Social Media and its Role in the Success of '100 Millions' Health' Campaign in Egypt

This research addresses the influence of social media with its ever-evolving techniques that serve social campaigns focusing on people as the central theme of its concern. Developers of social media techniques are always looking for and making the necessary changes through intensive and successive campaigns across various social media channels, to reach its full impact on users taking into consideration important marketing elements, such as culture and timing of said campaigns among other elements. Social media is a great way to communicate with the public. It contributes to building trust, elevates the spirits of society, enhances tolerance by considering emotions of individuals and it reinforces the feeling of belonging. It could positively affect the behavior and moral levels of humans. All that while working in an integrated framework of analysis that is run by governments, international institutions, civil society organizations and private sectors. These institutions factor in the public needs to better deliver their messages, there is no doubt that these types of social media campaigns are becoming a great deal of interest in different societies at different levels. As Egypt is aligning itself in recognizing the importance of evolution in social media and ultimately aim to change the negative reality and transform society to better reality; I will address in this study the role of social media in the success of “100 Millions’ Health” campaign that took place in Egypt. This campaign was able to gain great amount of popularity through social media networks and contributed to the convergence of Egyptian public opinion about its objectives.


Introduction
The continuous research development over the past decades has helped the social media and the rapid developments in the field of communication and information in the promotion of ideas through technology that contributed to reaching the minds of the masses that are different and diverse. It has also documented the link between the use of social media and the increasingly popular Internet in multiple campaigns, including health campaigns, the subject of our study.
Marketing through social network is not just a trend, but it is a way to reach more people each month with more than 2 billion active users on Facebook, one billion on Instagram, and 365 million on Twitter all over the world (Baker 2019). This reflects the importance and value of marketing through social communication in the success of the health campaign currently underway by Egypt, entitled "100 Million's Health, and efforts to achieve it, as this campaign is in favor of the advancement of the health system in Egypt.

First topic: Methodological Framework
The problem of the study was identified through: • The increasing number of people infected with C virus, and the spread of common diseases such as cardiovascular disease, diabetes, cancer and chronic lung diseases (Saleh 2013), in conjunction with the increasing interest of the government to improve the health of the Egyptian citizen. • Lack of a healthy culture, which is a major barrier to improve health in Egyptian society, shows the importance of covering health campaigns in all its different aspects by reviewing their facts and informing them in order to influence the public and raise its awareness.

First: Problem of the Study
Due to the growing interest in health campaigns that have been discussed recently, for many reasons, including the spread of pandemics and other intractable diseases that affect both the individual and the community, the health issue has become a major issue. In the context of the health challenges faced by the Egyptian government and its efforts to improve the health status of the Egyptians, with the development and expansion of social networks and the spread and interactivity with the public; with the emergence of the term social marketing, in the beginning of the seventies of the last century, and the promotion of positive ideas and values. The problem of the study was identified to describe the nature of the relationship between social networks like Facebook, Twitter, YouTube, Instagram, Google+ and smart phones. Therefore, these methods were the most capable of addressing and influencing public opinion, as well as social campaigns such as the "100 Million' Health" campaign, the subject of our study, which urges the Egyptian citizen to participate.

Importance of the study
The importance of the study as follows: Scientific importance a) a) Highlight the health campaigns, their value and importance, and knowing the extent of the public's desire for these campaigns and obstacles in this regard. b) Clarify the level of contribution of the electronic media in keeping up with events and dissemination of information on ongoing campaigns and follow-up. c) Make use of online communities through multi-network social networks to promote community issues and national campaigns, and to provide information on current events in the health field immediately and effectively through electronic media, in order to raise the level of health awareness of citizens.

Applied importance
a) The results of this research can help to gauge the extent to which the public relies on the information provided in the social networks and their impact on the formation of public opinion and the formation of its interests. b) This study provides practical indicators for the development of the use of electronic media campaigns, in view of the rapid growth of the Internet and its applications. c) Identify a methodology to study health, value and importance, and effectively integrate them into the design of health campaigns for community service. d) Benefit from the results of this study in overcoming the problems facing the application process of health campaigns.

