Literacy Bridge
A report from the field by Literacy Bridge Country Director Andy Baylor
The purpose of our maternal and child health programme is to significantly decrease the number of preventable deaths through the Talking Book with actionable, on-demand recordings from health experts and community leaders on safe birthing practices and steps to avert illnesses, like diarrhea, and malaria.
The programme seeks to improve the health of 24,000 pregnant women, mothers of neonatal children and mothers of children under the age of five in 75 low-literate communities across rural Ghana. The goal of this programme is to maximize the number of positive health behaviours adopted by making relevant health information readily available to them.
In July 2011, I introduced the programme to the officers in the Wa and Jirapa districts of the Ghana Health Service. They were delighted to learn about it, and said that it was a program that would greatly complement their efforts in reaching out to rural communities.
In August, I worked with directors of Ghana Health Service in Lawra, Jirapa and Wa districts to determine the information that they wanted to convey to help pregnant women, mothers, and their families in order to effect behaviour change. The directors developed messages on five key topics: exclusive breastfeeding for the first six months after delivery, delivery with a skilled birth attendant, use of treated insecticides bed nets, hand washing with soap and oral rehydration therapy. The messages were then recorded into the Talking Book for use in the programme.
In September, the programme was officially launched. I worked with Ghana Health Service in each district to produce a list of 40 communities based on the need of access to health information, availability of community health centers, and distance to the nearest health facility. From those 40 communities, 20 would be randomly selected to receive the Talking Book program and 20 would be used as a control group.
We conducted formative research in four communities. We verified the population of the communities, whether the community had access to health information, and we documented the antenatal and postnatal activities of women in our target population. The formative research information was made available to the Wa and Jirapa district health officers necessitating some slight changes in messages. The formative research showed that the communities had similar low literacy levels and access to health information. Also, during the same time we wanted to establish a baseline survey with which we could then measure the outcome of the maternal and child health programme.
In October, we began Phase I of the maternal and child health programme in two of the four formative research communities with lots of health messages created on the five key topics. The essence of Phase I was to learn as much as possible before expanding to the rest of the communities.
We have learnt so many things about the best methods of distributing Talking Books in a group setting so that the messages can heard by the majority of the people. We have learnt so many things that could work very well and those that we need to be careful with in Phase II. For example we realised that we needed two people each from each group to be trained on the use of the Talking Book, and these two people should not be the leaders of the group because there were issues of conflict of interest. We also learnt so many other helpful things about groups that I know would be beneficial in Phase II. The questions that women were asking indicated that the Talking Book was helping them learn things they previously did not feel could be harmful to their children or during their pregnancies.
The last time I was in Dapuaha, one of the formative research communities, I could hear children singing songs that were used as teaching messages in the Talking Books. It was awesome!
participants at a user training session
In November, Fidelis and I began visiting the communities to familiarize ourselves with the locations, the communities , and to interact them. We also have plans to organize some youths in the communities to train in January as volunteers and community contacts.
Right now, we are continuing to learn as much as we can about these communities. We have also finished the baseline survey questions for Phase II, which will be reviewed by experts. Once we have the survey questions completed, we will be conducting surveys in all the communities. There is a lot of work to be done but the end results are saving the lives of women and their children.