title: The impact of a community driven mass media campaign on the utilisation of maternal health care services in rural Malawi.
abstract: BACKGROUND
  Mass media is critical in disseminating public health information, improving health knowledge and changing health behaviours. However, most of the mass media public health interventions do not sufficiently engage the local people; they are externally determined. Due to this, very little is known about the effects of locally instigated mass media promotion. Therefore, the aim of this study was to examine the impact of a community driven mass media campaign called Phukusi la Moyo (tips of life) on the utilisation of maternal health care services.
  
  
  METHODS
  A community-based cross-sectional study involving 3825 women of reproductive age (15-49 years) was conducted in rural Malawi to evaluate the Phukusi la Moyo (PLM) campaign. To do this, we compared the utilisation of maternal health care services between women who were exposed to the PLM campaign and those who were not. Respondents were identified using a multistage cluster sampling method. This involved systematically selecting communities (clusters), households and respondents. Associations were examined using Pearson chi square test and a multivariable logistic regression model.
  
  
  RESULTS
  The likelihood of using contraceptives (AOR = 1.61; 95% CI = 1.32-1.96), sleeping under mosquito bed-nets (AOR = 1.65; 95% CI = 1.39-1.97), utilising antenatal care services (AOR = 2.62; 95% CI = 1.45-4.73) and utilising postnatal care services (AOR = 1.59; CI = 1.29-1.95) were significantly higher among women who had exposure to the PLM campaign than those who did not. No significant association was found between health facility delivery and exposure to the PLM campaign.
  
  
  CONCLUSIONS
  Women exposed to a community driven mass media campaign in rural Malawi were more likely to utilise maternal health care services than their unexposed counterparts. Since, the use of maternal health care services reduces the risk of maternal morbidity and mortality, community-led mass media could play a significant role towards improving maternal health outcomes in low-and-middle-income countries. Therefore, we recommend the use of locally driven mass media in disseminating public health information in limited resource settings.
authors.affiliation: Parent and Child Health Initiative (PACHI), Research Centre, Amina house, Off Chilambula Road, P.O. Box 31686, Capital City, Lilongwe, 3, Malawi. fzamawe@gmail.com.|The Ministry of Health, Lilongwe, Malawi. fzamawe@gmail.com.
authors.forename: Collins O F
authors.initials: COF
authors.lastname: Zamawe
authors.affiliation: MaiMwana Project, P.O. Box 2, Mchinji, Malawi.
authors.forename: Masford
authors.initials: M
authors.lastname: Banda
authors.affiliation: Parent and Child Health Initiative (PACHI), Research Centre, Amina house, Off Chilambula Road, P.O. Box 31686, Capital City, Lilongwe, 3, Malawi.|The University of Malawi, College of Medicine, School of Public Health, Blantyre, Malawi.
authors.forename: Albert N
authors.initials: AN
authors.lastname: Dube
mesh_terms: D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D003268:Contraception Behavior / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008295:Malawi; D008402:Mass Media; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D057147:Mosquito Nets / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000706:statistics & numerical data*; D055815:Young Adult
references.citation: Int Health. 2013 Sep;5(3):180-95
references.pmid: 24030269
references.citation: Stud Fam Plann. 1998 Sep;29(3):309-23
references.pmid: 9789324
references.citation: PLoS Med. 2012;9(7):e1001257
references.pmid: 22802737
references.citation: Lancet. 2012 Jul 14;380(9837):111-25
references.pmid: 22784531
references.citation: Malawi Med J. 2010 Dec;22(4):112-9
references.pmid: 21977831
references.citation: Health Educ Res. 2011 Jun;26(3):456-65
references.pmid: 21393376
references.citation: J Sch Psychol. 2010 Feb;48(1):5-37
references.pmid: 20006986
references.citation: J Health Commun. 2009 Jan-Feb;14(1):15-42
references.pmid: 19180369
references.citation: Lancet. 2008 Sep 13;372(9642):962-71
references.pmid: 18790319
references.citation: BMC Public Health. 2007;7:352
references.pmid: 18088437
references.citation: Stud Fam Plann. 2007 Jun;38(2):113-20
references.pmid: 17642412
references.citation: Behav Res Methods. 2007 May;39(2):175-91
references.pmid: 17695343
references.citation: Glob Health Action. 2014;7:22904
references.pmid: 24433945
references.citation: BMC Pregnancy Childbirth. 2014;14:38
references.pmid: 24447854
references.citation: J Acquir Immune Defic Syndr. 2014 Aug 15;66 Suppl 3:S329-40
references.pmid: 25007204
references.citation: Am J Prev Med. 2014 Sep;47(3):360-71
references.pmid: 25145620
references.citation: J Health Commun. 2014;19 Suppl 1:190-215
references.pmid: 25207453
references.citation: Reprod Health. 2015;12:31
references.pmid: 25881061
references.citation: Int J Equity Health. 2015;14:32
references.pmid: 25889973
references.citation: BMC Res Notes. 2015;8:345
references.pmid: 26264412
references.citation: Indian J Public Health. 2015 Jul-Sep;59(3):220-4
references.pmid: 26354400
references.citation: BMC Public Health. 2015;15:1007
references.pmid: 26433689
references.citation: BMC Infect Dis. 2015;15:437
references.pmid: 26493559
references.citation: Lancet. 2004 Jul 17-23;364(9430):295-300
references.pmid: 15262109
references.citation: Lancet. 2004 Sep 11-17;364(9438):970-9
references.pmid: 15364188
references.citation: J Health Popul Nutr. 2004 Dec;22(4):429-39
references.pmid: 15663176
references.citation: Lancet. 2013 May 18;381(9879):1721-35
references.pmid: 23683639