Clara Straimer (Business Development Manager, Development Media International), Effective Altruism Global X Berlin, 8 Oct 2016

1. DMI
DEVELOPMENT MEDIA INTERNATIONAL
Changing behaviours.
Building evidence.
Going to scale.

2. TOD IM 20. JAHRHUNDERT

3. 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

4. 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?

5. HOW MANY PEOPLE BENEFIT
I. Wirkung schätzen
II. Wirkung messen
III. Wirkung erzielen

6. 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)

7. 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

8. 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

9. HOW MANY PEOPLE BENEFIT
I. Wirkung schätzen
II. Wirkung messen
III. Wirkung erzielen

10. Measuring Impact – Burkina Faso RCTII. WIRKUNG - MESSEN

11. HOW MANY PEOPLE BENEFIT
I. Wirkung schätzen
II. Wirkung messen
III. Wirkung erzielen

12. 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

13. Saturation

14. 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

15. 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

16. Science

17. Medienanalyse – Wirkungsanalyse – Verhaltensanalyse – Pretesting
III. WIRKUNG ERZIELEN – SCIENCE
Campaign
Design
Media
Analysis
Impact prediction MessageI.
Behaviour Analysis Message Brief Script
Pretesting
Production
II.

18. Stories

19. Ergebnisse
So… HOW MANY PEOPLE DID BENEFIT?

20. 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

21. DOSE RESPONSE
Each additional week of broadcasting adds 0.9% change

22. IS THIS THE MOST EFFECTIVE THING
YOU CAN DO?
I. Kosteneffizienz messen (DALYs)
II. Kosteneffizienz im Vergleich

23. I. KOSTENEFFIZIENZ MESSEN
Kostenanalyse anhand von Disability Adjusted Life Years (DALYs)

24. 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

25. DEVELOPMENT MEDIA INTERNATIONAL
Changing behaviours.
Building evidence.
Going to scale.
HOW GOOD WOULD SUCCESS BE?

26. 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

27. Vielen Dank fuer Ihre Aufmerksamkeit
... NOCH FRAGEN?
KONTAKT
clara.straimer@developmentmedia.net

28. 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.
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