A longitudinal, cross-sectional study to assess the impact of media campaigns on maternal and newborn health behaviours and their drivers

BACKGROUND: BBC Media Action is developing TV and radio programming to help address high levels of newborn and maternal mortality in Bangladesh, Ethiopia, India, and South Sudan. Standard measures are being used across the four countries to measure programming impact upon health-seeking behaviours and upon the following outcomes, which are potential drivers of health behaviour change: knowledge, attitude, self-efficacy, social norms, and interpersonal discussion. METHODS: Programming impact will be assessed using a longitudinal study design. Cross-sectional surveys will be conducted at baseline, midline, and endline in each country over a 2–3-year period. Approximately 8000 women with an infant aged 0–9 months will be surveyed at each timepoint. Shifts in outcomes (such as knowledge of healthy behaviours) over time will be analysed and differences in outcomes between women exposed to the programming and those not exposed will be examined. Furthermore, dose–response analysis will be conducted to explore the effects of different levels of exposure to programming. The relation between behavioural outcomes and the potential drivers will be analysed to help better understand the drivers of maternal and newborn health behaviours. Measures have been piloted and survey instruments will be subject to retrospective testing and refinement. Additional qualitative research will also be conducted with the target population to help understand impact and provide contextual information at the country level on how these drivers might impact behaviours. FINDINGS: Preliminary findings on the relations between health behaviours and potential drivers for Ethiopia, India, and South Sudan will be available in summer 2013. Research continues into 2014/15/16, when midline and endline surveys will be conducted across the four countries. Full findings on associations between exposure and outcomes, and on the relations between behaviours and potential drivers, will be available in 2016/17. INTERPRETATION: This is an innovative, standardised design across multiple countries that aims to examine under-researched drivers of selected maternal and newborn health behaviours. The implications for evaluative research and measurement development will be discussed alongside issues of comparability. FUNDING: The research was carried out thanks to funding from the UK Department of International Development/UKaid, which supports the research and policy work of BBC Media Action.