By Cameroon Link, Email: camlink99@gmail.com 
Cameroon Link and the Development Media International (DMI) U K held business profile exchange talks at the Djuega Palace Hotel in Yaoundé on the 20th February, 2013. Cameroon Link was represented by James Achanyi-Fontem, Executive Director, while Will Snell, Head of Public Engagement and Development, led the DMI United Kingdom delegation, accompanied by Lavoie Mathew, Burkina Faso Country Director of DMI and Bassirou Kagone, DMI Broadcast Liaison Manager. Similar meetings took place at the WHO Cameroon office, ministry of public health, UNESCO and Cameroon Radio Television. The purpose of the meetings was aimed at lay the foundation for a mass media child survival campaign in Cameroon to be undertaken BY DMI and other partners. The Commonwealth of Learning connected Cameroon Link to DMI.
Executive summary
In Cameroon, almost one in eight children dies before the age of five. This number could be reduced using simple interventions and behaviour change. For example, malaria accounts for 16% of under-five deaths, but only 21% of children sleep under insecticide-treated nets. Our campaigns could lead to dramatic increases in the uptake of this and other basic interventions. We can reach 60% of the population through radio messages alone (compared to 43% for television). Our model indicates that a DMI mass media campaign in Cameroon would save 14,000 lives every year.
About Development Media International
DMI is a social enterprise with non-profit and for-profit arms. It was established in 2005 by Roy Head, who ran the Health Division of the BBC World Service Trust for eight years, running 15 campaigns with 150 staff. DMI's experts have led some of the world's largest and most successful media health campaigns in Africa, Asia, and South America over 30 years.
DMI was created to distil this experience into a set of systems to run campaigns much more comprehensively, cost-effectively and sustainably. The team has a proven track record of managing multi-million dollar projects (involving 500 to 8,000 broadcasts) on TV and radio. Funders of previous campaigns include DFID, PMNCH, WHO and USAID. For examples of the impact of previous DMI mass media projects on health behaviours, see www.deveIODmentmedia.net.
Project outline
Many barriers to healthy behaviours (e.g. use of ORS/ORT and malaria bed nets) are due to a lack of knowledge and mistaken beliefs. For example, many mothers believe that the colostrum (first milk) is unhealthy, or that the best way to stop diarrhoea is to stop providing the child with food and liquids. In Cameroon, just 15% of infants are exclusively breastfed up to six months. A key barrier is the mistaken belief that breast milk is not enough to meet the nutritional needs of an infant during the first six months. DMI's media campaigns will increase the coverage of key interventions by promoting healthy behaviours and dispelling mistaken beliefs. This will save lives: in Cameroon, 37,000 children under five die every year from diarrhoea, pneumonia and malaria. Many deaths are due to unhealthy behaviours.
DMI has developed a unique statistical model, combining data from the Lancet Child Survival Series and its own evidence base for the impact of behaviour change campaigns. The model predicts how many under-five lives we can save by changing behaviours for particular health issues in each country, enabling us to design campaigns with maximum impact. It predicts that a mass media campaign alone can reduce child mortality in Cameroon by 16%, more cost-effectively than almost any other health intervention (at $6.08 per disability-adjusted life year or DALY). DMI is running a $12m randomised controlled trial in Burkina Faso in partnership with LSHTM, funded by the Wellcome Trust and Planet Wheeler Foundation. This is the largest, most rigorous evaluation ever of a mass media intervention.
Our objective is to design and implement a radio and TV child mortality behaviour change campaign in Cameroon, in partnership with the Ministry of Health & Public Hygiene and major radio and television broadcasters. We would develop health messages in collaboration with the Ministry of Health & Public Hygiene, the World Health Organisation and UNICEF. The main broadcast format is 60-second adverts (in local languages), but longer-format interactive shows
are also possible. There is also potential to integrate mobile phones into the campaign, for example by encouraging listeners to call in to radio shows, or by partnering with existing Health initiatives (such as helplines.
Project deliverable
•DMI researches the social attitudes and beliefs of target audiences and identify key barriers to behaviour change.
•Produce creative outputs that target those barriers, using international producers and local script-writers.
•Broadcast the outputs at scale (e.g. 6-10 radio spots per day) in all major languages, on all key media stations.
•Build the capacity of local partners, including broadcasters and (where feasible) Ministries of Health.
•Collaborate with national and global public health authorities, including WHO, UNICEF and Ministries of Health.
