Using Talking Books in a refugee camp to spread the message of health
In 2017, UNICEF Rwanda piloted the use of Talking Books at Mahama Refugee Camp. During the six-month project, Community Health Workers (CHWs) used Talking Books to share consistent, quality health and hygiene messages with Burundian refugees to support UNICEF’s social and behavior change programs, empowering 50,000 Burundian refugees with new knowledge and skills to ensure improved health and quality of life.
The Mahama Camp pilot project was funded by the Government of Japan and the Paul and Cathy Cotton family. Global Humanitarian and Development Foundation (GHDF), the NGO that implements UNICEF Rwanda’s Communications for Development (C4D) program, partnered with Amplio to run the project.
Civil unrest in Burundi has led to over 400,000 Burundians fleeing to neighboring countries of Rwanda, Democratic Republic of Congo, Tanzania, and Uganda. Mahama Camp is Rwanda’s largest camp, with a population of around 60,000 Burundi refugees. Limited access to clean water in the camp heightens the risk of diseases related water, sanitation and hygiene (WASH), including cholera. Because many Burundi refugees come from rural areas, they often have limited knowledge of health and sanitation issues, which can exacerbate the health risks. Additionally, low literacy among refugees makes it difficult to disseminate information.
To address the situation, UNICEF partnered with the Government of Rwanda, the United Nations High Commissioner for Refugees (UNHCR), and others to establish primary health, immunization, and water, sanitation and hygiene facilities. But they needed a way to raise awareness and demand for these essential services.
Refugees at Mahama Camp listen to a Talking Book.
EMPOWERING COMMUNITY HEALTH WORKERS TO STRENGTHEN MESSAGING AND MONITORING
UNICEF selected the Amplio Talking Book to support their C4D activities at Mahama Camp. To strengthen the quality of messaging and monitoring, 385 Talking Books were distributed to CHWs, including 25 for Early Childhood Development centers.
For Mahama Camp, Talking Book content was recorded in Kirundi, a Bantu language spoken by Burundi refugees. Messages focused on health and hygiene, with songs, dramas, and interviews on key family practices. Topics ranged from breastfeeding and immunization, to diarrhea, menstrual hygiene, and HIV prevention. Content included children’s songs and episodes from the Itetero radio show, an educational program produced by UNICEF and Rwanda Broadcasting Agency.
CHWs used Talking Books to share information and promote social and behavior change through a variety of communication approaches, including social mobilization events, door-to-door sensitization, group discussions, and home visits. The Talking Book has a built-in speaker, which allows families and groups to listen and learn together. In order to reach even more people, CHWs used megaphones to amplify Talking Book messages for community meetings.
For the pilot project at Mahama Camp, Talking Books included audio songs and dramas from Itetoro, an educational children’s program produced by UNICEF Rwanda in partnership with the Ministry of Gender and Family Promotion, Rwanda Broadcasting Agency, and Imbuto Foundation.
EXPANDING REACH WITH LIMITED RESOURCES
With Talking Books, CHWs reported that the delivery of key messaging was faster and more reliable. They were already employing a door-to-door communications strategy for health education, but the Talking Book allowed them to expand their reach in new settings. Also, although CHWs are trained on key issues, they sometime forget information or misremember it, leading to confusion. Using Talking Books to deliver consistent messages helped limit the distortion of information.
As a result, CHWs increased the number of beneficiaries reached door-to-door from 8,511 to 17,869. Using Talking Books during community meetings and child welfare centers extended the reach even further. UNICEF Rwanda estimated that 50,000 Burundians benefited from Talking Book health promotion activities.
A CHW begins a Talking Book listening session.
INCREASING ENGAGEMENT AND ACCOUNTABILITY
Because Talking Books content included children’s songs and stories, children were especially interested in listening, which was a good strategy to sensitize them to the information. Group listening sessions encouraged discussion on hygiene within the communities. Audio dramas and interviews kept people engaged.
Talking Book usage data helped increase accountability. Each device tracked which messages were played, for how long, and how often. Amplio provided dashboard reports, enabling program administrators to monitor program delivery and engagement, and stay more connected with the work on the ground.
In addition, CHW used Talking Books to record community feedback in the refugees’ own words and voices, to share with program managers. For example, UNICEF messaging instructed people not to share drinking cups. However, user feedback revealed that most households didn’t have enough cups to go around.
Usage data and user feedback showed what content performed well and where updates or improvements were needed. Overall, community members gave positive reviews of the efficiency of the messaging. Many requested more information about diarrhea prevention and had further questions about breastfeeding.
Talking Book Pilot Project at Mahama Camp
Partners: UNICEF Rwanda and Global Humanitarian Development Fund, with support from Centre for Behaviour Change and Communication
Funding: Government of Japan and the Paul and Cathy Cotton family
Duration: July–December 2017
Key issues: Breastfeeding, Immunization, Diarrhea, Malaria, Hygiene and Sanitation, Menstrual Hygiene, HIV Prevention
Reach: 50,000 Burundi refugees
RESULTS AND FINDINGS
When the project came to a close, UNICEF Rwanda’s Humanitarian Situation report concluded that Talking Books helped to increase the number of refugees receiving health education. Program analysis showed that CHWs with Talking Books reached 2.75 times more men, 2.5 times more women, and 1.5 times more children than through their routine door-to-door efforts. Use of Talking Books also reduced workloads for CHWs and provided additional insights for program managers.
Although most often used in rural, remote areas, Talking Books are uniquely suited for use in refugee camps, where aid organizations can struggle to reach their target populations because of language barriers, low literacy, and limited staff. Talking Books allow organizations serving refugee populations to efficiently deploy key messaging to large, low literacy populations in an effective and engaging way.
Global Humanitarian and Development Foundation is a non-governmental organization established in Rwanda in 2000. GHDF’s areas of work include humanitarian response, economic development, youth programs, and HIV/GBV prevention. Learn more about GHDF’s work at https://ghdf.org.rw
To learn more about the Rwanda refugee situation, see:
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