Medical Aid Films (MAF)

830 women die every day from preventable causes related to pregnancy and childbirth. 99% of these deaths occur in low resource settings and many could have been prevented with access to timely, high quality healthcare. However, access to care is not always available due to a lack of health knowledge in communities and a global shortage of trained health workers.  

MAF uses live-action film, animation and media to deliver life-saving maternal and child health education to health workers and communities in low resource settings. We produce audience-centred, context relevant training films on maternal health, new-born and child health, and emergency obstetric and neonatal care to transform the health outcomes of vulnerable women and children.

Scaling our work globally would enable us to deliver life-saving health education to millions more people each year, significantly increasing access to high quality, affordable healthcare women and children in the most marginalised settings.

Millions of women and children die every year due to complications of pregnancy and childbirth. In 2017, 295,000 women died in childbirth, more than one life lost every 2 minutes.[1] In 2017, there were 5.3 million deaths in children under the age of 5.[2] Globally, there were 2.6 million stillbirths.[3] 94% of these deaths are in low-income countries.[4]

Many of these deaths could have been prevented through the provision of high quality, timely, and accessible care.[5] However, maternal and child mortality rates remain high in low and middle income countries due to a global shortage of trained health workers; a lack of accessible, appropriate and high quality training resources for health workers in low resource settings, from medical and pre-service training through to CPD; geographical inequities in access to affordable, high quality maternal healthcare for women in rural and remote communities; and poor health literacy within these communities.

There is an urgent need for accessible, relatable, context-specific education and training content to upskill maternal and child health workers and increase health knowledge among women and their communities.

[1] WHO 2017, https://www.who.int/news-room/fact-sheets/detail/maternal-mortality

[2] WHO 2018, https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality

[3] WHO 2015, https://www.who.int/maternal_child_adolescent/epidemiology/stillbirth/en/

[4] WHO 2017, https://www.who.int/news-room/fact-sheets/detail/maternal-mortality

[5] ibid

MAF creates audience-centred, context relevant training films to deliver life-saving maternal and child health education to health workers and communities in low resource settings. We produce live action training films, animations and media to help health workers deliver babies safely; provide emergency obstetric and neonatal care; and deliver high quality ante-natal care. We deliver educational content to families in remote, rural and marginalised communities, helping to improve health literacy; increase use of health services; and enhance women’s confidence to make health decisions.

All of our films are produced with input from world-class medical experts and translated into local languages to support underserved communities. We work with implementing partners to integrate our films into training programmes and eLearning platforms; to disseminate content via mobile apps and low-tech solutions such as pen drives and offline media in the most remote and rural areas. Monitoring, evaluation and learning are key to our approach and used to shape future content development.

We have a library of 330 films freely available online, translated into 28 languages, used in 145 countries. Each year, our films reach 1million health workers through education and training programmes and a further 5million people view our films via online platforms.     

The vast majority of women who are dying from pregnancy related complications in low-income countries are in the poorest, rural, remote and marginalised communities where healthcare is either inaccessible or inadequate. They are required to travel long distances to reach the nearest health centres, which in emergency situations can mean life or death. Additionally, women in these settings are less likely to attend any antenatal visits. There are also gender-based disparities with women having little access to formal education and employment, resulting in very low levels of health literacy.

Aimed primarily at local audiences, the effectiveness of our educational content is dependent on significant research and user engagement that ensures language, use of role models and the depiction of context are relevant and relatable. We work in close consultation with health workers as an integral part of our production process, ensuring the content we create will be impactful with their audiences, and meet the most pressing needs as identified by themselves. We also work with local partners to ensure content is distributed in the most accessible format for target audiences, for example via rural film screenings, via tablets and mobiles, and offline via QNAP and other offline content provider mechanisms.    

Our solution directly addresses the challenge by adopting a two-pronged approach that:

• Improves the quality of care available to women and children in low resource settings by providing lifesaving, resource appropriate, accessible skills training to health workers in remote and rural settings, to better equip them to deal with health issues in their patient communities.
• Provides learning opportunities for individuals and communities on maternal and child health issues and healthy practices, so they know when to seek timely care.