Objectives of the study
The study aims to achieve the following objectives: 1) Evaluation of planning methods for health campaigns, the subject of the study, and the role of social media in these campaigns. 2) Recognize the importance of electronic media in promoting public awareness and understanding of health issues through the interactive means. 3) Monitor the pros that can be achieved by using websites in the social campaigns for the Egyptian public and identifying the obstacles facing the Egyptian public in dealing with websites.

Questions of the study
The research raised a number of questions as follows: 1) Main research question: What are the steps to set up a successful marketing campaign on Twitter, Facebook, YouTube, Instagram, Google+ and others? This question is a key aspect of this study and attempts to explore the steps of preparing a successful marketing campaign as follows (Parvanta et al. 2011):

First: Planning
Campaign leaders have to determine whether there is sufficient evidence to indicate that a health problem is conclusively within a given population.If confirmed, it is necessary to determine whether interventions have occurred in the past, whether they have been successful, and then to determine whether these strategies can be improved or adapted in the current intervention.
In our current campaign entitled "100 Millions' Health", health problems were discovered before the campaign began, as the campaign sought to: -Complete the Egyptian government's efforts to combat the C virus through the campaign of "100 Millions' Health", commissioned by the Egyptian President for the Egyptian Ministry of Health and Population to eliminate the waiting lists of 900,000 patients.
As well as the detection and elimination of C virus and NCDs (diseases of the liver, heart and blood pressure) for more than 50 million Egyptian citizens. The previous strategies were improved in the previous campaign, with the aim of making the campaign a success as follows: • The Ministry of Health has launched a website (www.stophcv.eg), which includes a window to search for the nearest survey center according to your residence, by selecting the province, then the section or center, and then showing the closest detection points to your area. • The campaign has been promoted on Facebook, Twitter, YouTube, Instagram, Google+, smartphones, as well as all printed and electronic Egyptian newspapers and periodicals, radio, TV programs and blogs. • Hold intensive training courses in all health departments and hospitals in the Arab Republic of Egypt. • Form fixed and mobile teams, as well as mobile work teams to pass on homes to serve people with special needs and sick conditions. • Training of 12,000 data entry to work in"100 Million's Health" campaign nationwide.
• The Ministry of Health has provided a database for all citizens over the age of 18 years at the level of the Republic, for the purpose of detection, and will be renewed at the end of the campaign. • A meeting was held with the director of laboratories and laboratory technicians at all survey points, explaining the role assigned to them and ensuring their readiness to work with the initiative, with a policy to provide and receive the requirements of the campaign and the method of collection and preparation of samples for examination. • Training of the untrained data entry on how to operate computers, tablets and the program of the initiative.

Second: Development
The campaign development phase helps to rearrange coherent priorities in light of what has been implemented, taking into account the desired behavioral changes or situations that leaders hope to influence among the target population. The development stage also includes an understanding of the existence of a harmful behavior or attitude, which is very important to reverse, in order to achieve the goals of the campaign. In this context, the following measures have been taken to ensure that the entire population aged 18 is exposed and communicate with the public as follows: • Coordination with the civil society to mobilize the citizens and inform them of the whereabouts of the teams. • Coordination with the directorates of education, social solidarity, youth, sports, endowments, representatives of churches, the Ministry of the Interior, the heads of cities, centers and local units to ensure public participation in the initiative. • Hold several meetings with hospital directors, health departments and officials of the information centers of the health departments and entrusting them with supervision and follow up of the required equipment, coordination and liaison with the supervisory team at the Directorate. • Take difficult decisions to face the obstacles and challenges of the implementation of the health campaign to ensure access to quality health services to the target audience.

