Last April, Amplio and Ghana Health Service used Talking Books to rapidly launch a COVID-19 awareness campaign in eight vulnerably districts in the Upper West Region. UNICEF provided the loan of their Talking Books. Our Ghana team worked with district health experts to record and produce local language COVID-19 audio messages to load onto Talking Books and then distributed the devices to 207 CHPS compounds and five community health volunteers (CHVs) per district. Community health nurses played Talking Book messages during antenatal care visits and at child wellness clinics. CHVs played messages during household visits.

The team also connected Talking Books to battery-powered outdoor speakers to broadcast COVID-19 messages in the markets and lorry stations. With Talking Books, GHS reached over 200,000 people with timely and accurate COVID-19 information.

”The Talking Book can deliver our health advice at the time of day when most people are home. With the radio, one may miss out. Also, the Talking Book plays the same message consistently, and I believe this consistency is an advantage.” —Dr. Bernard Ziem, Lawra Municipal Health Director, Ghana Health Service

Delivering timely and accurate health information

Amplio Ghana deployed three sets of messages, with content in four local dialects. The first deployment included covered coronavirus symptoms, treatment, and prevention, as well as meningitis information due to an outbreak in the region. Content included endorsements from health directors and traditional leaders. The second and third deployments addressed COVID-19 stigmatization and an increase in domestic violence, emerging issues identified by the team and local monitoring and evaluation (M&E) assistants. 

Each deployment included contact information for Ghana Health Service.

Usage statistics and household survey findings

To promote action learning, the team reviewed Talking Book usage statistics and worked with M&E staff to lead community dialogues. They also conducted a household survey in July and August at the project midway point. These activities all took place over the phone or in person with social distancing guidelines.

Usage statistics revealed that endorsement messages were the most played. Community health workers explained that people were scared and unsure about what to do. Messages from local leaders helped build trust and combat misinformation. Other popular messages included dramas on how to talk to children about COVID-19 and welcoming a COVID-19 survivor back into the community. The graph below shows a sample of COVID-19 topics with usage data for the number of times messages were played to completion.

 

Graph of COVID-19 topics and number of message completions

Survey respondents cited their top sources of COVID-19 information as radio (89%) and Talking Books (44.3%). However, not everyone has radios. Respondents reflected that Talking Books helped the most vulnerable community members gain access to important messaging. 

The survey also found evidence of COVID-19 stigmatization. Most community members were fearful of someone who had recovered from COVID-19, as well as going to the hospital for treatment. These findings informed the development of additional messages.

Through monitoring the team recognized a strain on Ghana Health Services. In rural districts, GHS typically sees a high turnover of community health workers. But turnover was even higher due to COVID-19. To build capacity for health education, the team ran Talking Book refresher trainings.

Endorsements and CHPS program expansion

GHS had positive feedback on use of the Talking Book to reach rural communities with timely and accurate local language messages during the pandemic. Community health nurses said the Talking Book helped them share important COVID-19 messages while they were providing direct services. CHVs said the Talking Book gave them more authority within their communities, leading to greater trust and engagement. 

When the COVID-19 awareness campaign came to an end in December, district health directors asked to expand the program. They want to use Talking Books to support other health promotion and health education priorities, including cancer, family planning, immunizations, and adolescent sexual and reproductive health.

In 2021, Amplio Ghana will partner with GHS and UNICEF to implement a Talking Book project at 27 CHPS compounds and 20 mobile medical clinics in Jirapa District. The initiative builds on a successful CHPS pilot project conducted in 2019. 

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