Skip navigation

Recent Knowledge on Soul Beat

Author: 
Angela Oyo-Ita
Xavier Bosch-Capblanch
Amanda Ross
Patrick Hanlon
Afiong Oku
Ekperonne Esu
Soter Ameh
Bisi Oduwole
Dachi Arikpo
Martin Meremikwu
Publication Date
Wednesday, July 1, 2020
Affiliation: 

University of Calabar (Oyo-Ita, Oku, Esu, Ameh, Meremikwu); Effective Health Care Alliance Program, Calabar (Oyo-Ita, Esu, Oduwole, Arikpo, Meremikwu); University of Basel (Bosch-Capblanch, Ross, Hanlon); Swiss Tropical and Public Health Institute (Bosch-Capblanch, Ross, Hanlon); Achievers University (Oduwole)

"Policymakers need to consider interventions that drive demand for vaccination to ensure optimal uptake of vaccination even among the possible resistant groups in the community."

A 2017 survey showed that only 21% of children 12 to 23 months of age are fully vaccinated in Nigeria. Several reasons contribute to low coverage, including poor parental knowledge and attitudes. In Nigeria, previous studies have shown that engaging traditional and religious leaders (TRLs) as agents of change to tackle misguided parental norms about polio vaccination improved uptake. TRLs are respected in their communities as opinion-shapers and guides in religious, social, and family life. This study, funded by the International Initiative for Impact Evaluation (3Ie), evaluated a multi-component intervention that involved training TRLs to engage communities in the planning, implementation, and monitoring of immunisation services in Cross River State, Nigeria.

  <div class="field button"><a href="https://www.3ieimpact.org/sites/default/files/2020-07/TW10.1073-Nigeria-TRL.pdf" target="_blank">Click here for the 53-page report in PDF format.</a></div>
Contacts (user reference): 
Source: 

3ie website, July 24 2020; and email from Angela Oyo-Ita to The Communication Initiative on July 26 2020. Image credit: World Health Organization (WHO) Nigeria

read more

Length: 
89'49"
Year of Production: 
Thursday, July 30, 2020

"As rumours and misinformation around vaccination and vaccine trials have become increasingly challenging, listening to communities and online conversations to detect and mitigate rumours with a risk of disrupting vaccine trials is key. This is particularly important in the context of COVID-19..."

Part of a Vaccine Confidence Project (VCP) webinar series, taking place in July and September 2020, this video provides an overview of the VCP framework for detecting and mitigating rumours around vaccine trials, with guidance on community management of rumours (using the example of the Ebola vaccine trials) and social media monitoring to listen to public sentiments, beliefs, and concerns around vaccination.

Contacts (user reference): 
Source: 

Emails from The Vaccine Confidence Project to The Communication Initiative on July 15 2020 and July 29 2020.

read more

Publication Date
Sunday, December 1, 2019

From Nigeria's National Primary Health Care Development Agency (NPHCDA), this report presents the context and status of polio eradication efforts in the country - outlining remaining challenges for focus in 2020, as well as goals, targets, milestones, and strategic priorities. The below summary focuses on the communication elements of the 2020 Nigeria Polio Eradication Emergency Plan (NPEEP).

  <div class="field button"><a href="http://polioeradication.org/wp-content/uploads/2020/06/Nigeria-NPEEP-Jan-2020.pdf" target="_blank">Click here for the 94-page report in PDF format.</a></div>
Contacts (user reference): 
Source: 

Image credit: Global Polio Eradication Initiative (GPEI)

read more

Author: 
Seyi Samson Enitan
Adesola Oyekunle Oyekale
Richard Yomi Akele
Kayode Abraham Olawuyi
Elisha Oluwatobi Olabisi
Amarachi Joy Nwankiti
Esther Ngozi Adejumo
Comfort Bosede Enitan
Publication Date
Sunday, July 12, 2020
Affiliation: 