Third: Evaluation
Evaluate whether the campaign has already succeeded in behavior change, which is an important part of any intervention initiative, noting that the funding and support provided depends on the effectiveness of the campaign. The success of the "100 Millions' Health" campaign, in terms of positive behavior change, was reflected in the high participation rate as well as the following points: • Take advantage of the growing impact of social research by sharing campaign content socially.
• Make use of online communities via multi social media, like Facebook, Twitter, and Google+ posts, reflecting the interest of campaign organizers and the public. • Since the first day, WHO has been supporting this initiative at all stages. Currently, there is an integrated team of WHO experts working as an external monitor to control performance within the screening, diagnosis and treatment centers to provide necessary support to the Ministry of Health to address any negatives arising during the survey. WHO, in close collaboration with all local and international partners, continues to support the efforts of the Egyptian Government to eradicate viral hepatitis, in addition to supporting the prevention of non-communicable diseases and strengthening the frameworks of health systems in Egypt, including basic health care.
In addition to the following positive feedback: • The representative of the World Health Organization (WHO) praised the Arab Republic of Egypt for the national campaign to eliminate the virus C is a health precedent recorded by history on the achievements of health in Egypt and an example of how to integrate the confrontation and targeting diseases that represent public health problems and huge in the country. • The World Bank Representative said, "We are pleased to cooperate with the Ministry of Health in Egypt in this initiative, and the positive results achieved in its first phase." He pointed out that the Bank is one of the campaign financiers and that he looks forward to transferring the Egyptian experience in this campaign and application in other countries for their impressive results. • The World Bank delegation also praised the Egyptian experience at the beginning of December.
Ernest Masia, Director of Health and Nutrition at the World Bank, said that he looked forward to transfer the Egyptian experience of this campaign and applying it in other countries. He called on the Minister of Health to present this experience to the WHO Annual Conference in Geneva.

Subsequent questions of the main question:
1-What are the most successful sectors in social marketing? The health sector is considered one of the most important areas of social marketing campaigns to promote health development, as it represents a vital sector that affects people as a result of the spread of epidemics and other diseases. It also contributes to the rephrasing of medical information and emptying it from direct instructional tone to suit the target group. In addition, it contributes to change behavior and make a significant change in the health culture to the public in order to improve the health status of the individual and society as a whole.

2-
What are the motivations of the public to participate positively in "100 Millions' Health" campaign? Social media campaigns are a coordinated marketing effort to enhance information, facilitate audience interaction and motivate positive engagement by following, commenting, or liking. The campaign was promoted on Twitter, Facebook, YouTube, Instagram, Google+, as well as in all printed and electronic Egyptian newspapers, periodicals, radio, television programs, blogs and smartphones. About 50 million SMS messages were sent to promote the campaign and places to conduct the survey. The site also featured the campaign's most important questions and answers to give a sense of visibility to all campaign targets.
In this regard, the slogan of the most intelligent campaign (100 Millions' Health) ( Figure 1) should also be mentioned. It is one of the factors that motivate the public to participate, as it was accurate and simple of expression. The slogan establishes a link between the regulator, the Egyptian Ministry of Health and Population, through the contact number. The goal of the campaign is to eliminate the C virus and to detect non-communicable diseases. The photo attracts millions of followers of social media who respond more than 200% of the content if only words (Volpe 2014), as well as active participation and effort by planners throughout the campaign to eliminate any obstacles or challenges facing the campaign.
Successful social media campaigns are linked to a social marketing message that aims to spread positive and valuable principles in society and promote good behaviors for individuals at risk. In this digital era, health communication and social marketing are finding new and more innovative ways to promote lasting behavioral changes that lead to better health. This is what has been achieved during the campaign, which has spurred the public to participate positively in "100 Millions' Health" campaign.

What are the pros and cons achieved by using websites and must be observed or avoided in campaigns?
The pros of using social media in the campaign: • The new generation of young people and technology-savvy audiences are more open to interaction with social channels, so this may be useful. • The ability to connect with the Circle of Friends and interact through social networks, facilitating the exchange of views and comments on the evolution of the campaign. • Take advantage of the growing impact of social research by sharing campaign content socially. • Using existing online forums across multiple social media.
• Contribute to increased access and efficiency of basic public health services, such as surveillance, research and communications. The cons of using social media in the campaign: • The Internet, specifically the applications of instant communication and social media, helps spread misleading information, falsehood and rumors quickly. • Because of the large amount of information freely available on the Internet, the theft and misuse of this information is likely.

