1 research outputs found
Effect of a mass radio campaign on family behaviours and child survival in Burkina Faso: a repeated cross-sectional, cluster-randomised trial
Summary: Background: Media campaigns can potentially reach a large audience at relatively low cost but, to our knowledge, no randomised controlled trials have assessed their effect on a health outcome in a low-income country. We aimed to assess the effect of a radio campaign addressing family behaviours on all-cause post-neonatal under-5 child mortality in rural Burkina Faso. Methods: In this repeated cross-sectional, cluster randomised trial, clusters (distinct geographical areas in rural Burkina Faso with at least 40β000 inhabitants) were selected by Development Media International based on their high radio listenership (>60% of women listening to the radio in the past week) and minimum distances between radio stations to exclude population-level contamination. Clusters were randomly allocated to receive the intervention (a comprehensive radio campaign) or control group (no radio media campaign). Household surveys were performed at baseline (from December, 2011, to February, 2012), midline (in November, 2013, and after 20 months of campaigning), and endline (from November, 2014, to March, 2015, after 32 months of campaigning). Primary analyses were done on an intention-to-treat basis, based on cluster-level summaries and adjusted for imbalances between groups at baseline. The primary outcome was all-cause post-neonatal under-5 child mortality. The trial was designed to detect a 20% reduction in the primary outcome with a power of 80%. Routine data from health facilities were also analysed for evidence of changes in use and these data had high statistical power. The indicators measured were new antenatal care attendances, facility deliveries, and under-5 consultations. This trial is registered with ClinicalTrial.gov, number NCT01517230. Findings: The intervention ran from March, 2012, to January, 2015. 14 clusters were selected and randomly assigned to the intervention group (n=7) or the control group (n=7). The average number of villages included per cluster was 34 in the control group and 29 in the intervention group. 2269 (82%) of 2784 women in the intervention group reported recognising the campaign's radio spots at endline. Post-neonatal under-5 child mortality decreased from 93Β·3 to 58Β·5 per 1000 livebirths in the control group and from 125Β·1 to 85Β·1 per 1000 livebirths in the intervention group. There was no evidence of an intervention effect (risk ratio 1Β·00, 95% CI 0Β·82β1Β·22; p>0Β·999). In the first year of the intervention, under-5 consultations increased from 68β681 to 83β022 in the control group and from 79β852 to 111β758 in the intervention group. The intervention effect using interrupted time-series analysis was 35% (95% CI 20β51; p<0Β·0001). New antenatal care attendances decreased from 13β129 to 12β997 in the control group and increased from 19β658 to 20β202 in the intervention group in the first year (intervention effect 6%, 95% CI 2β10; p=0Β·004). Deliveries in health facilities decreased from 10β598 to 10β533 in the control group and increased from 12β155 to 12β902 in the intervention group in the first year (intervention effect 7%, 95% CI 2β11; p=0Β·004). Interpretation: A comprehensive radio campaign had no detectable effect on child mortality. Substantial decreases in child mortality were observed in both groups over the intervention period, reducing our ability to detect an effect. This, nevertheless, represents the first randomised controlled trial to show that mass media alone can change health-seeking behaviours. Funding: Wellcome Trust and Planet Wheeler Foundation