Babcock University, Ilishan-Remo, Nigeria (S.S. Enitan, E.N. Adejumo); Ladoke Akintola University of Technology, Oshogbo, Nigeria (A.O. Oyekale, E.O. Olabisi); Afe Babalola University, Ado-Ekiti, Nigeria (R.Y. Akele); National Veterinary Research Institute, Vom, Nigeria (K.A. Olawuyi); Federal College of Veterinary and Medical Laboratory Technology, Vom, Nigeria (A.J. Nwankiti); Igbinedion University Teaching Hospital, Okada, Nigeria (C.B. Enitan)

"Sentiment for the anti-vaccine movement will continue to grow if public-health authorities failed to inspire confidence in the vaccine trial process."

  <div class="field button"><a href="https://www.researchgate.net/profile/Samson_Enitan3/publication/342945709_Assessment_of_Knowledge_Perception_and_Readiness_of_Nigerians_to_Participate_in_the_COVID-19_Vaccine_Trial/links/5f0eb16892851c1eff11d598/Assessment-of-Knowledge-Perception-and-Readiness-of-Nigerians-to-Participate-in-the-COVID-19-Vaccine-Trial.pdf" target="_blank">Click here for the 14-page paper in PDF format.</a></div>
Contacts (user reference): 
Source: 

International Journal of Vaccines and Immunization, Vol. 4, Issue 1. DOI: 10.16966/2470-9948.123. Image credit: NCDC

read more

Launched by Girl Effect in June 2020, Hear Her Voice is a research project giving 25 girls in 5 countries (Bangladesh, India, Malawi, Nigeria, and the United States) a platform to report on their experiences of life in COVID-19-related lockdown via digital diaries. Hearing their own voices is a tool for putting them at the centre of the pandemic response.

Communication Strategies: 

As part of the participatory research project, young women aged 18-24 are empowered and trained using a mobile app to become Market Research Society (MRS)-qualified researchers and Technology Enabled Girl Ambassadors (TEGAs). Face-to-face research is on pause due to COVID-19, so TEGAs turned the cameras on themselves to create weekly digital diaries. Girl Effect's girl-operated digital research tool (the TEGA app) allows girls to collect close-to-real-time insights into the lives of their peers. Co-created with girls, TEGA technology can operate in places with poor network connection. It has translation capabilities, data encryption, and emergency response to ensure the safety and data protection of all participants. Through the app, TEGAs conduct a range of different research methods:

  • Formative research: TEGAs can conduct interviews, revealing candid information to help understand issues or inform programme and product design;
  • Concept and creative testing: TEGAs can capture reactions and feedback insights into the design process, which allows for programmes to be adapted in real time; and
  • Monitoring and evaluation (M&E): TEGAs can collect qualitative and quantitative data, putting them in a position to regularly provide insights to improve the quality of programmes.

This approach is designed to unlock the open and honest conversations that might otherwise be lost or not included when collecting data in traditional ways, enabling the complexities of a girl's life to be viewed in real time through her peers. The data gathered through this process are shared on the Hear Her Voice website, which is updated on a regular basis with video clips, articles, and films, telling the human stories behind the headlines during this pandemic. Themes include: livelihoods, money, and skills; education and learning; information, myths, and stigma; mobile and technologies; health; and COVID-19 response.

One set of insights from the TEGAs on all 3 continents relates to the importance of information and communication technologies (ICTs) during this time. They said access to a mobile phone and data had become essential to them during lockdown for accessing online education, beating isolation, and gathering information about COVID-19. However, many TEGAs also reported spending too much time on social media, struggling with online learning, and assessing the accuracy of COVID-19 information spread via social media or WhatsApp groups. And the ability to get the most out of their devices is predicated on girls' access to data and having a good-quality smartphone. In India, for example, girls face financial and logistical barriers to accessing data. Many girls do not have their own device; sharing a phone can be stigmatised by parents.

