Q&A: Reaching Media-Dark Communities for COVID-19 Response Webinar Follow-Up
Updated: Nov 25, 2021
Questions from Amplio’s April 23 webinar on using Talking Books for COVID-19 response in Ghana’s rural remote communities
On April 23, Amplio hosted a live webinar on our joint COVID-19 response campaign led by Literacy Bridge Ghana (LBG), in partnership with Ghana Health Services and UNICEF. Community health nurses and volunteers are using Talking Book to share messages on COVID-19 symptoms and prevention strategies during listening sessions at community health centers and through house-to-house sensitization. So far, the project has been rolled out in 207 CHPS zones in Upper West Region, near the Burkina Faso border.
The webinar generated many questions about the COVID-19 response project in Ghana and Talking Books in general. (You can watch the webinar video here.) Thank you to our thoughtful and engaged audience for participating!
GHANA CONTEXT AND LOGISTICS
It’s great that the Talking Book is reaching the dark-media communities. Why is the COVID-19 response concentrated in only the Upper West Region?
We focused the current intervention on the Upper West Region of Ghana because that area has high health burdens, critical sanitation and hygiene needs, and generally vulnerable populations. Importantly, it is on the border of Burkina Faso, which is facing a fast-growing humanitarian crisis. Strategically, we want to mitigate the risks of cross-border activities as much as possible. In the next phase of the intervention, we will scale to include the Northern Region, which has similarly vulnerable populations and borders Togo.
Is the Talking Book COVID-19 response also being used by CHPS and Community Health Workers in the Upper East Region of Ghana?
This intervention is not currently operating in the Upper East Region. In this intervention, the Talking Books are operated by Community Health Nurses during their regular antenatal and child health sessions. Community Health Volunteers are also equipped with the devices to use during their regular door-to-door outreach efforts. These were existing roles and structures through Ghana Health Services, and CHVs and CHWs have not taken on additional duties for this intervention. Rather, we have integrated the Talking Books into their regular duties to make COVID-19 messaging more effective.
LANGUAGES AND CONTENT
All the countries where the Talking Book is now implemented are English-speaking countries. Is it a strategic decision of the Amplio team?
One of the most valuable Talking Book benefits is that you can deliver content in local languages. The messages for each Talking Book program are locally developed by Amplio’s partners, with support from social and behavior change experts, communications consultants, and relevant stakeholders. It’s a best practice to test new messaging with target communities. Depending on the region, our partners often produce content in multiple languages.
Amplio currently has Talking Book partners in Niger, Kenya, Ghana, and Zambia, with upcoming projects in Ethiopia, Uganda, and Nepal.
Do you have a set of COVID-19 response messages in French?
We do not currently have COVID-19 messages in French. Thus far, the Talking Book COVID-19 response intervention is only being implemented in Ghana. The messages have been recorded in four local languages: Dagaare, Tumu Sissali, Lambussie Sissali, and Kasem. LBG has shared its content with community radio stations, Whatsapp groups, and other NGOs. Although it could be possible to translate and re-record the messages being used in Ghana, you would want to test them for relevance to your target community.
How do community members or health workers manage the amount of content and prioritize types of messages by themselves (e.g., COVID-19)?
Messages on the Talking Books are organized into categories (playlists). In order to keep navigation simple for users, there are only two levels of navigation: category title and messages within that category (there are no sub-categories). Furthermore, we recommend that there only be 3-5 messages per category, which helps to optimize navigability and usability. Our data shows that including more messages becomes ineffective for the user.
INTEGRATING TALKING BOOKS WITH OTHER COMMUNICATIONS CHANNELS
How does the success rate of Talking Books compare with other visual IEC materials? Have you done any studies on the comparative impact of social behavior change?
CBCC, Amplio’s affiliate in Kenya, integrated Talking Books into their social and behavior change strategy for USAID’s Afya Timiza project from 2018 to 2020. CBCC integrated Talking Books with other educational materials to train and support Community Health Volunteers to improve access to maternal and child health education and services in semi-nomadic pastoralist communities.
An impact evaluation compared health outcomes for three populations: a comparison community, a community supported by Afya Timiza training and visual educational materials, and a community supported by Afya Timiza’s training, visual education materials, and the Talking Book.
The evaluation found that programming areas that coupled print materials (flip books_ with the Talking Book saw significantly greater improvements. Key indicators examined were the number of new ANC visits (p<0.05) and the number of pregnant women completing 4 ANC visits (p<0.01).
These results supported our experience that Talking Books are able to offer another supportive learning modality and, in doing so, complement visual IEC materials. We want to conduct further impact evaluations and welcome conversations with potential partners interested in collaboration.
Can Amplio Talking Books be integrated with mobile phones?
Yes! Talking Book can be integrated into other social and behavior change communications approaches, such as community radio, SMS, IVR, and other IEC materials—in fact, we encourage it! For example, in 2019, Literacy Bridge Ghana used Talking Book messages to link communities to local language hotlines for vital information and counseling around sexual reproductive health and rights. Data from Talking Books and the hotline registers was analyzed, shared with stakeholders, and used to improve audio messaging and outreach approaches at the community level.
In the Government of Niger’s Smart Villages project, Talking Books are being used alongside SMS, interactive voice response, and video solutions to improve community outcomes around health, agriculture, and education.
DISABILITY AND INCLUSIVITY
How can we ensure that we do not leave out the differently-abled people, for example, the deaf and blind who cannot easily hear or see information easily?
The Talking Book’s icon-based user interface was designed in collaboration with low-literate users. Navigation icons are embossed with a dot to allow the visually impaired to use the device. Because it is an audio platform, the Talking Book is not designed to serve the hearing impaired. We would recommend integrating other communications and outreach channels to disseminate messaging and raise awareness among those populations.
We recognize that Talking Books will not always be the right communications approach for certain populations. Therefore, we work with partners to develop integrated strategies to get their messages out to all target populations.
Does the Talking Book use batteries, and is the battery type easy to access?
Talking Books can use either AA or D-cell batteries, depending on what is locally available. Battery life depends on the quality and size of the batteries. In our experience, a pair of locally available D-cell batteries allow approximately 8 to 12 hours of listening. A new version of the Talking Book that works with rechargeable batteries is currently in development.
Do you have problems with people removing the batteries to sell them?
We have not yet experienced the issue of people selling the batteries in any of our projects. Moreover, because the Talking Book is a dedicated device, our partners report that they have no problems with theft!
How is the sustainability of the Talking Book technology in terms of finance, technical, etc.?
Amplio prioritizes building local capacity so that partners and communities can manage their Talking Book program independently. We will be launching a new online learning platform and Community of Practice to help our customers and their implementing partners more efficiently and cost-effectively learn how to use our technology and share best practices.
Amplio and its affiliates can advise you on sustainability planning for your Talking Book program, including how to involve stakeholders and service providers in the process for greater impact.
What is the cost of the Talking Book?
Each Talking Book is $49, plus shipping costs, duties, and taxes (which vary by country). When purchasing Talking Books from affiliates in Kenya, Ghana, or Ethiopia, the price per device will vary slightly because shipping and duties have already been paid by those affiliates. Additionally, we charge a $3 monthly service fee per Talking Book during the first year of implementation. The fee covers training, analytics, and technical support services provided by Amplio.
In addition, Amplio and its affiliates offer a range of other services, such as M&E design and reporting, in-person training, program strategy consulting, and content development and production. Our affiliates in Ghana, Ethiopia, and Kenya provide social and behavior change (SBC) solutions across all sectors. They regularly partner with international and local organizations, as well as national and county governments.