"...findings can be useful for future studies of SBC [social and behaviour change] interventions using social media for framing the analysis and selecting the appropriate metrics for the denominator, as well as for budgeting and planning SBC programs using social media."

Conducted by Breakthrough ACTION, Merci Mon Héros (MMH) is a youth-led multi-media campaign in Francophone West Africa seeking to improve reproductive health and family planning outcomes using radio, television, social media, and community events. One component to this project is a series of youth-driven videos created to encourage both youth and adults to break taboos by talking to each other about reproductive health and family planning. Research has shown that social media as a tool to convey (i.e., obtaining, sharing, or exchanging) information to the public can help inform or motivate health-related behaviour change and/or influence health decision making and allow targeted messaging with hard-to-reach groups. This article describes a costing study that was conducted to capture costs associated with the design, production, and dissemination of 11 MMH videos (in French) on social media in Côte d'Ivoire and Niger.

The complete MMH campaign is described in more detail at Related Summaries, below. But, in terms of the present research, the 11 videos were disseminated via social media (e.g., Facebook, Twitter, YouTube, Instagram) and via radio, television, and community-based events in nine countries (Burkina Faso, Côte d'Ivoire, Togo, Niger, Democratic Republic of Congo, Guinea, Mali, Benin, and Senegal). The videos consisted of individuals recounting their experiences when someone in their life shared information about reproductive health issues and how this information helped them better understand their health and options. This study is limited to the videos' dissemination in Niger and Côte d'Ivoire. These two countries were selected for analysis because (i) the youth design challenge (YDC) that sparked the original MMH campaign idea was held in Côte d'Ivoire, and (ii) Niger has the highest total fertility rate in the world and high levels of adolescent pregnancy.

This costing study focused on the resources needed to replicate the development of videos delivering social and behaviour change (SBC) messaging through social media platforms in a similar setting. Design costs included those associated with the YDC, training, and production. Dissemination costs associated with the core MMH videos include personnel costs associated with social media influencers/bloggers paid to disseminate and promote the videos, social media paid advertising, and costs associated with the MMH launch in each country (e.g., equipment rental, services). Included in the costs are those associated with in-kind contributions, such as donated personnel time and meeting space, which were valued at the expected costs based on information on the value of the donation provided by Breakthrough ACTION country teams. Broader societal costs were not included, such as the costs associated with the time for the intended audience to view the videos or the cost of internet access for users of social media.

The total costs to design, produce, and disseminate the 11 MMH videos in Côte d'Ivoire and Niger from November 2018 through October 2020 were US$44,981. Unit costs were calculated using three different denominators: reach (the number of people who saw MMH posts at least once); engagements (the number of times people engaged with MMH posts through reactions, comments, shares, retweets, mentions, and likes); and views (the number of times the 11 videos were viewed for at least 30 seconds). Average unit costs were:

• US$0.16 per reach - This cost is comparable to the median unit costs for traditional SBC mass media campaigns per person exposed (US$0.17 for television, US$0.26 for radio, US$0.25 billboards/flyers). In the world of social media, however, reaching someone's screen is not likely sufficient for a person to absorb and process the campaign's message, as social media feeds are abundant with other content simultaneously competing for one's attention.
• US$1.29 per engagement - A remaining question is whether individuals who are engaging with the MMH content without fully watching the videos are still receiving the basic messages of MMH around destigmatising and normalising conversations about RH. Thus, future SBC impact analysis could investigate to what extent "engagement" is associated with improved knowledge, beliefs, and attitudes that the videos are addressing.
• US$4.27 per video view - This cost is comparable to SBC unit costs for group interpersonal communication. In the West Africa context, most individuals need to pre-purchase internet bundles for viewing media. As such, after getting a sense of the primary message, viewers may be stopping the videos early to conserve internet credit or because the videos are not engaging their attention.

For both Côte d'Ivoire and Niger, ~60% of the costs went into design and production, and 40% went into dissemination. The unit costs for Côte d'Ivoire and Niger are very similar, with slightly higher unit costs in Niger due to the lower reach of the MMH videos in Niger compared to Côte d'Ivoire. The lower reach of SBC via social media in Niger is likely a function of more limited internet connectivity in Niger relative to Côte d'Ivoire and other countries in the region, where only 2% of the population is on Facebook in Niger compared to 18% in Côte d'Ivoire.

According to the researchers, "One of the novel approaches undertaken by MMH is the collaboration with youth in the design, production, and dissemination of the MMH videos. While the counterfactual of what it would cost to design and produce MMH without the involvement with youth was not assessed in this analysis, any additional costs associated with youth-led SBC should be weighed against the economic benefits of building capacity in the next generation of SBC professionals in the region. These benefits are not captured in this analysis but have important implications for potential societal returns on investment."

In conclusion: "Looking forward, SBC programmers should investigate which denominator(s) (e.g., reach, engagement, views) provide the best measure to capture based on the program objectives. Additionally, future research that pairs effectiveness and cost studies on SBC via social media are essential to better understand the utility of this channel for promoting positive behavior change."