The insights are being used to design interventions to meet girls short- and long-term needs. For example, based on the India findings about girls' desire for reliable information, Girl Effect created youth-friendly COVID-19 content for their youth brand Chhaa Jaa, which reaches millions of Indian girls through its social media channels. Specifically, Hear Her Voice data showed that girls in India were struggling to access sanitary pads because of limited mobility during lockdown. Organisers thus honed Chhaa Jaa to digitally connect girls to sexual and reproductive health (SRH) services such as helplines, apps, and online doc consultation services, including trialling home delivery of contraception and sanitary pads. Girl Effect also ran a campaign during Menstrual Hygiene Week in May 2020 to encourage girls to talk openly about menstruation.

According to Girl Effect, safeguarding girls' online privacy is a challenge during strict lockdowns, when supportive services are not available and women and girls face additional risks. Organisers also had to ensure they gained truly informed consent from the TEGAs because these findings are being shared so publicly (though pseudonyms are used). Risk assessments and service mapping helped pinpoint what services could support TEGAs if they needed assistance. Girl Effect used their recruitment app, a tool developed to gather informed consent, digitally and remotely, that works by using audio files in local languages to explain how data will be used. The TEGAs then respond to multiple-choice questions to ensure full comprehension. The TEGAs also consented to each individual video on the microsite and all the footage in the films. Finally, organisers carry out briefings via WhatsApp and check in to make sure the TEGAs are happy, healthy, and keen to keep contributing at regular intervals.

Development Issues: 

Girls, Health, Technology

Key Points: 

Beyond the threat of the coronavirus itself, girls and women face a heightened risk of gender-based violence, economic stress, and a lack of access to education, health care, and SRH services. There is a risk that hard-won gains for girls could slip backwards as a result of the pandemic. Yet, according to Girl Effect, despite immense coverage of COVID-19, there is a lack of data and understanding about girls' experiences under lockdown. Rarely do we hear about girls' lives from the perspective of girls themselves. Without the inclusion of girls' perspectives, solutions to support them during this crisis - both short and longer term - won't be as effective as they could be.

Contacts (user reference): 
See video
Source: 

"The Power of Technology for Girls in COVID-19 Digital Response", by the Girl Effect team (Sneha Chaturvedi, Aparna Raj, and Isabel Quilter), ICTWorks, August 5 2020; Hear Her Voice website; and TEGA page on the Girl Effect website - all accessed on August 5 2020. Image credit: Girl Effect via Twitter

Length: 
97'17"
Year of Production: 
Wednesday, July 22, 2020

"...keeping our finger on the pulse and talking with with people listening to what their sentiments are will be important as we plan out our preparedness moving forward..." - Heidi Larson, Director of the Vaccine Confidence Project (VCP), London School of Hygiene & Tropical Medicine (LSHTM)

Contacts (user reference): 
Source: 

Emails from The Vaccine Confidence Project to The Communication Initiative on July 15 2020 and July 29 2020.

read more

Publication Date
Monday, June 1, 2020

"[P]ositive father involvement and participation is associated with improved outcomes for all family members."

  <div class="field button"><a href="https://heartlines.org.za/wp-content/uploads/2020/06/fathers-matter-spreads-low-res.pdf" 0="s:6:&quot;a:0:{}&quot;;" target="_blank">Click here for the 70-page report in PDF format.</a></div>
Contacts (user reference): 
Source: 

Heartlines website, July 20 2020; and email from Latasha Slavin to The Communication Initiative on July 21 2020. Image credit: Heartlines

read more

Author: 
Christer L. Pettersson
Nigussu Solomon
Publication Date
Monday, April 1, 2019
Affiliation: 

Fojo Media Institute

"Social media is the dark horse. Social media has, in a few years, turned the political landscape in Ethiopia on its head not only as a means of mobilising people, but also as a means of spreading rumours, hate speech and disinformation."

