Engaging Kids to Fight Malaria
An interview with the team behind the MOSKI KIT, a Sanofi tool against malaria.
When we last caught up with the MOSKI KIT team, they had already piloted this concept within 4 countries, and scaled the initiative to 15 across Sub-Saharan Africa.
eyeforpharma celebrated that achievement at the 2016 Barcelona Awards, where the Sanofi team won the Most Valuable Patient Initiative Award.
6 months on from the award, we wanted to check in how the project had grown since, so we sat down with Dr. Francois Bompart, Medical Director of Sanofi’s Access to Medicines unit to find out.
eyeforpharma: Thank you for joining us Francois. So I understand you’ve been close the project since the beginning. How did you first get involved?
I’ve actually been working in Malaria for around 10 years, and right from the beginning, we said that we could do more than provide drugs, but also help raise awareness of communities directly impacted by malaria.
Around 8 years ago, we started wondering how we could involve school children to tackle this. Everywhere they are ambassadors for their communities, and, of course, they have a future that we should invest in. So we decided to test an intervention in Cote-D’Ivoire to see if we could help school-teachers with their malaria education.
The key thing was that objects were created with local people. They alone could design the tools that would be accepted and understood locally.
Theatrical performance was a big part of community culture where we were working, so we had this idea to design the program involving this element to tap into it and make it more fun. We developed a model where the teacher would give the class and then ask the children to create a performance to share what they had learned. The objective was to change their behaviors and those of their communities to fight malaria. It got quite competitive, with schools challenging each other to do the best show.
eyeforpharma: So you realized you had this chance to make disease awareness engaging by introducing the element of play?
Yes, and this is when the MOSKI KIT came about. The design challenge became: how can we structure this better to ensure that messages were adapted to kids? What are we able to do to make the impact bigger than just this exchange between the teacher and the child?
This is when we started thinking about objects that could be left behind in the classroom, like board games, or card games, and this is when we started creating the MOSKI KIT.
The key thing was that objects were created with local people. They alone could design the tools that would be accepted and understood locally. This was also our key principle when it came to scaling the design. Every time we looked at a new country, we would run a local test first, and we would involve local NGOs when we went to the classroom. It was really important that it was someone local and legitimate.
eyeforpharma: When I last spoke with your colleagues, you’d already achieved a lot in starting to scale. What are the latest numbers?
So far we have distributed 1340 MOSKI KITS across 16 countries. In every country, we have also worked with the local ministry of health to ensure that our actions are aligned with their priorities.
eyeforpharma: Digging behind these numbers, what is the actual impact? What does it mean to have distributed 1340 kits? How many people do you hope to reach with each kit?
We are talking about over 30,000 school children directly reached. But one of the concerns we have had is this very question of impact.
We first tried to do a survey before and afterwards to understand the results with classes that received the workshop. The first time we tried this we had a funny result, the teachers were told ahead of time that a ministry of health project on malaria was starting and that we would be coming and doing the workshop. We found out that the teachers had immediately rushed off to teach the kids, fearing that they would be evaluated if disease knowledge was bad! This obviously really skewed our survey results…
eyeforpharma: Well at least you had a positive unintended impact, it drove education outcomes! So what did you try to get around this?
Well, we are about to launch a study that is a lot more structured in Dakar, Senegal, within an urban area and a rural area.
It is structured as an impact assessment, in each setting we will have one set of schools using only the traditional chart to raise awareness, and in the second set, we will be using all the tools within the MOSKI KIT.
We are also partnering with the national malaria programs in all countries where we work, and we ask them to follow up with schools to check if the kits are being used.
“Many of us are medics or pharmacists, so it is hard for us to put ourselves in the shoes of a 10-year-old. Turning the language from medical language to language that kids engage with, it is difficult! So that’s why we work with teachers.”
eyeforpharma: What about cost-effectiveness? How much does it take to run this kind of a program?
The kits cost around $50, and we will send people from France in order to train the initial trainers, who in turn will train other people - this is our model of growth. For example, we sent a colleague who knows the kit very well to Guinea, where she distributed the kits to 42 schools and trained 24 people. She was incredibly well received.
eyeforpharma: What have been the biggest challenges?
The main hurdle is really to work with people who know how to speak to children. Many of us are medics or pharmacists, so it is hard for us to put ourselves in the shoes of a 10-year-old. Turning the language from medical language to language that kids engage with, it is difficult! So that’s why we work with teachers.
Another big challenge is in formalizing relations with local partners. If an NGO is involved, they want to be sure that there is no commercial element to the deal.
There is a lot of paper work that has to be exchanged, and it takes a lot of time.
eyeforpharma: Did you try anything which just didn’t work out?
Early on, we designed dominoes asking children to match the problem with the solution regarding malaria prevention. This appealed a lot to adults in western countries but did not work with children in Africa.
eyeforpharma: What are you most excited about in the future?
I’m most interested in the hard data to say: what is the impact? How has it or hasn’t it helped? What I would like to focus on now is getting good quality scientific data to answer this question. The timeframe is about a year with the study that we are doing in Senegal.