In conjunction, these two approaches help to expand access to high-quality, affordable care for new-borns, pregnant women, and new mothers. 

Whilst there are many organisations around the world working to address the fact that women are dying from preventable pregnancy or birth related complications, there are very few that are approaching this problem by utilising the power of film to strengthen training and education at scale. Other organisations that focus on the use of film from a health and development perspective include:

• Global Health Media
• Picturing Health
• Film Aid

Medical Aid Films sets itself apart from our competitors through our entire life cycle approach to creating impactful content. This begins from audience and contextual understanding, collaborative and expert reviewed content, innovative dissemination to reach audiences, to robust monitoring and evaluation of use, outcomes and impact. 

We also challenge traditional development practices with innovative ideas, tools and techniques – for example using blended learning with audio-visual content, inspiring participatory user-centred and story-driven case studies, and optimising content for dissemination. 

We maintain a library of content on our website, offering our film list freely under a creative commons license. We also have a YouTube channel with 81,000 subscribers and we share and disseminate content widely through digital communications. 

Our solution uses audio-visual media - film, animation and media content - to deliver maternal and child health care training in low-resource settings. Using experienced film production crews and global health experts, MAF produces live action film, animations and media content for health worker training, health education, social and behaviour change communication, and sharing best practice. 

Our content is integrated into blended education programmes, training, campaigns and made freely available both online and offline through digital and mobile platforms and using DVD/USB/mobile formats. 

All of our content is available under a creative commons license on our website and YouTube platform – this material can be accessed by any individual or organisation for use within their programming or activities.

We aim to ensure we meet the rapidly evolving needs of our learners through adopting a ‘digital first’ approach, and harnessing the potential of new technologies, interactive learning, gaming, multimedia platforms, and 360/VR stimulation to develop new content. We are also focused on finding innovative digital ways to disseminate our content and reach and engage with new audiences. One of our key goals for scaling our work is to significantly expand our digital capacity and digital footprint over the next five years.

MAF is also embarking on a wider process of digital transformation across the organisation. This will ensure that all our work has a digital approach at its core; that we make data driven decisions; and that we capitalise upon new audio-visual and digital dissemination technologies to increase our impact. 

Film is a very powerful tool for education and training in low resource settings as it is highly accessible; helps present complex information simply; improves learner recall; and can be used beyond the initial training period:

• Integrated visual-verbal learning increases learning by large measurable amounts[1] and human beings process visual information more efficiently than text[2].
• A report by Dalberg Global Development Advisors describes the use of multimedia as the most impactful and cost-effective approach to training community health workers[3].
• Film and multimedia can overcome literacy and language barriers, this “has special power for Community Health Workers, who often may have low levels of literacy”[4]
• Evaluations of MAF programmes have demonstrated that using film in training programmes can increase knowledge and improve recall. In Nigeria, test scores from a video-based training programme for 2,500 healthcare workers showed an average 32% improvement in knowledge after the pilot phase. In DRC, a final evaluation of an MCH education project found that mothers’ knowledge of danger signs in pregnancy increased from 0.9% to 47%; post-labour danger signs from 6.1% to 57.9%; and danger signs of new-born illness from 4.4% to 49.1%.

[1] Varying between 23% –89% (Richard Mayer, 2001)

[2] E.g. 90 percent of information that comes to the brain is visual (Hyerle, 2000)

[3] Dalberg Global Development Advisors, Preparing the Next Generation of Community Health Workers: The Power of Technology for Training, 2012

[4] Mayer, R.E. (2010).  Applying the science of learning to medical education. Medical Education, 44 (6), 543–549.

Medical Aid Films works towards the goal of improved health of women and children by transforming high quality educational film content into:

• Outputs for audiences and education/ training providers
• Shorter-term outcomes for communities and health workers
• Longer-term outcomes around the provision of care and healthy life choices and decisions

Medical Aid Films’ strategy has three axes, which underpin our theory of change:

• To create content that informs, engages and inspires, using the power of storytelling, positive role models, local languages and context to bring health education and training to low resource settings.
• To collaborate with health partners to produce sustainable, scalable resources and innovative strategies for delivering content to audiences.
• To strengthen health worker training using the power of film to enhance recall, communication complex information and demonstrate procedures and skills.