Methodological procedures for the study Type of study:
This study belongs to the descriptive studies that are interested in studying social media sites and their role in social campaigns. They seek to describe a phenomenon, monitor, analyze it and interpret its consequences . (Suleiman 2009 The theory of dependence on the media was chosen to rationalize the subject of the study. The theory suggests that public reliance on the media increases the importance of the media to the public in the context of three-way interactions between the media, the public, and the social system. Researcher Sandra J. Ball Rokeach (Grant, Ball-Rokeach, and Guthrie 1991) made the first beginnings of this theory when she presented in 1974 a research paper entitled "The Concept of Information", which calls for a shift from the mainstream concept of the media as a means of persuasion to view it as an information system. In this research, the media's ability to create, shape and manipulate information was published and disseminated not only to the local audience but also to the global audience.
Studies on the theory of dependence on the media focused on the relationship between the public and the media, and the impact of this relationship on interpersonal relationships, as well as on the nature of the decisions taken by the individual based on his reliance on these means (means of communication).
The process of relying on the media is influenced by several factors, which are determined as follows (Loges 1994): • The nature of society and its objectives as a result of relying on different media.
• The nature of society and the availability of sources of information in this society.
• The nature and diversity of the media and their ability to provide information to the public.
• The nature of the time or circumstances experienced by individuals or society.
• The nature of the information provided by the media and the extent to which it satisfies the needs of the individual or society. The reasons for the individual's dependence on the media are influenced by his previous experience with this mean, where the public relies on the means that he feels provide him with the information he wants (Hollander 1997). The dependence of the individual on the media is influenced by the individual's use of the media. The power of the media according to the theory of dependence depends on the sources of information through which the individual achieves his or her main objectives. These objectives can widen and increase as society becomes more complex (Culbertson and Stempel 1996).

The theory of dependence on the media is based on a set of assumptions (Baran and Davis 2006, 227):
• A triangular relationship between the public, the media and the community. This relationship directly determines many of the influences that the media can have on people and society.
• The greater the degree of centralization of information raised by any media, the greater the public's reliance on that media. • The degree of public reliance on media varies depending on their differences in goals, interests, and individual needs. The process of individual dependence on the various media is more complex than mere exposure to this method. In many cases, exposure to this method happens by chance or because there is a communication habit that the individual always follows, without being considered a basic source of information (Baran and Davis. 2006, 320-322).
The basic hypothesis of the theory is that the process of interaction and mass communication involves a complex and reciprocal relationship between a large number of interacting variables that can be identified simply in three terms (Media, Audience, and Community). This relationship identifies many of the influences that the media can have on people (the public) and society (Khalil 2008).

Application of the theory of dependence on the current study
The idea of dependence, here, is based on the Egyptian public's reliance on the media to acquire information and concepts about national campaigns, especially the "100 Millions' Health" campaign conducted by the Egyptian government for all members of Egyptian society in all Egyptian governorates. The theory is based on the existence of a relationship between the means of social media and the understanding of the members of the community of the importance of the campaign and its usefulness. Thus, the main idea of the theory is that the more the public in Egyptian society relies on the media to gain and understand information, the more important the media will be to individuals.
Information enables the media to achieve its role, which is provided by the theory of dependence. The public exposure to campaigns in social media as sources to rely on them in the completion of information, and establish the subject of the message, which means social media and its role in the success of the campaign "100 Millions' Health" in Egypt. This theory also contributes to the connection between the theory and the purpose of the thesis.

Previous studies
Social media and health campaigns: 1-Strongin, Dana. 2010. " Health Promotion Strategies Among Practitioners in Three Settings: the Role of Directionality and Balance" (Strongin 2010). The study addresses the issue of health care, related costs and insurance in light of the growing cost of health care. Still, the health of the US population is not always good compared to people living in other countries such as Canada and the United Kingdom. Results: First, the possibility of creating ways, rather than relying on funding, to implement two-way strategies. Second, health campaigns and promotion of health behaviors to prevent disease lead to early detection and treatment of chronic diseases. Thirdly, engaging in partnerships is an important way to create more effective campaigns that ultimately lead to healthier societies. 2-Monroe, Brittney. 2016. "Targeting Effectiveness in Digital Healthcare Advertising" (Monroe 2016). The study was conducted with a group of digital media users to gain a better understanding of how individuals seek out information about online health care, where ad messages are displayed to a digital media user to effectively advertise online on digital health care. Results: 1-Many health campaigns target individuals by targeting the audience and ads. 2-Using audience targeting and reaching them is an important way to tell marketers who your target audience is.
3-The importance of access to information by applying the use of the Internet and digital media, in the field of health care research.

