Talking Book COVID-19 response in Ghana

Amplio partnering with LBG, Ghana Health Services to reach rural remote communities

UPPER WEST REGION, GHANA – In response to the COVID-19 pandemic, Amplio is partnering with Literacy Bridge Ghana (LBG) and Ghana Health Services to share lifesaving information with rural remote communities. Community health nurses and volunteers will use Talking Books to share key messages on COVID-19 throughout eight districts in the Upper West Region. To help mobilize, UNICEF Ghana granted the use of their Talking Book devices.

“Amplio has redirected funds to support LBG’s initiative to act quickly in this emergency situation,” said Cliff Schmidt, Amplio founder and executive director.

COVID-19 CHALLENGES IN UPPER WEST REGION

Even in the best of times, the Ghana health system struggles with a limited health workforce and lack of facilities. LBG’s executive director, Tiah Aloysius Gumah, says the COVID-19 virus could be devastating to vulnerable communities in the poverty-stricken Upper West Region. 

“At LBG, we’ve taken measures to protect ourselves and our families. However, this is not the case for the vulnerable people in our operational areas. In this region, big organizations have shut their doors and evacuated their staff. Many services have been suspended. Also, there’s a great risk of the virus spreading through cross-border trading activities,” Gumah said. 

Upper West Region borders Burkina Faso, which is likely to be a coronavirus hotspot. 

Other factors that put the region at risk include low literacy levels, lack of mass media, poor hygiene and sanitation conditions, and deep-rooted practices and social norms, such as gatherings during funerals, at local marketplaces, and for communal meals.

LEVERAGING CHPS ZONES FOR COVID-19 RESPONSE

With support from Amplio, LBG is partnering with Ghana Health Services (GHS) and other key stakeholders to launch a COVID-19 awareness campaign in eight districts: Jirapa, Lawra, Wa West, Nandom, Nadowli-Kaleo, Sissala East, Sissala West, and Lambusie-Kane.

So far, LBG has deployed Talking Books in 207 CHPS zones.

“Currently, Ghana’s lockdown is only for the two major cities—Accra and Kumasi. However, even if the lockdown extends to rural areas, community health nurses provide an essential service and will continue to work. Therefore, our plan is to leverage the Community-based Health Planning and Services (CHPS) zones to deliver health education with Talking Books. We recently conducted a successful project with CHPS health workers, so we have a blueprint,” Gumah said. 

In 2019, Amplio and LBG partnered with UNICEF and GHS to run a Talking Book pilot in eight CHPS zones. Nurses reported that using Talking Books allowed them to share health information more efficiently and effectively during antenatal care visits and child welfare clinics. Also, they observed that the use of Talking Books engaged more fathers in maternal and child health, which has been associated with positive health outcomes. 

TALKING BOOK CONTENT AND PROGRAM DESIGN

LBG worked with GHS to produce audio content in four local languages. Information sources included World Health Organization, UNICEF, Centers for Disease Control, Medicine for Humanity, and John Hopkins Coronavirus Resource Center. Topics include COVID-19 signs and symptoms, prevention and protection, preparing for lockdown, social distancing protocols, and how to talk to children about COVID-19. LBG also added messages about meningitis due a deadly outbreak in the region. 

To engage listeners, Talking Book messages are produced as songs, dramas, interviews, and social influencer endorsements. “For example, we’re including endorsement messages from the Health Directors of each district,” Gumah said.

LBG is also working with district assemblymen, as well as Christian and Muslim religious leaders, to ensure that everyone is on the same page with COVID-19 messaging.

Here’s how the project will roll out:

• LBG will train CHPS nurses and community agents on Talking Book technology, content, and COVID-19 safety protocols.

• Nurses will use Talking Books to conduct listening sessions at CHPS centers and play Talking Book messages during household visits.

• Health volunteers will conduct house-to-house sensitization and use Talking Books to share clear, consistent messages. To ensure quality control, CHPS nurses will provide oversight and address any issues related to COVID-19.

• LBG and GHS directorate staff will monitor the program and provide technical support for each district.

• Amplio will provide technology support and assist with monitoring and evaluation.

In addition, Talking Book content will be formatted for other communication platforms, including local language Whatsapp groups, and shared with community radio stations to expand access to COVID-19 information.

SAFETY MEASURES TO PREVENT SPREAD OF THE VIRUS

Amplio has provided funding for personal protective equipment for the project, including rubbing alcohol, masks, and gloves. LBG and GHS are adhering to the Government of Ghana’s COVID-19 protocols and adding other safety measures. At this time, the government is limiting community gatherings to 25 people.

“The Talking Book has a speaker and microphone, so health workers can play messages and record user feedback while practicing social distancing during household visits,” Gumah said.

LBG also plans to connect external speakers to Talking Books to ensure more safety at CHPS centers during listening sessions. This will allow nurses to play messages for small groups of pregnant and lactating mothers while also practicing social distancing.  (Through a UNICEF Rwanda pilot project, community health volunteers used external speakers to broadcast Talking Book health and hygiene messages at Mahama Refugee Camp.)

RESPONDING TO PUBLIC HEALTH EMERGENCIES

This isn’t the first time Talking Books have been used for response to an emerging public health crisis. Last summer, Amplio worked with LBG and UNICEF to disseminate messages to vulnerable districts during a polio outbreak in Ghana. In 2014-2015, UNICEF Ghana’s C4D program used Talking Books to share cholera and ebola information. 

“Amplio’s goal is to help our partners safely and ethically respond to this pandemic. We’re starting with eight districts, but we know there are many other districts that could use our support. We’re currently seeking additional funding to make that happen,” Schmidt said.

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