Our inputs are:

• We produce films for training, health education, behaviour change, advocacy and share best practice
• We develop content for local audiences, carrying out research and user engagement to ensure relevant language, role models and context
• We have a global reach, with content used in 145 countries

Outputs are categorised in two ways:

• Firstly, how audiences experience our film content
• Secondly, how our films enhance our partners’ and film ‘users’ health interventions and increase participant satisfaction. In general, audiences should find our films compelling, inspiring, memorable, informative, relatable and easy to follow – all of which should increase levels of user satisfaction and positive responses to health education and training initiatives using the films. 

Positive responses to the films lead to shorter-term outcomes including:

• Increased knowledge
• New skills
• Increased confidence
• Greater motivation in communities and health workers

These lead to longer-term outcomes around:

• Improved delivery of care
• Improved health awareness, actions and choices, where wider socio-economic, cultural and environmental factors influencing these outcomes are either addressed or are not barriers to these improvements in care provision and health behaviours.

Ultimately, these longer-term outcomes contribute to MAF’s goal of improved health of women and children in low resource settings. 

Currently, 1 million health workers are directly and meaningfully affected by our films through education and training programmes in low and middle income countries. In addition, a further 5 million people view our content online each year.

We have put the foundations in place to now look to scale our work. We have a strong library of film content (330 films in 28 languages), a track record working with globally recognized partners, and the production, research and monitoring and evaluation expertise, to take the organisational to the next level.

In one year, we aim to reach and meaningfully impact 2 million health care workers via education and training programmes, and in five years’ time, we aim to be meaningfully impacting 5 million health care workers every year with high quality learning materials.  We will have built our profile globally and become known as a leading global content creator with a sustainable funding base, and we will continue to put our audiences – women and children, at the heart of our work.

Over the next five years, our primary impact goals are to:

• Expand our digital capacity and digital footprint to widen our audience reach and the impact of our work. We are keen to utilize the power of new technologies to directly engage with audiences in new ways, working with technology partners we want to explore and maximise the opportunity to scale our work – to ensure our content reaches those that need it most.
• Build organisational sustainability and financial stability, focusing on sustainable approaches and business models, exploring innovative new ways to fund our work, and leverage our skills to access alternative growth streams alongside traditional development funding.
• Further build the evidence base for film as a powerful tool for transformational learning, and share that learning with our fellow social impact organisations across the non-profit, public, academic and private sectors.

The barriers we face include:

• A lack of funding for specific monitoring and evaluation (M&E) focusing on the impact of educational film. Many of MAF’s films are used within the context of wider health education and training programmes. Wider project M&E often focuses on measuring specific health outcomes, without always assessing the contribution of individual aspects of the intervention towards achieving those outcomes. It can therefore be challenging to evidence the specific contribution that MAF’s film content has made to achieving health outcomes within a wider programme of health education and training. 
• MAF’s current income streams mean we miss opportunities to engage effectively with wider audiences. Many of MAF’s film productions are commissioned by partners to achieve specific learning outcomes. As such, they are often tightly financed, permitting just one or two films focused on a single issue with one specific demographic, language and audience. This means we can miss opportunities to adapt our content for wider audiences.
• We have minimal resources to disseminate our content more widely via digital platforms 1.7 billion women in low and middle income countries now own a mobile phone and over a billion use mobile internet. Mobile devices are becoming an increasingly powerful tool for delivering life-enhancing information to millions. With minimal resources to invest in video search engine optimisation (VSEO), we are competing in a crowded online environment without the tools to raise our voice above the chatter and make our content discoverable to those that most need it.

