Malawi’s Life Is Precious Campaign

The Life is Precious (or Moyo ndi Mpamba) campaign in Malawi promotes healthy practices in six priority health areas:

This sign reads, “Let’s sleep under a net every night throughout the year to prevent malaria – Life is precious.

Implemented by the Support for Service Delivery Integration (SSDI) Communication Project, a USAID-funded project with the Ministry of Health, the campaign is implemented in 15 districts. SSDI Communication, which began in 2011 and runs into 2016, is managed by the Johns Hopkins Center for Communication Programs (CCP) in partnership with Save the Children.

Inquire

SSDI Communication began by reviewing relevant research on health and the many communication strategies already in existence. These included communication strategies for malaria, nutrition, maternal and neonatal mortality and morbidity, HIV and AIDS, and family planning. SSDI also designed and conducted a population-based survey and qualitative research in the 15 districts where it worked.

They found that well-being is associated by most Malawians with smaller families, self sufficiency, food security and the absence of disease. They also found that while many people were aware of the government’s recommended health practices, many did not believe in the efficacy of these practices or did not think that they were able to adopt them. A summary of key findings from the SSDI research by health area includes:

• Malaria: Insecticide-treated nets were considered highly efficacious, although most people thought they might not be safe. Nonetheless, the majority of children under five slept under nets. Overall, three-quarters of mothers sought medical treatment for a child with fever. However, only about one-third of mothers recognized the need to take a feverish child to a health facility within 48 hours of the onset of fever.
• Family planning: Most men and women know of at least one modern family planning method and approve of using them. On average, men and women would like to have 4.1 children. Most men and women have used a modern contraceptive at some time in their lives and about half were using contraceptives at the time of the studies. About three-quarters of men and women believed others they know use contraception.
• Maternal health: Overall, knowledge of danger signs associated with pregnancy was very low; approximately one-fifth of respondents were unaware of any danger signs for the child or the mother. Among women who gave birth in the past five years, 98% received some antenatal care; and childbirth was attended by a trained medical professional. Over 80% of births took place in a hospital or health facility.
• Water and sanitation: Three-quarters of respondents knew that improper hand washing can cause diarrhea and about half associated it with cholera transmission. About 90% reported washing their hands after using the toilet, 80% before handling food, but less than 30% after cleaning a defecating child. Most people thought that poor access to safe water was the greatest barrier to good health.
• HIV and AIDS: Most adults believed that they could reduce their risk of HIV through abstinence, faithfulness and condom use; more than 90% knew that mother-to-child transmission of HIV could be prevented. The majority did not believe that male circumcision effectively reduces HIV risk. Less than 20% thought that “most” people they know use condoms with casual partners. Less than one-quarter of men and one-tenth of women reported condom use at last sex. Approximately 22% of males and 3% of females reported having more than one sexual partner in the previous 12 months.

 Design the Strategy

SSDI Communication conducted two participatory workshops to design the Life is Precious communication strategy. During the first workshop, senior MoH officials, SSDI and other stakeholders identified key messages for each of the six health topics, and identified four life stages around which to prioritize key messages. The four life stages are young couples (about to get married/newly married), parents of children under five years, parents of older children (6-12 years of age) and adolescents.

The second workshop took place after the SSDI formative research was completed and the 2010 Malawi Demographic and Health Survey (MDHS) report was finalized. During this workshop, senior MoH officials, SSDI and partners revisited the life-stage audiences and assigned health issues and practices to each, as shown in the diagram to the right.

Because SSDI formative research and data from the 2010 MDHS showed a high awareness among audiences on all six health topics, the central goal is to create a positive environment for men and women to actively discuss health problems and issues, find ways to tackle them together and then take action.

Using a mix of interpersonal and group communication, print and media materials, music and drama, the campaign reflects the audiences’ understanding of health and well-being by using positive images of audience representatives living out their aspirations – small healthy families doing simple things to stay healthy (treating malaria promptly and correctly, getting voluntary medical male circumcision to reduce HIV risk, using modern contraceptives, exclusively breastfeeding for the first six months, etc). The campaign is designed to offer audiences hope and confidence that they can change.

The campaign reaches each life-stage audience through a combination of media messaging, primarily through radio and billboards; community media including road shows, music festivals and community drama; interpersonal communication through community health workers, professional health workers, faith-based counselors and community volunteers; and supportive print materials.

 Create and Test

During a participatory workshop, representatives from the MOH, SSDI and partners developed three concepts for the overarching campaign slogan (see table below). Two of the concepts (Moyo ndi Mpamba and Ziri Bwino) were pretested among the intended audiences and the best received concept was: “Life is Precious (Moyo ndi Mpamba), Take care of it (Usamalireni).”

 Download the concept testing report.

SSDI decided to roll out the campaign in two phases:

Phase 1:  For 12 weeks, SSDI introduced the “Life is Precious: Take care of it” concept and brand, through high-profile national and zonal launches, theme songs by popular artists, radio spots, billboards, posters, branded t-shirts and wrappers.

Phase 2:  Through a mix of media, SSDI communicated malaria, sanitation, MNCH, family planning, HIV and nutrition messages. All messaging was branded with the Life is Precious slogan and logo and directed audiences to health facilities and community health workers for further information and services.

SSDI engaged graphic designers, advertising agencies, scriptwriters, audio producers and advertising agencies to develop a variety of branded media and supportive print materials. Life is Precious centerpiece materials, designed for the four life-stage audiences, carry messaging on all six health issues. SSDI pretested all materials with intended audiences. Centerpiece materials include: