Mobile Health (mHealth) Messaging to Facilitate Handwashing with Soap Behavior Change

On February 7th, 2019, the Global Handwashing Partnership, in conjunction with USAID and the Johns Hopkins Bloomberg School of Public Health, hosted a webinar discussion on the development and randomized controlled trial of a water, sanitation and hygiene (WASH) mobile health program in Dhaka, Bangladesh.

The Cholera Hospital-Based Intervention for 7 days (CHoBI7) mobile health program was developed to target the following key behaviors during the 7-day high risk period and to sustain these behaviors over time: increased handwashing with soap at stool and food related events, water treatment with chlorine tablets, and storage of household drinking water in a water vessel with a lid.

Mobile messaging was delivered in Bangla over a 12-month period, through voice and text messaging on the Viamo platform. The mobile messages were designed around the character of a Medical Doctor from the iccdr,b Hospital, Dr. Chobi. In the voice messages, she has discussions with a female peer role model, and a male peer role model, around key WASH behaviors promoted. Text messages were found during the formative research to complement voice messages by serving as important reminder that could be shared with others.

Source: Global Handwashing Partnership

Date of Publication: November 17, 2021

Modern Kitchen Campaign, Bangladesh

The Clean Cooking Alliance (Alliance), government agency SREDA, Social Marketing Company and Purplewood implemented a campaign, between 2016 to 2019, for promoting clean cooking products in Bangladesh. The campaign aimed at increasing awareness and adoption of clean (energy-efficient and low emission) cookstoves and clean fuels like LP gas, wood pellets. The campaign also promoted a retained heat cooker, piloted by GIZ Bangladesh.

The campaign aimed to expand the stove-continuum to accommodate improved cookstoves and efficient fuels e.g. LPG, wood pellets. All thirteen products were brought under a category-brand, styled ‘Modern Kitchen’. The big idea was, “Times have changed, change your kitchen.” A social norming approach was also adopted, showing that forward thinking households were upgrading their kitchens, and minding the health of the cook (usually the female household head).

The campaign used radio, print, billboards, rickshaw branding, interpersonal communications (IPC), community-theater, movie-screenings, and fairs. Also used were bulk SMS, helpline and geo-targeted Facebook marketing. All materials were pre-tested in the field and fine-tuned before deployment. In each case, usage situations of clean cooking products were highlighted.

The key pitch was a soap-opera style, over-the-top family drama, screened outdoors. In the story, a flamboyant man realizes that – despite his clothes and gadgets – his meek older brother is more modern; because a truly modern man protects his home and family. Multiple product usage and maintenance videos were produced. To create hype, ‘kitchen makeover’ activities were carried out in 16 locations.

For women, the campaign went into playgrounds and yards. In the street theater performance, the heroine was a young ‘Modern’ new-bride who tries to clean up her in-laws’ kitchen. A TV celebrity endorsed HAP messaging, and starred in a mock Teleshopping Program about stoves. Outreach workers carried videos and materials to households and conducted IPC sessions.

Over 300 days of SBCC activities reached an estimated 1.6 million unique individuals. Online video views totalled 550,000. Final evaluation, carried out by Berkeley Air Monitoring Group, showed a ~40% increase in brand awareness. Nearly 15000 units of clean stoves and fuels were sold during the campaign period.

Source: Purplewood Limited

Date of Publication: November 16, 2021

Job Aid: Diagnosis of Obstetric Fistula

This is a checklist-type job aid for health professionals to use when a woman presents with leakage of urine at a primary health center. The yes/no flowchart guides the health care worker through a series of questions to determine if the diagnosis is indeed obstetric fistula. If it is, there is a list of recommendations to prepare the patient for repair surgery.

Source: EngenderHealth

Date of Publication: November 16, 2021

Schistosomiasis (“Bilharzia”) Monitoring in Uganda, Round 1 October–December 2016

Performance Monitoring and Accountability 2020 Schistosomiasis (PMA Schisto) was a research module created specifically for Uganda, to develop the first nationally representative prevalence rate of Schistosomiasis, a highly endemic and neglected parasitic disease.

The first round of PMA Schisto was implemented by Makerere University School of Public Health in Kampala, in partnership with the Uganda Bureau of Statistics (UBOS), the Uganda Ministry of Health’s Vector Control Division and the Schistosomiasis Control Initiative. Overall direction and support was provided by the Johns Hopkins University Water Institute and the Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins School of Public Health

Source: Uganda Ministry of Health

Date of Publication: November 10, 2021

What do Pineapples Have to do with Teens and Contraceptives?

The pineapple is the mascot for Tanzania’s Kuwa Mjanja (Be Smart) movement, carried out by PSI’s Adolescents 360 Project (A360). The Adolescents 360 project is working to revolutionize the way adolescent girls access contraceptives in Tanzania, Nigeria, and Ethiopia. The pineapple was chosen as the mascot because “they stand tall—they are proud! They wear a crown, like a queen who knows her worth and demands respect. And even though they are tough on the outside, they are beautiful and sweet on the inside.”

Through the program’s human-centered research, the team discovered that that many girls don’t recognize themselves as “sexually active” unless they are married and, even if they do relate to that term, they don’t think they are going to get pregnant now.

Kuwa Mjanja, a brand deeply rooted in Tanzanian culture and puberty rituals, is about growing up strong and smart. A key part of the program is making contraceptives relevant to adolescent girls right now. Kuwa Mjanja brings the benefit of contraceptives into a girl’s present by positioning contraceptives as “the first step to making your life your own.” The program promotes contraceptives as a useful tool for girls who dream of a better future. It reassures girls that when they are ready to have the children they dream of, their fertility will be waiting for them. It sends the message to girls who already have children that their destinies are not fixed and their lives are not over.

Source: PSI

Date of Publication: November 9, 2021

Project m-Maitri: Interactive Voice Response (IVR) for Parent-to-Child Transmission

In 2016, Solidarity and Action Against the HIV Infection in India began a partnership with Janssen Global Public Health, an initiative of the Janssen Pharmaceutical Companies of Johnson & Johnson. The initiative, named m-Maitri, aimed to complement on-the-ground efforts at ensuring retention in the prevention of parent-to-child transmission cascade with interactive voice response (IVR) to consenting pregnant women and mother-baby pairs until the babies reach 18 months of age.

Messages commence in the antenatal period and until 18 months post-delivery. The service delivers customized messaging relevant to the woman’s stage of pregnancy and her infant’s development, and covers issues such as nutrition for mother and child, immunization, infections such as HIV, TB and malaria, anti-retroviral prophylaxis and treatment, safe delivery, early infant diagnosis and retention in care, and many other health behaviors. SAATHII’s technology partner in this initiative is Mahiti, and IVRS partner is IMIMobile.

A case study reveals more details about the program.

Source: SAATHI

Date of Publication: November 5, 2021

How to Use Chlorhexidine Job Aid

This one page job aid is an instructional sheet developed in pictorial format inorder to instruct healthworkers about how to apply CHX on the umbilical cords of newborns.

SI Research & Training Institute, Inc./Chlorhexidine Navi (Cord) Care Program Nepal (JSI/CNCP) is funded as a part of Saving Lives at Birth: A Grand Challenge for Development through USAID. Chlorhexidine for cord care is implemented both at health facility and community through out Nepal by September 2017.

Source: FHI 360, Permission taken from Nepal government

Date of Publication: November 5, 2021

Voices for Change

Voices for Change, V4C (Nigeria, 2013-2017) was a program which worked to strengthen the enabling environment for gender equality in Nigeria. The program targeted young women and men aged 16–25 years old and operated in four states in Nigeria: Enugu, Kaduna, Kano and Lagos. For some activities it operated at the federal level.

V4C is a unique example of a program applying social norms theory at scale and addressed the structural barriers to gender equality. In particular, it addressed discriminatory and harmful attitudes, behaviors and social norms. The three normative areas that V4C sought to change were women’s voice and leadership, women’s role in decision-making and violence against women and girls.

V4C was distinct from many other programs aiming to transform gender norms in placing communications and social marketing at its heart. A key reason for using a social marketing approach was to bring about change at scale.

The components of the approach to shifting discriminatory gender norms using social marketing were as follows:

  • Create a youth-focused brand: this allows you to talk to your audience in their own language, using music, fashion and media which appeal to them.
  • Place the audience at the center: it is essential to understand the lifestyles, aspirations and attitudes towards gender equality among your audience.
  • Promote the message in an attractive way: identify how gender equal behavior will benefit your audience and place these benefits at the heart of your communications. V4C promotes gender equality using messages around self-fulfilment, romantic relationships and career success, as well as human rights.
  • Use an integrated marketing strategy: make use of the full range of marketing tools to engage your audience.
  • Measure impact: ensure you have robust monitoring and evaluation systems including baseline and endline surveys to evaluate the effectiveness of your communications

Source: Voices for Change

Date of Publication: November 2, 2021

Family Planning Brochures

These brochures serve as a way of reinforcing information about family planning. They are distributed in Nigerian communities to remind community members of the benefits of birth spacing at all levels of society from the individual to the family and community level.

The brochures were designed to be state-specific with images that resonate with cultural and religious teachings in each state.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: November 2, 2021

Facts about Plague in California

This brochure shows areas of the state where plague is likely to be found in rodents and other animals, how to protect oneself, and how to recognize plague symptoms.

Source: California Department of Health

Date of Publication: November 2, 2021