“Guinea’s maternal and child health indicators are among the lowest in the world. Even before Ebola hit in 2014, trust and confidence in its health services were low. Ebola’s rapid spread further fueled fear and distrust, with many people believing health workers themselves spread the disease.”
As Guinea continues to recover from Ebola, the Health Communication Capacity Collaborative (HC3) is working with the country’s hardest hit communities to rebuild both trust in the health system and the quality of care delivered. This series of case studies examines some of HC3’s activities and tools that were part of an overall social and behaviour change communication (SBCC) strategy to improve health behaviours and increase the demand for and use of quality reproductive, maternal, newborn and child health (RMNCH) services in Guinea. Case studies deal with the use of community dialogues, the Bridges of Hope tool to stimulate discussion around RMNCH, the use of radio to reach wider audiences, and activities to rehabilitate and promote “Gold Star” accredited health facilities.
HC3 is a five-year, global SBCC project funded by USAID from October 2012 through September 2017. The project is designed to strengthen the capacity of developing countries to implement state-of-the-art SBCC programs. The Ebola emergency response and the post-Ebola recovery response are among the health areas addressed by HC3. HC3 is supporting the Government of Guinea, U.S. Government implementing partners and local SBCC professionals to design, produce, and implement a package of high-quality SBCC interventions to encourage Guineans to use their local health centers and improve associated behaviours.
The series of case studies is as follows (click on the title to download each case study in PDF format):
Guinea: Community Dialogues – Bringing Communities and Health Facilities Together
This case study looks at how HC3 worked to restore trust in the health system though community dialogues. With the help of trusted leaders, community dialogues took place between health providers and community members. This approach created and facilitated exchanges between community members and health providers to glean perceptions of health services and solicit suggestions for improvement. Community members identified barriers such as the high cost of services, charging for services that should be free, a lack of established service prices, unfriendly treatment of clients by health providers, stock outs, old or broken equipment, and a lack of information from providers.
Guinea: Bridges of Hope – Getting Communities Engaged in Health Decisions
This case study looks at how the programme created demand for health services by using the Bridges of Hope toolkit to engage communities, increase their understanding of certain health issues, and encourage them to go to their local health facilities for information, care and treatment. This interactive toolkit uses pictures and story telling to initiate dialogue, and was complemented by entertainment-education performances and songs to educate the public about the use of health services. HC3’s NGO partners trained community health workers (CHWs) to provide them with the skills and confidence to use these tools to stimulate dialogue and encourage health behaviour change at the community level. Health education topics included essential maternal, neonatal and child health services, such as antenatal care, facility-based delivery, birth preparedness, child immunisation, breastfeeding, and hygiene.
Guinea: Interpersonal Communication and Counseling – Building Trust in the Health System
This case study explains how HC3 conducted interpersonal communication and counseling (IPC/C) to build trust in the health system. The community dialogues HC3 conducted in Guinea revealed that one of the keys to increasing demand and use of services was improving the skills and behaviour of health providers to improve client communication and influence positive health outcomes. For this reason, IPC/C trainings for health providers were held throughout the project period and catchment areas. The trainings provided the tools and skills necessary for providers to welcome patients, facilitate patient interactions, reinforce messages for case management and advocate for patients to encourage their peers to use health services. Health providers were also trained to develop a communication plan that identified how and when to deliver regular health information and distribute SBCC materials, such as fliers and stickers.
Guinea: Interactive Radio Programs – Getting the Community’s Perspective
This case study looks at the process of how HC3 used radio to expand participation in the community dialogues, and create awareness of the need for, and availability of, maternal and child health services. As an important and trusted source of information, especially in remote and rural areas, radio reaches all corners of Guinea, in French and local languages. To implement its radio programme, HC3 worked with 38 stations in Conakry and the rural areas. Before launching the programme, HC3 held a workshop with partners and local radio stations. Workshop participants helped develop a guide that featured a variety of formats to be used, including 30- or 60-second public service announcements, talk shows, and interactive call-in programs. Another popular format used was a community game show called “Les Jeux Publique” that aired live on radio.
Guinea: Gold Star Campaign – Branding Quality Health Services
This case study looks at how HC3, in collaboration with the Maternal and Child Survival Program (MCSP) and the Ministry of Health, revamped the Gold Star brand to identify accredited quality health services, and increase trust in and demand for health services. It describes the different communication activities used in the campaign to enhance the visibility of the Gold Star symbol as a sign of high-quality services delivered by selected health facilities. They included logo design, television and radio spots, billboards and flyers, as well as community-based activities.
Guinea: Rapid Rehabilitation – Improving Health Facilities
This case study looks at how HC3 initiated rapid rehabilitation activities to improve health facilities aiming for Gold Star accreditation. It highlights how community engagement in support of the rehabilitation process was a fundamental component of this process. They created ownership on the part of the community, and helped health providers understand the perceptions and needs of the community. It also brought everyone together to realise a shared vision for improving their community’s health.
HC3 website on Apri 26 2017.