This report, written from a journalism and freedom of speech perspective, is intended to be an introduction to the many issues and aspects related to how social media influences sustainable, independent news publishing, freedom of speech, and growth of democracy in Ethiopia. It offers a mapping of where media and social media are at in the country, against the backdrop of intensified local and international debate and actions that seek to come to terms with social media platforms, including their use by undisclosed political forces. The report, published by Fojo Media Institute, forms part of the "Media Reform in a Time of Change - Promoting Journalism and Democracy" programme.

  <div class="field button"><a href="http://media.fojo.nu/2019/04/Ethiopia_Social_media_in_Ethiopia.pdf" target="_blank">Click here to download the 29-page report in PDF format.</a></div>
Contacts (user reference): 
Source: 

Fojo: Media Institute website on July 27 2020. Image credit: Michael Tewelde

read more

Author: 
Abdu A. Adamu
Rabiu I. Jalo
Desire Habonimana
Charles S. Wiysonge
Publication Date
Wednesday, June 24, 2020
Affiliation: 

South African Medical Research Council (Adamu, Wiysonge); Stellenbosch University (Adamu, Wiysonge); Bayero University/Aminu Kano Teaching Hospital (Jalo); University of Burundi (Habonimana); University of Cape Town (Wiysonge)

One of the routine health services that is being disrupted by COVID-19 is childhood immunisation. Africa is of particular concern because the performance of immunisation programmes on the continent even in the pre-COVID-19 era was largely sub-optimal. Nigeria and South Africa are among the countries that are expected to have the highest numbers of COVID-19 cases, and the diphtheria-tetanus-pertussis-containing vaccine (DTP3) coverage level in these countries was reported to be 57% and 74%, respectively, in 2019. In this worrisome context, this article is premised on the belief that, instead of studying individual components of the immunisation system (e.g., vaccine supply and logistics), a systems-based approach that conceptualises all components of the system as interrelated entities should be adopted.

  <div class="field button"><a href="https://www.sciencedirect.com/science/article/pii/S1201971220305075" target="_blank">Click here to read the article online or to download it in PDF format (5 pages).</a></div>
Contacts (user reference): 
Source: 

International Journal of Infectious Diseases, Volume 98, September 2020, Pages 161-65. https://doi.org/10.1016/j.ijid.2020.06.072

read more

"How might we empower caregivers to seek and fully utilize immunization services in their communities?"

Through the Empowering Caregivers in Immunization Challenge, launched in 2019, IDEO, IDEO.org, and the Gates Foundation convened nearly 20,000 changemakers from over 120 countries around the world in an effort to support the adherence to immunisations within portions of East Africa that have not yet reached equity in access or distribution. The focus is on demand: "the actions of individuals and communities to seek, support and/or advocate for vaccines and vaccination services." As part of the Challenge, changemakers explored the current state of vaccine innovation in global public health, why caregivers play such an important role in the system, and which lenses might help most effectively understand and design for solutions.

Communication Strategies: 

In the context of immunisation programmes, "demand generation" means ensuring that caregivers, communities, and other key stakeholders value immunisation, find it a safe and effective practice, feel confident in the reliability of services and provision systems, and are aware and motivated enough to seek immunisation services. The Challenge focused on caregivers as a window into immunisation as part of a strategy for shifting the mindset toward "customer"-centric thinking (within a space that has largely been oriented toward suppliers and delivery approaches) and for exploring the nuances of demand through a human lens: understanding the current immunisation experience and why so many new solutions are needed.

Specifically, in the Challenge, organisers looked for solutions that: clearly articulated an answer to the challenge question (above), addressed a problem that is pressing and real by articulating the gap this idea is filling, and were new or in early stages but are related to the core competencies of an organisation. Thirty-two shortlisted concepts received feedback from the Gates Foundation and additional expert stakeholders in the vaccine innovation space. Then, US$50K in prize funds were awarded to 5 Top Ideas, with 5 additional teams receiving Honorable Mention.