Comment on previous studies
This presentation is as much as possible for previous studies. It is consistent with our current study of using health campaigns through social media to motivate the public to participate in campaigns and to gain a healthy culture.The study of Dana Strongin (2010) focused on the issue of health care and the creation of other means of financing due to its high cost.While the Monroe Brittney (2016) study took advantage of the Internet and digital media to determine the targeted audience for health campaigns for effective advertising. − Value:Johan Larsen: If done correctly, connected care will improve public health and quality of life, which is the real value. We shouldn't forget that healthcare is about people and not just technology, dollars and cents (Eramo 2018). − Healthcare:The prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions (American Heritage®2016).

Applied side of the research
This paper examines the effectiveness of the marketing of social media for the latest health campaign conducted by the Arab Republic of Egypt and launched by Egyptian President Abdel Fattah Al-Sisi to ensure the health of citizens. The Egyptian government launched this campaign under the title of "Prevention is better than cure" entitled "100 Millions' Health" to detect and eliminate the C virus and the detection of non-communicable diseases (liver diseases, heart and pressure) to more than 50 million Egyptian citizens and try to treat diseases in the early stages.In addition to eliminating the waiting lists of patients of the virus of C 900 thousand citizens, as well as to improve the health culture of the Egyptian citizen through social interaction through social media. Health campaigns increasingly need social media to support, promote and disseminate information and data to improve both personal and community health practices. The media aspect of the campaign: The campaign was promoted to target and motivate the public to participate positively in the following social media: Facebook, Twitter, YouTube, Instagram, Google+ and smartphones. In addition, 50 million text messages were sent, as well as published in all printed and electronic Egyptian newspapers, periodicals, radio, television programs and blogs. A popular song was also was launched. Category of portlets used in campaign media. Campaign adopted on the following pillars:

About the campaign
• The health pillar: which dealt with clarifying the correct scientific and health facts, and spreading the health culture in order to improve both personal health practices and motivation for community participation. • The economic pillar: to clarify the material benefits that will accrue to the public as a result of maintaining the health of the individual the pillar of society, so as to benefit the individual and the society as a whole in the field of production and work. • Behavioral pillar: encourage behavioral changes, by explaining negative behaviors and their adverse effects and attention to positive behaviors. • Religious pillar: focuses on the religious aspects associated with human health and the absence of negatives that harm health. The campaign also adopted the following appeals: Emotional appeal: emotional and rational stimuli were used together, both to address the individual's mind and spirit to achieve the desired goal of the campaign.

Results
I will review only the first and second phases due to time constraints as the third phase ends on April 30 and the deadline for submitting the research is May 6, and I will review the results of the third phase when the research is presented at the conference.
The results of the first and second phases were published under the title "The target category of citizens" (Al-Masry Al-youm 2019) (also published on Facebook, Messenger, Twitter, Google +) Target group of citizens: C virus testing: Citizens older than 18 years of age, who have never been treated. Non-communicable diseases: Citizens over 18 years of age.
• The total number of citizens examined in the first stage is 13 million.
The result of second phase: • The second phase started from 1 December 2018 until 28 February 2019.

Results of the Third Phase:
• The third phase started from 1 March 2019 until 30 April 2019.