We aim to overcome these barriers by:

• Securing longer term partnership funding to facilitate more dedicated M&E on the impact of film: We have been successful in securing funding and partnering with academic institutions to undertake small-scale M&E and research activities, but we need to expand this work further. We secured our first large scale, three-year grant with a significant M&E component in 2019 and we have developed a fundraising plan to ensure we secure at least one large scale grant each year. This will enable us to strengthen our impact evidence base, through closer connections to implementing partners and access to frontline stories and case studies.  
• Increase levels of core funding to enhance our ability to invest in MAF’s internal infrastructure, digital strategy and reach wider audiences. We have been working with Ernst & Young to build a road map to growth, including developing a detailed investment case and business plan which will enable us to secure investment funding from social and venture philanthropy mechanisms. This growth in core income will in turn allow us to invest in reaching wider, underserved communities by exploring digital strategies, web optimisation, technology and tools to ensure our content reaches those who need it most, for example using machine learning and translation technologies to deliver new language versions of our resources. We also want to improve access to our content by making technical additions to our web presence to improve our information architecture and cataloguing of our films through machine-readable metadata.  

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MAF’s staff team is made up of:

• Full time staff – 1
• Part time staff – 7
• Freelance staff – 3
• Volunteers – 3

We also subcontract elements of our work to third parties, such as animators and film makers, on an ad hoc basis.  

Collectively, MAF’s staff team have decades of extensive, broad ranging experience in delivering simple, critical information into the hands of health workers in low resource settings and working with marginalized and vulnerable populations. Collectively, our staff team have experience in:

• Educational TV broadcasting
• Film production, production management and direction
• Multimedia content production
• International health and global development
• Programme management, monitoring & evaluation, capacity building

MAF’s work is guided by a Medical and Health Advisory Panel comprised of leading experts in obstetrics & gynaecology, neonanatology, midwifery and global health. This Panel includes MAF Founder, Professor Eric Jauniaux, Professor of Obstetrics and Fetal Medicine at the EGA Institute for Women’s Health at University College London.

We have been recognized in recent years as a dynamic and innovative organisation, winning the BOND (the UKs international development network) ‘Most Innovative’ organisation award in 2017, and Asian Voice’s ‘Most Enterprising Charity’ award in 2019. This innovation remains at the core of our approach – and we will continue to be the adaptive organisation that has driven our success to date.

Partnerships are at the core of MAF’s operational model, ensuring the content we create is aligned to context and need and delivered by those organisations best placed to reach the communities we serve.

We currently work with a range of partners to deliver our solution in two distinct ways:

• Delivery partners: MAF collaborates with delivery partners to create specific pieces of film and media content to meet identified learning needs within wider maternal and child health worker and community health education training programmes. MAF partnerships of this nature include a partnership with the World Health Organisation, International Rescue Committee, London School of Hygiene and Tropical Medicine and the Tropical Health Education Trust (THET).
• In country implementation partners: These partners are local NGOs, Ministries of Health and other on the ground organisations in low- and middle-income countries who we work with to ensure our content reaches those who need it most. These partners also help to review our content and conduct monitoring and evaluation on the ground, allowing us to gauge the impact of our work. Current implementing partners include Amref International, SAfAIDS, ZACOP, Zayohub and Restless Development. 

MAF's current business model involves delivering our services to health workers and communities a network of partner organisations, with work funded through a blend of three primary channels:

1. Grant funded services: Most often in collaboration with other NGOs and academic institutions, we apply for and secure funding to create content for health programmes. Donors include institutional funders, private foundations and family trusts.

2. ‘Partner’ funded services: We are “commissioned” by a broad range of organisations (e.g. the World Health Organisation, INGOs, private sector companies) to produce content to meet a specific brief.

3. Core services supported by philanthropic donations: Individuals and philanthropists support the organisation’s core work through making donations and providing gifts in kind (services and expertise).

MAF’s cost structure for grant and partner funded work follows a film production template and enables swift scale up to meet increased demand.

The revenue we secure in B2B transactions is customer dependent. When submitting applications for funding, our costing includes all relevant film production expenditure and 10-15% is allowed for overheads, but no profit margins are added.

MAF has three key income strands in our funding portfolio, as mentioned above:

• Partner funded work: Earned income generated by content commissioned by partner organisations to meet specific learning objectives.
• Grant funding: Grants secured directly from charitable funders or in partnership with other NGOs, predominantly restricted to the running of specific programmes and projects.
• Philanthropic donations: Charitable donations from individuals, from small monthly donations to larger major gifts. Predominantly unrestricted income.

Our next five-year strategic plan, from 2021 – 2026, will focus on building financial sustainability by diversifying our income base and exploring innovative new ways to fund and grow our work, alongside traditional grant and development funding. We are exploring impact investment, and are taking the first steps to ensure the organisation is investment ready. We are also shifting the emphasis of our grant fundraising strategy to secure more sustainable, long term grant income, proactively seeking more large-scale multiyear partnerships instead of focusing on lower return, short term partner funded projects. We recently had our first major success in this field, securing a three-year, six figure grant from a charitable foundation. 

We are applying to Solve in order to access the expertise, guidance and resources we need to grow our solution and take it to the next level.  

After 13 years of operation and steady but slow growth, Medical Aid Films is now poised to significantly grow our offer and impact. We have a strong library of film content, a track record working with globally recognized partners, and a strong base of production, research, monitoring and evaluation expertise.

However, to create a step change in our work, we need to develop sustainable sources of funding; access technological and digital expertise to grow our digital footprint; and invest in research, monitoring and evaluation to better understand our audiences and evidence our impact. We would greatly appreciate the opportunity to utilise the Solve community’s expertise and knowledge in the areas of tech development, business modelling and impact validation in order to accelerate our plans for growth.

Partnership working and collaboration is integral to MAF’s strategic and operational activity, and we would welcome the opportunity to grow and learn from the broad ranging experience of the Solve community. We would also welcome the opportunity to exchange ideas and lessons learned with peers who have been experimenting with audio-visual technology for maternal and child health education and training in low resource environments.

We would like to partner with organisations with expertise in the following areas, in order to scale our work, increase our impact, and build financial sustainability:

• Tech and digital development, including partners with expertise in utilising new audio-visual technologies and improving dissemination of existing audio-visual content
• Sustainable and alternative income models, including partners with expertise in impact investment and enterprise based income models
• Impact validation, monitoring and evaluation, including partners with expertise in making data driven decisions

We would also like to partner with impact investors who would be willing to fund the infrastructural developments we need to make in order to sustainably grow and scale our work. 

We would use the Health Workforce Innovation Prize to increase access to training for the maternal and child health workforce in low income countries by exploring tech-based ways to scale the translation of our health training films to local languages.

Developing health resources in relevant local languages is crucial for health workers and communities in low income countries, and an important part of our strategy. We want to increase accessibility for speakers of marginalised languages, bringing life-saving information to health workers and populations underserved by existing resources.

This prize would enable us to explore Information Communication Technology solutions to address these barriers, for example using machine learning and translation technologies.

Medical Aid Films works in collaboration with the public sector, predominantly Ministries of Health, in low- and middle income countries at all stages of researching, producing and disseminating our solution, namely audio-visual health education and training content for maternal and child health workers and communities. This approach ensures that our solution aligns with national health messaging, supports public health strategies, and strengthens existing health worker training programmes.

Significant growth in data connectivity combined with decreasing costs of hardware, has driven an unprecedented increase in digital inclusion in low and middle income countries. This widening in access to online content brings the potential to service previously hard to reach communities with life-saving digital health information. However, many Ministries of Health we work with do not currently have the capacity to effectively digitally disseminate audio-visual health education and training content to the most marginalised communities.

The Bill & Melinda Gates Foundation Funded Award would help us to improve the digital dissemination of life-saving maternal and child health education and training content, produced in collaboration with local Ministries of Health, in low and middle income countries. The prize would enable us to invest more in effective digital strategies, web optimisation, and technology and tools to “bridge the digital divide” – utilising the huge opportunities of new technologies to get our audio-visual training content to underserved communities. The prize would also help us to improve access to our content by making technical additions to our web presence to improve our information architecture and cataloguing of our films through machine-readable metadata - in short, making our content easier to find online for our intended audiences.