Specifically, organisers focused on supporting the top of the innovation funnel, testing an experimental support model with a small set of 5 organisations, in service of understanding what it would eventually take to offer right-sized support to a larger cohort of early innovators. They recommend the following characteristics to prioritise in funnel design:

  • Deep understanding of context and contextual challenges;
  • Prioritising measurement of team and leadership capacity, rather than just the innovation;
  • Leveraging models that are accessible to low-bandwidth, low-accessibility contexts; and
  • Providing support from a programmatic team.

Thus, following the Challenge, 5 promising innovations were invited to join the IDEO Immunization Innovation Lab. Founded on the belief that people's experiences, perceptions, and preferences are critical to bringing about the behaviour change needed to bridge the immunisation gap, the 5-month accelerator programme took a human-centred approach to shift health ecosystems in the region - with an eye towards scaling support for future cohorts of public health changemakers in the East African region and beyond. Thus, in the first few months of 2020, each team was paired with one-on-one customised coaching and design support from industry leaders, meant to accelerate impact throughout the programme and after. Then, shared learning across the cohort was designed in response to the overlapping needs and growth goals identified for each organisation. Activities included working sessions and advising on best practices in health programme design, business design, and planning.

After the 5-month accelerator period, the programme supported implementation of the projects in East Africa via additional funding, mentorship coaching, and design collaboration.

Winning teams, with brief summaries of their work, include:

  1. Mama Chanjo - Masaai caregiver champion programme, Moita Kiloriti, Tanzania - Mama Chanjo set out to increase community and caregiver knowledge, attitudes, and intentions to vaccinate their babies by reinforcing social norms for immunisation and by strengthening communication between pastoralist mothers and fathers in Tanzania's Maasai communities. They did this by empowering Maasai mothers and their communities to become a part of the solution for immunisation uptake and improved maternal/baby health in their communities. The team worked with young Maasai mothers who were especially adherent to immunisation schedules to teach other mothers in the community about the importance of vaccines and maternal health. Specifically, they trained 10 MamaBaba Chanjos, each champion training 35 caregivers. In total, 140 new mothers, 120 pregnant mothers, and 90 fathers were reached, resulting in 140 children starting their immunisation journey. It is hoped that the impact will have a ripple effect in communities as others are mobilised, including grandmothers, mothers, fathers, traditional community leaders, teachers, and health workers. Throughout the process, Mama Chanjo worked to build partnerships within the Tanzania health ecosystem to begin to grow and scale their work.
  2. BIC Shanti - Empowering teen mothers, Luwero, Uganda - The Shanti Birth House, operated by Budondo Intercultural Center, is focused on improving maternal and infant health in Uganda. The project funded through this programme is specifically focused on increasing immunisation uptake for teen moms in Luwero. The team is doing this through a two-pronged approach: (i) implementing an education and awareness campaign for young mothers and their partners, and leveraging community health champions; and (ii) tackling some of the root causes they have identified for young mothers by providing holistic care and opportunities for economic empowerment in partnership with local governments. Completed design research and prototyping resulted in registering and onboarding 25 community health workers (CHWs) from 8 villages who are conducting home visits to ensure that all children get fully immunised and that teen mothers have access to accurate information on immunisation. Three teen mom groups of 30 members each were organised and provided with livelihoods support. These efforts resulted in providing information to 334 teen moms and partners, and connected 375 teen moms to CHWs. BIC Shanti formalised their relationship with district ministries and brought on a partner organisation to support economic empowerment of caregivers as an incentive.
  3. STAMP - Community-led caregiver reward system, Kiambu and Nairobi, Kenya - STAMP CLEANTECH created a royalty rewards programme in an effort to strengthen community-owned immunisation advocacy processes. The organisation reaches out to children aged 0-12 months and their caregivers by addressing barriers to immunisation uptake due to lack of accessible, trusted health information in Kiambu and Nairobi, especially during the COVID-19 pandemic. Over the course of the programme, they piloted in 4 communities, trained and onboarded 4 volunteer doctors, and reached 323 children during their initial pilot phase, in addition to on-boarding an additional 200 caregivers registered not included in the initial pilot.
  4. OGOW EMR - Electronic registry app for caregivers and clinicians, Somalia - OGOW EMR created a desktop and mobile app for medical records, inventory management, and caregiver immunisation data that provides a digital copy of child immunisation records and includes a calendar schedule for adherence, educational materials, and Q&A functionality in Somali and English. OGOW's customised portal and dashboard is designed to enable strategic and effective use of quantitative and qualitative data to monitor, learn, and communicate health surveillance metrics. The teams now partner with World Vision to help run COVID-19 awareness campaigns in Somali, endorsed by the Federal Ministry of Health. They are working alongside community champions to increase local education and uptake. In addition, they partnered with SomRep, a consortium of 7 international agencies that adopted the OGOW EMR app to reach over 45,000 pastoralists across 45 villages with COVID-19 risk communication and community engagement (RCCE) interventions.
  5. Preventive Care International (PCI) - Male champion programme, Mukono, Uganda - Piloting in 3 under-immunised communities (urban, rural, and island) in Uganda's Mukono district, the PCI team trained and activated male champions to educate community members about immunisation through the use of mobilisation trackers, board games, and family events featuring sports and games. These male champions are working to change the perception that "immunisation is a woman's issue" and are creating community ownership over child healthcare. They connected with 2,000+ caregivers and continue to strengthen their partnerships within the health systems in all 3 pilot communities. In response to COVID-19, PCI updated their education materials to sensitise champions regarding prevention methods and increased community outreach to promote social distancing.

