In Kenya, Centre for Behavior Change and Communication is using Talking Books to train and support community health volunteers (CHVs) for Nutrition International’s Right Start Initiative, a multi-faceted initiative to reach over 100 million women and girls with improved nutrition. In Kenya, the project is called “Anzilisha.” Amplio’s Talking Book is called “DigiSomo,” which means “digital learning” in Swahili.

Accelerating Nutrition International’s Anzilisha initiative in Kenya

When Doreen Oyiko Omukokwa, a community health volunteer (CHV), leaves home every weekday morning, the most important thing she carries is a bright yellow, portable Talking Book audio device. It could be she is heading out to the Emuhaya Sub-County Hospital or to the field to talk with clients about maternal and child health and nutrition. Whatever the situation, the Talking Book is her faithful digital assistant.

“I’ve been a community health volunteer for 12 years. In all that time, I’ve acquired a good amount of knowledge, but I’m also a human being who forgets,” Doreen says. “When I was given this device to use for the Anzilisha project, it was like a savior, a God-sent support tool. “

Doreen uses her Talking Book to share Anzilisha nutrition and healthcare messages. 

Using Talking Books to train and support Anzilisha CHVs

Doreen is one of the many CHVs who are actively involved in Anzilisha, a five-year project (2016-2020) funded by Nutrition International to reduce anaemia, low birth weight, maternal and new-born mortality, and stunting in Kenya.

The project, which is being implemented by CBCC in partnership with the Vihiga County Government, has had great benefits to mothers and their children in the region. So far, CBCC has used Talking Books to train over 296 CHVs in five counties and help them effectively deliver Anzilisha messages far and wide.

Doreen says the Talking Book is straightforward and intuitive to use.

A digital assistant for sharing and recording health messages

“With the Talking Book, I can choose which health message to play. I’m also able to record brief messages — in this case, client questions. There are 24 messages, which I normally play for a group at the healthcare facility when pregnant and lactating mothers are present. To use it, I have to alert the mothers. I schedule the meeting with them in advance, so they can come early for the Health Talk, before their appointments begin.”

Health Talk is the time before treatment commences, when patients are taught important issues about their health. For Anzilisha, Doreen limits her topics to the health of mothers and children less than five years of age.

At the Emuhaya Sub-County Hospital facility where Doreen is working today, her audience consists of pregnant women and lactating mothers, including mothers of six-month-old babies.

“If they lend me their time, I can play up to three messages,” Doreen explains. “These have to do with ANC, breastfeeding, and starting complementary feeding. That way mothers at different stages can benefit.”

Improving the quality of nutrition and healthcare for women, adolescent girls, and children in Kenya

The Right Start Initiative, called “Anzilisha” in Kenya, is a comprehensive program reaching nine countries in Asia and Africa, designed and run by Nutrition International with the goal of improving the quality of nutrition for 100 million adolescent girls and women of reproductive age.

Supported by the Government of Canada, the project aims to reduce anaemia, stunting, birth complications, and maternal and newborn deaths, as well as the number of low birth weight newborns ― and protect pregnancies from neural tube defects such as spina bifida.

In Kenya, Nutrition International will invest $9.1M (CAD) over five years to 2020.

Implementing partners: Center for Behavior Change Communication (CBCC) in partnership with Kenya’ Ministry of Health, Ministry of Education, County Governments, Red Cross, and Christian Health Association.

Approach: CBCC uses multiple tools and strategies, including advocacy, behavior change communication, social mobilization, capacity strengthening, and innovations like Talking Books.

Reach: The project aims to reach 710,000 pregnant women with WHO-recommended iron and folic acid supplementation, over 665,000 newborns with a package of interventions at birth, and 636,000 children under two years old with nutrition services.

For more information, see Nutritional International’s Right Start Kenya Fact Sheet (PDF) and Infographic (PDF).

Doreen uses the “DigiSomo” to facilitate health talk at Emuhaya Sub-County Hospital.

An impressive, helpful technology for rural communities

For Doreen, the Talking Book has become a vital part of her work. She says the device is straightforward and intuitive to use without a waste of time.

 “The clients really benefit,” she says. “Sometimes I might forget an important point, but the gadget doesn’t. It has a button for volume and other actions and uses a battery of cells that can last for about a month with heavy use.”

The Talking Book also impresses and pleases her clients.

“The villagers feel that some cool technology has come to be a part of their lives and they are proud to have such a gadget at work among them, which makes them take the Anzilisha messages more seriously,” she says.

Dorren says Talking Book messages have given her knowledge too. 

“If I had had access to this information when I was a new mother, I’d have been a lot better off,” she says. “I didn’t know about the first 1000 days. I didn’t know a lot of things! But Anzilisha is helping me interpret and understand what I went through. Now I know important points about pregnancy, birth, and care of children, which I share with new mothers.”

Doreen takes pride in being able to help new mothers do better.

“I’ve had this device since December 2017. With the Talking Book, I can attend to between 20 and 25 clients in a day, five days a week, so I’m making a difference in the communities I serve.”

CBCC publishes colorfully illustrated print materials to use with Talking Books.

Anzilisha social and behavior change messages are making an impact 

Sometimes mothers are reluctant or forget to attend their ANC visit. In such case, the nurses may not know how to reach them. Through the Anzilisha project, CHVs like Doreen are using Talking Books to strengthen communication in rural areas, build trust, and schedule appointments.

“For example, we have trained women to note when they miss their menses. Most of them now know that the moment they notice their period has delayed they should walk straight to a health facility to get help,” says Doreen.

There are early indications that the labour of Doreen and other CHVs is bearing good fruit — exclusive breastfeeding has taken off tremendously and the children born the Anzilisha-prescribed way are extremely healthy in comparison to those born the old-fashioned way.

“The difference is clear,” Doreen says, who attributes much of her success to the accurate information provided through the Talking Book.

“The DigiSomo Talking Book has had a great impact on my communication. It assists me. Where I may be wrong, it keeps me in line. I may not necessarily remember 24 messages, but the gadget reminds me. This includes messages about the importance of attending ANC appointments, taking iron and folic acid supplements (IFAS), being aware of the danger signs in pregnancy, and using chlorhexidine gluconate (CHX) to clean the umbilical cord. There’s also a message about the need to have the Mother-Child Health handbook.”

Doreen says the Talking Book is robust enough to withstand rough handling, but notes that she has never dropped it. She looks forward to many more years of improving community health with the help of her digital assistant.

This blog post was written by Sammy Kewe for Amplio’s affiliate, Centre for Behavior Change and Communication (CBCC), and previously shared on CBCC’s website. Sammy Kerre is a business reporter and CEO of Prime Page Communications in Nairobi. You can follow him on Twitter at @SammyKerre.

Centre for Behaviour Change and Communication (CBCC) is a Kenyan organization that provides locally driven health communication solutions, including social and behavior change communication, strategic planning, policy analysis, capacity strengthening, research, and technical assistance. Learn more here

Nutrition International is a global organization dedicated to delivering proven nutrition interventions to those who need them most. You can read about their nutrition research, policy formulation, and development programs in more than 60 countries, primarily in Asia and Africa, at www.nutritionintl.org.

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