•Evaluate the impact of campaigns using baseline/end line, time-series and dose-response analyses.
The DMI approach is to campaign on all key maternal and Child health Issues. Once key staff has been trained, and the infrastructure and relationships established, the marginal costs of conducting additional campaigns are very low. Campaigns can be conducted on a different issue every month for little more than the cost of a single-issue campaign:
January: Breastfeeding
February: Water and sanitation
March: Diarrhoeal diseases
April: Giving birth in a health facility
May: Malaria prevention and treatment
June: Birth spacing and family planning
A 3-days workshop ended at the Ocean City Radio Kumba in the south west region of Cameroon on 16th May 2013. The training was a platform for exchange between COL Cameroon link partnership initiative and the radio production staff on how to ameliorate the process of designing health programmes targeting pregnant women and breastfeeding mothers. Welcome the facilitators and trainees, the Station Manager, Richard Shengang, it was a great learning opportunity for the volunteer-broadcasters, most of who are holders of a first degree but never received any training in journalism.
He reminded the radio staff that the training had been announced in the CLP Cameroon plan during the training organized at the Women’s Empowerment Centre in Kumba last January 2013. Mr. James ACHANYI FONTEM, COL Cameroon link partnership liaison and key training resource person explained that the development of underprivileged communities and their wellbeing through healthy community initiative is the awaited outcome of open distance learning using community radio stations.
Four community radio stations in four health districts of two regions in Cameroon have benefited from the training on radio story design programming on mother and child health care with special focus on breastfeeding. The southwest and west regions were selected for the start of the scaling up phase of the project in Cameroon. Infant and young child feeding and especially breastfeeding was agreed upon as the issue of discussion and investigation by the broadcasters.
The resource person justified the choice with the fact saying, statistics have shown that only 20% of the Cameroonian women breastfeed their children exclusively for the first six months after delivery and there is a call for concern to improve on the rate through behavior change communication initiatives. Breastfeeding, he continued is a natural way that guarantees food security and safety of babies since it promotes attachment of baby to the mother and encourages normal growth.
The trainees received some tips on how to come up with good and attractive programmes through formative research, involvement of the listeners who are the beneficiaries and health experts. The broadcasters were trained on the techniques of conducting face to face interviews with mothers, pregnant women and experts on the subject. Men and youths were also interviewed in the process to talk about their roles and how they contribute in assisting mothers.
He added that throughout the process in Bonakanda, Medumba and Bare Bakem, programme coordinators were encouraged to exchange their productions with other community radios to increase variety of programmes on the issues treated. He observed that, this consequently leads to an increase in the radio audience.
At each station the trainees went to the field in groups of four to practice what they learnt during the training and how to research for materials to build programmes. In Kumba, Group one treated the issue of exclusive breastfeeding, while group two tackled the issue of breastfeeding in emergency situations. In Bangangte, the programme focused on preparation of the world breastfeeding week in medumba langauge. The programme from Bonakanda was in pidgin and in Bare Bakem the programme was produced in French.
The broadcasters talked to people in the hospitals, health centres, handicapped persons centre, food markets, administrative offices and the streets in the different localities. Kumba for example has a population of 600.000 inhabitants and 75% are farmers and over 60% are women involved in petit trading. Men interviewed approved of the fact that it is their duty to encourage their wives to breastfeed children and assist them at home, but very few accomplish their responsibilities.
When the broadcasters returned to their stations, they were given the opportunity to exchange on the material gathering process, the difficulties faced in accessing information and how they resolved them. After editing the voices collected, the team members put their heads together to construct the script production and mixing.
Speaking about difficulties, it was observed that many people are shy to speak when the recorder is shown to them. Some fear to make mistakes but were advised to speak in the language they master. On the other hand, some women think breastfeeding is a matter of choice and not a child right. A woman said, a person can chose to breastfeed or choose not to do so depending on the circumstance..
During the workshop evaluation, broadcasters expressed their satisfaction. Many said, the training got them not only to increase their knowledge on how to inform the public rightly through CLP, but they as learners benefited a lot on how to come out with good and attractive programmes. The polite and friendly approach, they stated, is one of the tools for collecting interviews.
The trainees through the station managers, expressed their thanks and gratitude to the Commonwealth of Learning and Cameroon link for creating the great learning opportunity on how to develop health programmes on mother and child issues, A participant added that the knowledge gained will be useful throughout their lives. Certificates of participation were handed over to the trainees at the closing session on the third day of the workshop.
