Update on Maternal and Child Health Care

January 13th, 2012

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.

Microsoft Alumni Foundation 2011 Integral Fellows Award Celebration

December 3rd, 2011

Cliff Schmidt, along with Tricia and Jeff Raikes, Robbie Bach, and Bill and Melinda Gates, was a featured speaker at the Microsoft Alumni Foundation’s 2011 Integral Fellows Award Celebration. More than 500 Microsoft alumni and guests were in attendance to hear from Cliff about Literacy Bridge’s work this past year and why the Talking Book matters. Cliff received the Integral Fellows Award in 2010. The following is an excerpt from his speech.


Cliff walks to the stage with this song playing in the background.


Nice song, right? That was the “diarrhea song”.

The women who recorded it had fun with the song, but their words are quite serious: “diarrhea can kill your baby”.   In fact, it’s the 2nd leading cause of child deaths worldwide.

Today, mothers in West Africa are playing this song and accessing dozens of other health messages and audio interviews where they are learning how to prevent diarrhea by washing their hands with soap, and how to treat dehydration with a mixture of sugar, salt, and water.  If everyone had this knowledge, nearly 1 million lives could be saved each year.  These mothers now have access to this knowledge and much, much more.

My organization, Literacy Bridge, is delivering this type of life-saving knowledge in a form that doesn’t require literacy. We work with local partners around the world to create compelling audio recordings, which we then load into this “library of spoken knowledge” – a device we call the Talking Book.  People then use Talking Books to learn about and discuss these issues, and to record their own thoughts and feedback about the content.  Our goal is to create the most cost-effective learning platform for the poorest people on earth so that they can improve their health and productivity.

And here’s what an improvement in productivity looks like: This subsistence farmer, Braole Felix,  planted half of his corn crop with his traditional practices that he learned from his parents and grandparents. Here’s what that half looked like.





Then he planted the other half of his crop using what he learned from his Talking Book’s agriculture recordings of his crop.

The Talking Book that Felix is holding is powered by software. Taking a page from Bill Gates and Microsoft, we want our software to run on the best available hardware for the job.  But there’s currently a real gap in affordable and usable hardware for people living on $1/day who want to learn, but can’t read and don’t have electricity. So we filled that gap with the Talking Book….


Thank you to Microsoft, the Alumni Foundation, and many of you in this room for the opportunity to respond to Dr. Martin Luther King, Jr.’s question ‘What are you going to do for others?”  I truly hope there is a person or a cause that inspires you in the same way that Dr. King has moved me to do my part to help people in the most impoverished places on earth have access live-saving and life-changing knowledge.

Back by Popular Demand at Microsoft Alumni Foundation (MSAF) Celebration 2011

November 14th, 2011

Cliff Schmidt receiving the 2010 MSAF Integral Fellows Award from Bill and Melinda Gates

2010 Integral Fellows award winner Cliff Schmidt will be speaking at the MSAF 2011 Celebration, Wednesday, November 16, at the Bill & Melinda Gates Foundation. Keep checking back for updates.

Notes from the Field — Why Talking Book Matters

November 14th, 2011

Cliff Schmidt has been in Ghana since September 29, 2011 to kick off Literacy Bridge’s Integrated Health & Agriculture Program , along with Literacy Bridge team members: Ayva Larson, LB maternal/child health program manager ; Andrew Azaabanye Bayor, Ghana country director; Fidelis Da-Uri Awonodomo, Ghana program staff, and; Raymond Yeldidong Bayor, Ghana program staff. The team has been working with local experts to create child and maternal health messages, and meeting with chiefs and others in Ghanaian villages to begin implementing the Integrated Health & Agriculture Program.

Here is what Cliff wrote on October 5 —

We just lost water in our guest house in Jirapa. It was here an hour ago, but now it’s gone. And we all wish we could take showers.

The LB office in Wa is also where Andy often lives, and is where I have been sleeping when we were in Wa earlier in the week. It has no running water or toilet; just an outhouse with a hole in the ground.

I mention this because this reminds me that getting people to wash their hands with soap sounds simple until you think about how inconvenient it is when there is no running water, and when fresh buckets of water require a lot of effort and aren’t always where you want them to be. Ayva and I are at least lucky to have Purell to help, but that’s not an option for anyone else here.

My point is that, when people think about the five key health behaviors [including hand washing with soap, use of insectide treated bed nets and the use of oral rehydration therapy] that prevent maternal and under-five mortality and we are helping Ghana Health Service to promote , I hope they understand that it’s not that people are lazy or just need a simple message that might be delivered on the radio or in a cell phone SMS text. Instead, we need to make the best case we can through songs and expert interviews and peer endorsements and engaging quizzes to convince someone that they need to take much more effort than any of us have to do at home to keep their families healthy, and we have to engage community health leaders to be sure we do this the most efficient and effective way.

