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Across pastoralist groups, dairy products often fulfill major nutritional, economic, and socio-cultural functions. These
contributions are jeopardized by poor milk quality with studies among pastoralist groups showing dairy products
can harbour a long list of pathogens. These potential risks underscore the need for more effective dairy hygiene
interventions. Here, we determine how health messages advocating the “novel” method of pasteurization versus
boiling, and administered in narrative versus technical formats, can have an impact on hygiene practices and milk
quality in Maasai pastoralists. Four Maasai villages in northern Tanzania were purposively selected to receive
intervention strategies that varied in message format (narrative or technical) and heat treatment advocated (boiling
or pasteurization). Census lists were used to randomly select 30–35 households in each village (N = 125). Across
three visits, milk hygiene knowledge and attitudes were monitored, hygiene practices were directly measured by
smart thermometers that recorded heat treatment, and milk quality was determined by calculating total bacterial
counts (TBCs) (N = 1007). Compared to initial levels, TBCs in the pasteurization-narrative village (N = 33) exhibited a
73.4% decrease (OR 0.148–0.480) after 7 days and a 59.1% decrease (OR 0.216–0.734) after 14 days. The boilingnarrative
(N = 28) exhibited a significant decrease at 7 days (− 68.8%, OR 0.161–0.606), but this decrease was not
significant after 14 days (− 35.5%, OR 0.322–1.253). There were no significant decreases for the pasteurizationtechnical
(N = 29) or boiling-technical (N = 31) villages after 7 or 14 days. In addition, narrative health formats led to
significantly greater retention of health messages and peer-to-peer sharing. Interventions to improve milk quality in
pastoralist and other livestock-dependent communities may benefit from enabling the “novel” method of
pasteurization. More broadly, our results suggest that the use of narrative messages can promote healthy
behaviours when cultural norms are contrary to best health practices as well as enhance the sustainability and
scalability of interventions targeted at hard-to-reach populations, including most pastoralist communities. |
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