A pregnant mother and father smiling
More than a beloved international pastime, football—what Americans call soccer—is now a proven tool for engaging men in the fight against malaria in pregnancy (MiP), thanks to a multimiedia campaign out of Uganda.
If not tackled early, malaria in pregnant women can lead to maternal mortality, miscarriage, and stillbirth. In Uganda, 13 percent of malaria cases occur during pregnancy.
Strategies to prevent MiP are simple and inexpensive: intermittent preventive treatment in pregnancy (IPTp) costs 12 cents per dose (less than 40 cents for a minimum of the 3 doses), and long-lasting insecticidal nets (LLINs) cost less than $5.
However, despite the availability of these effective preventive measures, use is limited. Men, who are usually households’ core decision makers on malaria prevention and control practices, remain unaware of the importance of supporting the women in their households to attend early antenatal care (ANC) visits and sleep under LLINs.
This may be because malaria awareness interventions tend to reach many more women than men, according to a 2017 gender analysis by USAID’s Malaria Action Program for Districts (MAPD).
Men rarely visit the health centers where health education activities take place, but they often follow football. Therefore, MAPD saw the 2018 FIFA World Cup (June 14–July 15), as a great platform to bring education on malaria and prevention techniques to men.
Football for behavior change
The goal was to connect with men on an emotional level by positioning malaria prevention as a responsibility associated with heads of households, while motivating men to change their behavior based on “self-determination theory.”
In 25 of its 49 implementation districts, MAPD delivered malaria-prevention messages before kick-off using a multi-channel approach that included experiential mobile cinemas, radio spots, announcements from local football commentators and community dialogues.
As a result, there was an increase in IPTp uptake among expectant women and, consequently, a reduction in MiP throughout the World Cup period.
Uptake of the third dose of IPTp increased by 12 percentage points in the intervention sites, from 40 percent to 52 percent, while in the control districts it reduced from two percent to one percent. Malaria in pregnancy reduced by three percentage points and ANC visits increased from 40 to 43 percent in the intervention districts, while it only increased from 18 to 19 percent in the control districts. Of the 538 people who responded to exit interviews, 80.6 percent were male. About 54 percent expressed their intention to ensure that they and their households were using LLINs consistently and correctly; 9 percent pledged to remove mosquito breeding places from their homes; 38 percent indicated that they would seek treatment within 24 hours of onset of fever; and 31 percent promised to adhere to test results. More than 7 million people (54 percent of the target population) were reached with radio messages, while 1,967,200 were reached with interpersonal and experiential activation messaging during World Cup matches.
In addition, the MAPD World Cup campaign, called “Giving Malaria the Boot!” won the African Excellence Award for the best multimedia campaign.
Next steps
Football facilitated a connection with a disengaged male audience using matches as edutainment vehicles to convey key malaria-control messages, contributing to significant improvements in women’s health. When engaged, men can contribute to an increase in uptake of malaria-prevention actions at the household and community levels.
Having found that football can effectively engage young men around malaria messaging, MAPD is now planning a nine-month-long second phase of the intervention, built around Premier League football matches.
Malaria Action Program for Districts (MAPD) is a USAID-funded project that aims to reduce malaria-induced childhood and maternal morbidity and mortality in Uganda. The project implements evidence-based high-impact activities, working with Uganda’s National Malaria Control Program and the district health management teams.