Case study

The humble egg

in Malawi

Puja Peyden Tshering, Kalpana

Beesabathuni, Srujith Lingala and
Rowena Merritt

7.1 Introduction and problem definition

Poor nutrition (known as malnutrition) remains a challenge in Malawi and is a major

contributor to preventable child deaths in the country (1). Many Malawian children often
suffer from micro-nutrient deficiencies, which include anaemia and zinc deficiency. Stunting
(being too short for one’s age), which is at 37.1%, is also a major challenge in Malawi and
children living in rural areas are more affected. Maternal undernutrition may also contribute
to the high burden of child mal-nutrition rates; anaemia amongst pregnant women is 41.8%
(2, 3).

Eggs are an excellent source of protein and micronutrients. However, eggs continue to be
scarce and
costly in Malawi - the average per capita annual consumption is only 27 eggs, compared to
180 globally (4). Cultural beliefs and taboos also undermine egg consumption. For example,
in some Malawian communities, eating eggs is associated with stomach pains, or even with
baldness in babies.
To address supply bottlenecks in the poultry landscape, Sight and Life - a Humanitarian
Think Tank, along with Lenziemill (Malawi's largest animal feed provider and veterinary sup-
porter), implemented the Egg-hub. The Egg-hub is a scalable and financially viable business
model in Malawi. The Egg-hub organizes backyard farmers into small groups of five and sup-
ports them in setting up a medium-scale poultry farm (720-1200 bird size farm), complete

DOI: 10.4324/9781003200086-18
CASE STUDY 7

with cages and bio-security clothing. The Egg-hub successfully helped in the production
of 3.5 million more eggs annually in Malawi. With egg supply in place, Sight and Life then
looked at increasing demand for eggs and subsequent egg consumption among pregnant
and
breastfeeding women, and children aged between 6 months and 5 years. To do this, a social
marketing project was developed with the overarching aim of contributing to reduced rates
of malnutrition in Malawi.

7.2 Primary research

As a start of the social marketing project, formative research with pregnant and breastfeeding
mothers, as well as mothers of children under 5 years old was conducted to understand their
aspirations, concerns, and their idea of what a healthy child looks like and eats. Information
was
also gathered to understand the perceptions of Malawian mothers in relation to eggs,
exploring
participants’ knowledge, attitudes, perceptions, and current consumption habits in relation to
eggs, as well as barriers to consumption.

The research found many interesting insights, including:

i) All mothers talked about their regrets. They felt frustrated that they were unable to fulfil
their
own aspirations. This led to them wanting their children to fulfil their dreams.

ii) While often everyday life can be challenging, the Malawian mothers worked hard to provide
the best they could for their families, hoping for a better future for their children. They made
personal sacrifices to try and secure this.

iii) Eggs were generally consumed by fathers or visitors (guests visiting the households) which
meant that pregnant or breastfeeding women and children under 5 years of age rarely ate
eggs. Also, eggs were mostly consumed either as boiled eggs or scrambled with nsima
(maize-
based porridge) or rice. So, although eggs were a convenient food option, mothers were not
aware of how else to prepare eggs.

iv) Health was linked to growth, development, productivity and success, hence Malawian
moth-
ers described a healthy child in the following ways - “fat or plump,” “good skin,” “strong,”
“active and bright” and “does not get sick often.” A healthy child is associated with unending
positivity and radiating happiness.
na

v) All the participants felt a sense of pride in buying products that were produced in Malawi.

7.3 Behavioural objectives

The behavioural objective was to increase the consumption of eggs among children aged
between
6 months and 5 years old, and pregnant and breastfeeding women. A thorough evaluation
was
conducted to measure changes in:

1. Knowledge, attitudes, and perception of benefits in relation to eggs.

2. Recall of key campaign messages and campaign branding visuals.

3. Consumption of eggs.

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7.4 Interventions

A social marketing campaign was developed, alongside behaviour change interventions to

reduce
the barriers to change. All the eggs coming out of the Egg-hub were branded as “Zonse
Momo”
eggs. Zonse Momo was chosen since the term means “all encompassing” or “self-contained”
and
this was open to interpretation in many ways, be it for the consumer or the farmer. It could
mean
power, or energy or wholesomeness, and it could mean that everything good is contained
inside
an egg. The brand elements were:

e Brand “Big Idea” - Grab every opportunity to make your family healthy and happy!
e Tone - Energetic, Warm, Happy, Sociable, Approachable, Trustworthy, Genuine.

e Main message - More Eggs, More Smiles!