Clinton Global Initiative (CGI) 2011

October 28th, 2011

President Bill Clinton congratulates Cliff Schmidt on Literacy Bridge's CGI commitment

The CGI Annual Meeting offered an unparalleled opportunity to introduce Literacy Bridge to a worldwide audience. Among the many people who learned from Cliff Schmidt about Literacy Bridge’s work included President Bill Clinton, former Secretary of State Madeleine Albright, and actress/activist Geena Davis.

Each expressed strong interest in Literacy Bridge’s work along with a large number of people from all corners of the world. For example, President of the Rockefeller Foundation Judith Rodin said that she has been impressed with Literacy Bridge from the day that she was first introduced to its work as a member of the selection committee for the Microsoft Alumni Foundation Integral Fellows Awards. Cliff was chosen as one of three award winners in 2010. President Obasanjo, former President of Nigeria, was among several leaders who expressed a great deal of interest in getting the Talking Book Program into their countries.

Literacy Bridge’s CGI commitment attracted attention from CGI members, as well. The Health & Agriculture Communication for Women & Children Program was developed in response to the need for a comprehensive solution in global health and hunger. Utilizing an integrated, cost-effective communications strategy, the program incorporates critical health messages and farming best practices that help reduce maternal and child mortality.

Literacy Bridge Featured on BBC Radio and More

October 27th, 2011

BBC Radio

“[The Talking Book] is taking further what has been done with text messages for many years… and turning it into stuff that you can listen to on a device that is dedicated for this purpose and does it very well…There is a whole ecosystem around this…designed to make it as easy as possible for people to get information out as possible to people who would otherwise not have access to technology…who won’t necessarily be literate…This will prove to be incredibly valuable to people all over the place,” said BBC’s commentator Bill Thompson. These remarks and more followed Cliff Schmidt’s interview on the BBC radio program Click, which aired on October 25.  Here’s Cliff’s interview with Click’s host Gareth Mitchell.

TV

Cliff Schmidt was invited for a return visit to King TV’s New Day Northwest. Members of the Microsoft Alumni Foundation, along with Literacy Bridge staff and supporters, were in the studio audience when host Margaret Larson opened up the segment by calling Literacy Bridge’s Cliff Schmidt “…one our favorite guests.”  Thank you to Margaret Larson and the Microsoft Alumni Foundation, for making this TV appearance possible.

Microsoft Alumni Foundation Website

Featured news article on the Microsoft Alumni Foundation site –  Literacy Bridge founder honored to join Bill Clinton’s social- change task force by Monte Enbysk,a Microsoft alum (1999-2010) and a Bellevue-based editor and writer.

Launching the Integrated Health & Agriculture Program

October 26th, 2011

Shortly after the CGI Annual Meeting, the Literacy Bridge team met in Ghana to kick off the integrated health and agriculture program Health & Agriculture Communication for Women & Children. Literacy Bridge Maternal/Child Health program manager Ayva Larson chronicles her experience in Ghana in the following blog.

The community of Gozu is home to approximately 500 individuals, most of whom are subsistence farmers. The community has no electricity, no running water and almost no access to medical care. The nearest hospital is an hour down a bumpy, dirt road in the town of Jirapa. The community has no cars or trucks, and motorcycles are a rarity. It is in this community that Literacy Bridge launched the beginning of the Health & Agriculture Communication for Women & Children Program, a program designed to help reduce maternal and child mortality rates.

The program focuses on five key health messages identified by UNICEF and Ghana Health Services as having the greatest impact on reducing mortality rates in pregnant women and children under the age of five. These key health messages are:

  • Hand washing with soap.
  • Proper use of insecticide treated bed nets for pregnant women and small children.
  • Use of oral rehydration therapy for children with diarrhea.
  • Delivery with a skilled birth attendant.
  • Exclusive breastfeeding for the first six months of a child’s life.

Literacy Bridge added one additional message:

  • The best food combinations to create the most nutritious food for small children and pregnant women.

During our time in Ghana, Literacy Bridge staff met with health officials, agriculture ministers and other development agencies to determine how to best create content around these key subjects. The result was interviews, songs and simple messages created to engage community members in low-literate, rural communities in the Upper West of Ghana.

Gozu was the first community Literacy Bridge approached, and the first community to provide essential feedback to our staff. When we first visited the community the sun was beginning to set, and a small group of men were sitting on wooden benches by the road. We first approached the group to ask for an audience with the Chief. When he arrived, we described the program to the Chief, demonstrated a Talking Book and asked if he felt this information was useful to his community. He felt it was very useful and agreed to hold a community meeting the next morning to introduce our staff and allow community members to ask questions.

The community of Gozu.

