Are digital social media campaigns the key to raise stroke awareness in low-and middle-income countries? A study of feasibility and cost-effectiveness in Nepal

Abstract

Background Stroke is a major global health problem and was the second leading cause of death worldwide in 2020. However, the lack of public stroke awareness especially in low- and middle-income countries (LMICs) such as Nepal severely hinders the effective provision of stroke care. Efficient and cost-effective strategies to raise stroke awareness in LMICs are still lacking. This study aims to (a) explore the feasibility of a social media-based stroke awareness campaign in Nepal using a cost-benefit analysis and (b) identify best practices for social media health education campaigns. Methods We performed a stroke awareness campaign over a period of 6 months as part of a Stroke Project in Nepal on four social media platforms (Facebook, Instagram, Twitter, TikTok) with organic traffic and paid advertisements. Adapted material based on the World Stroke Day Campaign and specifically created videos for TikTok were used. Performance of the campaign was analyzed with established quantitative social media metrics (impressions, reach, engagement, costs). Results Campaign posts were displayed 7.5 million times to users in Nepal. 2.5 million individual social media users in Nepal were exposed to the campaign on average three times, which equals 8.6% of Nepal’s total population. Of those, 250,000 users actively engaged with the posts. Paid advertisement on Facebook and Instagram proved to be more effective in terms of reach and cost than organic traffic. The total campaign cost was low with a “Cost to reach 1,000 users” of 0.24 EUR and a “Cost Per Click” of 0.01 EUR. Discussion Social media-based campaigns using paid advertisement provide a feasible and, compared to classical mass medias, a very cost-effective approach to inform large parts of the population about stroke awareness in LMICs. Future research needs to further analyze the impact of social media campaigns on stroke knowledge.

Implementing stroke care in a lower-middle-income country: results and recommendations based on an implementation study within the Nepal Stroke Project

“…Both offline and online initiatives were undertaken to address quality improvement and public awareness. A social media-based stroke awareness campaign reached 3 million individual social media users in Nepal with organic traffic and paid advertisements on four social media platforms (Instagram, Facebook, Twitter, and TikTok) ( 16 ). Videos in the Nepali language were created and displayed on digital billboards in five public places for a total of 30 days.…”

“…The dissemination strategy employed in our public awareness campaign demonstrated remarkable efficacy in its penetration of the general population, which can be partially attributed to the inclusion of marketing experts within our research team ( 16 ), leveraging the World Stroke Day Campaign, and adopting a multifaceted approach utilizing diverse modalities.…”

Stroke Awareness and Knowledge in the At-Risk Population: A Community-Based Study

“…Social media-based campaigns using advertisements provide feasibility and cost-effectiveness to raise stroke awareness in the general population [20]. Such campaigns can be particularly effective during pandemic disasters like the coronavirus disease 2019 pandemic, with lower costs compared to in-person or paper distribution methods [21].…”