title: Use of mobile video show for community behavior change on maternal and newborn health in rural Ethiopia.
abstract: BACKGROUND
  A number of factors affect Ethiopia's efforts to meet Millennium Development Goals 4 and 5 to reduce maternal and newborn mortality. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) project, as part of its overall strategy, implemented behavior change communication interventions to increase women's demand for and use of antenatal, birth, and postnatal services. Seeking to reach "media-dark" areas, MaNHEP implemented a mobile video show focused on maternal and newborn health. We report on the effect of the mobile video show on community knowledge, attitudes, and beliefs regarding maternal and newborn health, especially regarding care-seeking behavior and use of a skilled attendant for birth and postnatal care.
  
  
  METHODS
  Two main data sources are used: qualitative data gathered through mobile video show participant discussions in 31 randomly selected kebeles (villages with about 1000 households) and focus groups in 4 kebeles (2 from each region), and quantitative data generated from 510 randomly selected adults participating in MaNHEP's endline survey. Qualitative data were thematically analyzed by the research team, and the accuracy of the transcriptions and categorization was also checked.
  
  
  RESULTS
  The mobile video show reached a total of 28,389 mostly young or adult females in 51 kebeles. At endline, mobile video show attendees (vs nonattendees) reported significantly (P < .001) higher rates of recall of key MaNHEP messages about use of health extension workers for pregnancy registration, labor and birth notification, and postnatal care. Qualitative analysis yielded 3 overarching themes: mirrors to the community (the portrayal is accurate); call to action (we have to change this); and improvement ideas (suggested positive actions).
  
  
  CONCLUSIONS
  The entertaining nature and local organization of the mobile video show event encouraged attendance. Building the video around recognizable characters (particularly the husbands) contributed to bringing about desired changes in people's knowledge and beliefs. Making the show readily available (through the mobile van) and bundling it with facilitated reflection sessions had a considerable impact on people's knowledge and confidence.
authors.forename: Binyam Fekadu
authors.initials: BF
authors.lastname: Desta
authors.forename: Hajira
authors.initials: H
authors.lastname: Mohammed
authors.forename: Danika
authors.initials: D
authors.lastname: Barry
authors.forename: Aynalem Hailemichael
authors.initials: AH
authors.lastname: Frew
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hepburn
authors.forename: Christine
authors.initials: C
authors.lastname: Claypoole
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001296:Audiovisual Aids / Q000592:standards; D003142:Communication; D003150:Community Health Workers; D005002:Ethiopia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008427:Maternal Health Services; D008875:Middle Aged; D008880:Midwifery; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D012111:Residence Characteristics; D019035:Rural Health Services; D012424:Rural Population; D012922:Social Change; D055815:Young Adult
keywords: behavior change communication; community action; maternal and newborn health