Discussions
Due to the development of social media during the past decades, which contributed to the success of the health campaign conducted by Egypt entitled "100 Millions' Health", to eliminate the C virus, diabetes, high blood pressure and obesity. This campaign provided campaign coordinators with all the facts, information and ideas to help community members benefit from health care, which is key to improving health. Where people are supported by modern ideas and new ways to lead life towards health well-being, through various social networks that include different changes of knowledge, attitudes and behavioral intentions of the masses. It has eliminated Westernization and stimulated public participation, but the most important fact is the development of plans, action strategies and problem solving that result in implementation, which helped to make decisions about the mechanisms of action that policy development groups can implement.
Social media is one of the important elements in the success of the "100 Millions' Health" campaign conducted by Egypt. The campaign coordinators provided all the facts, information and ideas from various social networks, including the various changes of knowledge, attitudes and behavioral intentions of the masses. It has eliminated the behavior of Westernization and stimulated the masses to participate, but the most important fact is the development of action plans and strategies and the solution of problems that arise when applied, which helped to make decisions on how to act and which policy development groups can implement.
Previous studies have been positive and confirmed for our current study using social media in health campaigns, Dana Strongin (2010) and Brittney Monroe (2016). Strongin took care of health care and its importance as in our study. The Monroe study matched our study in content. Because the campaign targeted all citizens infected with the C virus, treat them free of charge and reassure them just as the Minister of Health and Population said that the year 2020 would see the country rid of the virus completely.
The average infection of C virus was 4% to 6% in the first and second stages. In addition to the early detection of diabetes patients where the average prevalence of diabetes patients 4% in the first stage and 6% in the second stage, and the average blood pressure of 90/140 ml is 21% in the first phase and 20% in the second stage.The patients were followed up and provided treatment to those surveyed in hospitals or health centers, as well as visits, communications and text messages. In addition to the formation of mobile teams to pass on homes to serve people with special needs for sick cases to ensure that they take the rest of the steps to evaluate and free treatment for those who prove the infection. Finally, the study proved the possibility of applying the use of social media successfully in the field of health campaigns.
All this is aimed at protecting and treating society members of the damage and diseases that can be exposed to it.It is not only the development of strategies to mitigate the potential negative effects, but the achievement of the objectives of the campaign in full, without which to continue to increase the numbers of patients and delayed treatment, giving way to surrender to disease and loss of hope in treatment and the establishment of a healthy society.

Conclusions
The problem of the study is the early detection of C virus, as well as the early detection of diabetes, high blood pressure, and obesity for unregulated older than 18-year-olds through a "100 Millions' Health" campaign, which was the result of high mortality rates of these diseases. As Egypt ranks first in the global C virus infection (Mou'ns 2013; Ezz Al-Arab 2014; The International Bank 2018). The campaign was based on the first social communication means that made a difference in raising citizens' awareness of health culture, which reflected their behavior and was characterized by positive participation.The campaign aims to rid the Arab Republic of Egypt of the virus completely in 2020, as stated by the Minister of Health and Population, and to treat other diseases.
I cannot identify any reason for the failure to participate in the campaign where participation is one of the elements of its success, only referred to the exclusion of children and adolescents under the age of 18 by the coordinators of the campaign, to ensure the quality of the campaign. Nevertheless, I emphasize its success in targeting the masses and motivate them to participate in health awareness, and follow-up treatment with patients, and so our dreams of health of our society changed to reality.
Because of the success of the campaign, the state began to conduct other campaigns on our children in schools for the treatment of diseases of anemia and obesity and stunted cooperation between the ministries of health and education, which was conducted during the month of February.The treatment of infected children and another eye health awareness campaign initiated by the Ministry of Health began in conjunction with the international community's celebration of International Day of Sight (Al-Masry Al-youm 2018).
Not only that, but also the results obtained have made a valuable contribution to the preparation of similar campaigns in other countries as noted in the positive reactions of the Director of Health and Nutrition at the World Bank, Ernest Massia. He said that he looked forward to the transfer of the Egyptian experience of this campaign and its application in other countries.In addition to benefiting from all the strategies and mechanisms and plans for success.
This success and the rapid spread of awareness of the health culture of citizens as we have already mentioned, as a result of the use of social media, which indicates the importance of using these modern means to promote such campaigns, which achieved contact with the largest target audience throughout the Republic.

Recommendations
1) The interest of government institutions and non-profit organizations in developing their content through the electronic media, which helps to raise awareness of issues of community development in general and health issues in particular. 2) Use influential young people with social networking pages and activists who are popular with young people in disseminating campaign messages, as well as reviewing comments received from the public and disseminating responses received by campaigners. 3) Pay attention to social and cultural factors that affect health at different levels, including individual behavior and physiology, family, community, environment, social networks, living and working conditions. 4) Make use of digital media when planning social campaigns. 5) It is possible to use partnerships with non-profit organizations if possible because they have more resources available such as time and money, which contributes to pushing the campaign to a higher and more effective level. 6) Pay attention to health campaigns and encourage early detection to avoid chronic diseases