The Campaign Big idea was carefully pre-tested before implementation. A total of up to 60
partici-
pants (30 mothers and 30 farmers) were involved in the pre-testing groups conducted in
Mponela,
Lumbadzi and Dzaleka.

Two radio advertisements were developed in alignment with the campaign tone and Big Idea.
The ads highlighted the various benefits of eggs and ended with a strong call-to-action for
Zonse
Momo eggs. Posters and roll-up banners were also used as the point-of-sale elements
displayed
at or near egg-selling points, within a 5-km radius of the closest Egg-hub farm. Shopkeepers
were
also given t-shirts promoting the eggs.

Interventions to reduce the barriers, and support the desired behaviour change, included:

1. Ladies Club - these are groups of women that attend interpersonal brand interactions
which
comprised of various activities:

e Cooking demonstrations where women learned different ways they could prepare eggs
and incorporate them into their daily diet.

e Talks by Health Workers. Health surveillance assistants addressed the women for
15-20 minutes, discussing eggs and answer any questions/concerns/doubts around
them.

e Quizzes and games - held in local community venues, fun interactive games were devel-
oped, with Zonse Momo branded t-shirts as giveaways.

e Short videos to convey the multiple benefits of eggs showed as part of the club activities.

2. Branded growth meters, stationed at Community Based Childcare Centres (CBCCs) or local
health clinics were branded with Zonse Momo elements. Every time a mother needed to use
it for her child, the staff at the local health clinic or CBCC would tell her about the benefits of
feeding eggs to her young child.

Figures CS7.1-7.3 show a few of the campaign materials used.

LENZIEMILL

Become An Egg
Farmer Today!

Lenziemill provides you with

everything you need to start a
poultry business. Including
equipment and materials
with no upfront payment and
low interest to get you
started!

Our support includes

¢ high quality pullets

regular feed supply
* cages.
world class training
in-house veterinary
support

What are you waiting for, get started today!

Call us on 088997766 for more information

CASE STUDY 7

Figure CS7.4 A poster directed at prospective poultry farmers who worried about training
and marketing support in their line of farming

The campaign sought to also create an appeal for small holder poultry farmers and aspiring
poul-
try farmers to join the Egg-hub. It chose to capture the key pain points associated with being
a

poultry farmer and addressed them in its posters as seen in Figure CS7.4.

7.5 Outcomes

The social marketing interventions and campaign were rolled out in two phases. The initial
phase

targeted three sites, including Mitundu, Dzaleka and Mponera in Lilongwe and Dowa districts.

The second phase targeted two additional sites in Nsaru in Lilongwe and Chiosha in Mchinji.
The
choice of sites was made based on the distance to the nearest Egg-hub farm.

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The project was evaluated by an external research company, based in Malawi and supported
by
the University of Kent. To evaluate the project, three data collection methods were used,
including:

e Survey conducted with mothers of children under 5 years old and pregnant and
breastfeeding
mothers in eight rural villages in Malawi to understand their knowledge of health benefits,
attitudes towards eggs, and their consumption of eggs.

e Interviews with key informants to gain further insights into how the campaign is being
received and to gain feedback on the campaign processes.

e Focus group discussions with mothers of children under 5 years old and pregnant and
breast-
feeding mothers to gain in-depth feedback on how the campaign messages and images are
being perceived and ways in which they can be modified and improved in the future.

