17.pdf
• Lives	Saved	Tool	
• Sarrassat S,	Meda N,	Ouedraogo	M,	Some	H,	Bambara	R,	Head	R,	et	al.	Behavior change	after	20	months	of	
a	radio	campaign	addressing	key	lifesaving	family	behaviors for	child	survival:	midline	results	from	a	cluster	
randomised	trial	in	rural	Burkina	Faso.	Global	Health:	Science	and	Practice.	2015;3(4):557–576.
Auszuege

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