In terms of evaluating impact within an acceleration model of this nature, organisers learned that co-creating metrics and evaluation processes with teams up front saved time and effort for everyone in the long run. This process also encouraged team buy-in and autonomy in the monitoring and evaluation process, from the start. For most of the 5 organisations, the outcomes of programme inputs will continue to evolve far past the close of organisers' engagement with them. "Foremost, in the ecosystem of demand generation - measuring impact against an immunization schedule requires patience and necessitates a longer timeline (18 months for completion of DPT-3 [Diphtheria-tetanus-pertussis], for example) as we consider caregiver and child influence based on a recently introduced innovation. A few additional aspects influencing this longtail: organiztional capacity to absorb and incorporate new ways of working, design and resource constraints within community contexts and access to consistent capital and guidance for continued implementation."

Development Issues: 

Immunisation and Vaccines.

Key Points: 

World Health Organization (WHO) data show that globally, 1 in 10 infants does not receive all their vaccines - mostly in the world's economically poorest and most historically under-invested communities. Despite many organisations focusing their efforts and resources on this issue, meeting the needs of un/under immunised children and caregivers remains a pressing challenge.

Access more information on and resources from this project:

  • Immunization Innovation Lab: East Africa - Accelerating Demand Generation [PDF, 89 pages, July 15 2020] - features more details about the projects, process, impact, learnings, experiments, and pivots. One overall insight is that building human-centred design capacity not only helped teams advance their product/service, but also increased their resiliency and capacity to pivot in the face of unexpected challenges. For example, STAMP learned to streamline systems to allow for adaptability: "Government directives on COVID-19 have greatly affected the household visits, congregating for caregivers for training on vaccines and interaction with Doctors. This affected the project since we had just started winning trust with caregivers and disrupted our initial plan. The team went back to the drawing board and started using WhatsApp and Zoom to discuss project and implement the same. CHVs [community health volunteers] had to be re-trained on virtual training and support to caregivers and Doctors hour shifted to virtual platform. The challenge has enabled a 24 /7 interaction between caregivers, doctors, and project staff."
  • See these additional resources related to the challenge.
Partner Text: 

The Bill and Melinda Gates Foundation, OpenIDEO, and IDEO.org.

Contacts (user reference): 
See video
Source: 

OpenIDEO website and Immunization Innovation Lab: East Africa - Accelerating Demand Generation" [PDF, July 15 2020] - both accessed on July 17 2020. Image credit: STAMP via IDEO

Research Methodologies