The data were collected at three time-points, once before the social marketing campaign and
interventions were launched (timepoint (T) 1), at a mid-point (after 3 months; T2), and at the
project end (end-point after 6 months; T3). The same people were interviewed at each
timepoint.
In order to understand what mix of behavioural interventions is most effective, different inter-
ventions were piloted in different areas, detailed in Table CS7.1. This was done as
interpersonal
communications and support interventions have been shown to be effective when improving
nutrition outcomes (5), however, they are very costly to implement. Therefore, it was
important to
understand the added value they provided.

7.5.1 Findings

Overall, the social marketing campaign and interventions increased the consumption of eggs
(Figure CS7.5). Over half of the target audience (51%, n = 217) ate eggs twice or more a week
at
follow-up (T3). This was compared to only 12% (n = 229) at baseline (T1). Only 7% did not eat
eggs
at all at follow-up, compared to 55% at T1.

The target audience in level 3 intervention mix areas consumed the highest number of
eggs (Figure CS7.6), in comparison to those in areas which received levels 1 and 2 intervention
mixes (Figures CS7.7 and CS7.8). Instead of buying more eggs, they instead saved them for
family
consumption.
This was in comparison to the target audience receiving level 2 interventions, where there
was only a slight increase in the consumption of eggs by the promised audience, mostly
redirected from other family members. However, visitors still were given most of the eggs
(Figure CS7.3).

What this tells us is that despite an increased supply of eggs, egg consumption did not really
increase in the desired way, as visitors continued to get the lion’s share of eggs in the
household.
Creating demand acted as a differentiator, being effective at improving egg consumption in
the
target audience as well as word of mouth publicity. Radio and point-of-sale interventions
were
not effective in this case, which highlights the importance and value of interpersonal
communi-
cations when reaching very rural communities, where literacy rates are often low.

7.6 Lessons for the planet

There are three takeaways for the planet here:

1. There is merit in implementing a holistic approach toward a nutrition problem, including

focusing on both the supply as well as demand aspects. Once the supply bottlenecks were
addressed in this case, the next logical step was to create demand for the 3.5 millions surplus
of eggs in the markets, with a focus on ensuring our target audience - those most at risk of
malnutrition - increased egg consumption.

2. The use of Interpersonal interventions is crucial - more so, when working in communities
that are “media-dark” or where literacy levels are low. This helps with social norming and
allows the target audience to see others like them engaging in a new behaviour, live.

3. Eggs incur a lower environmental impact compared to other animal source foods. Eggs
have
a two to eight times lower carbon footprint, two to four times lower ecological footprint (water
and land use) and have a lower carbon footprint than some plant proteins too, such as nuts
(using half the land and a fifth of the water supply). The humble egg is a climate-smart food
that can also help tackle malnutrition.

Case study questions

1.

2.

Why do you think interpersonal communications were more effective in this case example?

Why do you think it was useful to set objectives around several variables and not simply egg
consumption goals?

References

1.

World Health Organisation, Malnutrition Datasets. (2017). Geneva, Switzerland

2. UNICEF Malawi. (2018). The Nutrition Programme in Malawi [Factsheet]. https://www.

unicef.org/malawi/media/596/file/Nutrition%20Narrative%20Factsheet%202018.pdf

Levy, A., Fraser, D., Katz, M., Mazor, M., & Sheiner, E. (2005). Maternal anemia during
pregnancy
is an independent risk factor for low birth weight and preterm delivery. European Journal of
Obstetrics Gynecology and Reproductive Biology, 122(2):182-186. doi:
10.1016/j.ejogrb.2005.02.015.
Lingala, S. (2019, November 22). Boosting Egg Production to Reduce Malnutrition in Malawi.
Sight and Life. https://sightandlife.org/blog/boosting-egg-production-in-malawi/

Ezeah, G., Ogechi, E.O., Ohia, N.C., & Celestine, G.V. (2020). Measuring the effect of
interpersonal
communication on awareness and knowledge of COVID-19 among rural communities in
Eastern
Nigeria. Health Education Research, 35(5): 481-489. https://doi.org/10.1093/her/cyaa033