Using social media to change maternal health knowledge in Iraq

Since 2021, CARE has been running multiple Social Behavior Change Communication (SBCC) campaigns focused on reducing hesitancy about the COVID vaccine and promoting COVID prevention behaviors. These campaigns have made CARE increasingly interested in exploring how social media advertising can reach people at scale to change public health knowledge, attitudes, and behaviors.

So in 2022, CARE country offices decided to use what they learned to affect change on additional key health topics, such as maternal health and childhood immunization. Through a year-long accelerator program with Meta, CARE Iraq set out to learn how social media can complement on-the-ground health programs related to antenatal care (ANC) or health care during pregnancy.


  • CARE Iraq launched a two-phase SBCC campaign to promote maternal health during pregnancy, with Phase 1 reaching 1.4 million people in Mosul, where CARE’s maternal health program is focused. Phase 2, which expanded on its previous campaign, has been reached 2.8 million people both in Mosul and Nineveh.
  • The Phase 1 campaign saw strong levels of ad recall, but results from the Brand Lift Survey (BLS) showed no significant change in people’s likely belief about the importance of ANC visits. This may be due to the existing high basic knowledge of maternal health that CARE observes – 67% of the target audience probably already understood that prenatal care is important.
  • In Phase 2, the campaign expanded to geographic areas without on-site ANC education programs to understand differences between areas that received only online messages versus areas that received both online messages and offline programming.

Creative process

To help develop ads that would resonate with the target audience, CARE Iraq created a fictional protagonist known as “Fatima,” who is a 19-year-old woman, recently married and five months pregnant with her first child. Fatima, who wants to give birth to a healthy baby and make her family proud, left school after the 6th grade. All her knowledge of pregnancy comes from other women around her, mostly her mother and mother-in-law. This fictional persona is created from aggregate audience data and research.

In addition to designing for this key persona, CARE knew it would also be important to reach the target audience’s spouses, who would ultimately be the ones approving doctor visits and providing transportation. To that end, the copy that accompanied each ad was customized based on the gender of the audience.

CARE Iraq created a phased approach to social behavior change messaging, with the first phase of advertising emphasizing the importance of eight prenatal visits during pregnancy. This phase included a mix of static, graphic images and short videos (20 seconds) aimed at men and women between the ages of 18-49, and the ads featured real people, including a famous female news anchor.


Using Meta’s ad credits, Phase 1 of CARE Iraq’s campaign reached 1.4 million people in Nineveh province. As a result:

  • CARE continues to see Instagram as a key platform to reach women in the Middle Eastwith 28% of ads running on Instagram.
  • Video completion rate (VCR), a key communication metric, was 5.7%. This is a +43% increase from the VCR associated with the COVID vaccine announcements. Not surprisingly, women are more likely to watch the videos longerhaving a VCR of 7.1%.
  • Like the VCR, CARE observed that women shared campaign ads at a significantly higher rate. The number of shares from women who saw the ads was +136% above CARE’s share goal.

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