The following morning we returned to Gozu with Talking Books and all four members of our team: Andy Azaabanye Bayor, Fidelis Da-Uri Awonodomo, Cliff Schmidt and myself. We were greeted at the road by a group of women who sang, clapped and danced for our arrival. Their laughter and singing escorted us to the main ‘square,’ a central clearing in the community with a large tree for shade. There we were greeted by nearly 200 members of community, a very large turn-out for a market day. We were told many of the women would have to leave by mid-day to go to the market, but that all present were eager to hear about the Talking Book and the Child and Maternal Health Program.

What followed was an engaging speech and demonstration by Andy, Literacy Bridge’s Country Director. He described the program and demonstrated the recordings on the Talking Books. He answered questions, received feedback and made certain to engage all members of the community present. Andy and Fidelis took turns interpreting for Cliff and I as we described our roles in the project and how the program would unfold in the coming months. The community members were excited and honored that two people from so far away would care about their community and take the time to come all the way there to provide them with this information.

Community gathering

The meeting ended with more song and dance by the women, which in turn meant I had to dance in thanks. A good laugh was had by all at my terrible mimic of their joyous movements and we left Gozu for the second time, leaving behind instructions and Talking Books, and curious to gain feedback the next day.

The feedback we received in the following two days would help us to rethink some of our ideas and force us to address issues surrounding access. The Talking Books were listened to extensively and community members created their own recordings in response to our content. The final program will be more comprehensive as a result of this trip, and our understanding of the challenges facing these communities has continued to grow.

Interacting with the Talking Book

Access to knowledge is one of the most powerful tools anyone can provide. In communities like Gozu, a Talking Book can provide life saving information to the mother of a small child. The power of this kind of information cannot be underestimated. If you have extremely limited access to a medical facility, are illiterate and live in a remote community with no electricity your access to medical information is extremely limited. Literacy Bridge is trying to increase this access by bringing information from medical and agriculture experts directly to the communities.

For me, this trip informed how I think about the program I am helping to create and the potential impact it will have. I feel extremely privileged to have met the community members of Gozu and to have experienced our time in Ghana. The impact Talking Books can make in a community is incredible and I am humbled and proud to be a part of the Literacy Bridge Team.

United Way Day of Caring

October 25th, 2011

Thank you to the contingent of volunteers, including Microsoft employees, who volunteered at Literacy Bridge during United Way’s Day of Caring on September 18.  Literacy Bridge volunteer and supporter Mark Huck led the group in testing the Talking Book’s software and Audio Content Manager (ACM) features. Their work help ensure that the Talking Book works with ease and simplicity when in the hands of men, women and children living in some of the most inaccessible regions in the world.

Our gratitude goes to Frederick Akker, Joe Banks, Tatiana Fetisova, Jeremy Fried, Amruta Gulauikar, Carolyn Howsley, Brien Jacobsen, Olga Mathis, Preston Mathis (Microsoft Team Leader), Jonathan Palmer, Jonathan Poppe, Stacy Quan, Natalia Shul, and to our own Mark Huck for their invaluable help.

Literacy Bridge Happenings

October 22nd, 2011

The Talking Book was featured in the Open Gadget Playtime at TransferSummit/UK 2011, Sept 7 – 8.  Member of the TransferSummit planning committee Steve Lee reported that the Talking Book received considerable attention from attendees. TransferSummit provides a forum for business executives and members of the academic and research community to discuss requirements, challenges, and opportunities in the use, development, licensing, and future of Open Source technology.

International Literacy Day on Thursday, September 8 was marked by a special celebration sponsored by the Global Partnership for Education (formerly known as EFA-FTI), Brookings Institution, and USAID.  Literacy Bridge’s Partnership Relations Manager Debbi Winsten participated in a series of presentations, which resulted in the Talking Book being called out for its innovative approach to advancing literacy in developing nations.   

Literacy Bridge was featured at the September 13 Global Health Resource Center Advisory Board meeting at the University of Washington (UW). Cliff Schmidt spoke to the board about the history of Literacy Bridge and its work in maternal and child health.

 Cliff Schmidt was a panelist for the Marketing and Sales for Early Stage Social Ventures session at the two-day interactive UW Invention to Venture Workshop (12V) on October 22.  UW students interested in social entrepreneurship heard from Cliff about the iterative work of Literacy Bridge in creating and developing the Talking Book, its value proposition, as well as the importance of developing strategic relationships, among other topics.  The workshop was organized by the UW Global Business Center, which holds the annual Global Social Entrepreneurship Competition.  For more information see GSEC

Worldwide Volunteer Meeting

October 22nd, 2011

Volunteers from more than 20 countries throughout the world were tuned in for the first-ever Worldwide Volunteer Meeting webinar, September 24. Cliff Schmidt took meeting participants through the history of  Literacy Bridge and the evolution of its work.  They also heard showed them how they could participate in Literacy Bridge’s efforts.  See Literacy Bridge’s Volunteer page to become a volunteer.