Melodies of Influence

Overview

The Catalyzing COVID-19 Action (CCA) project is a collaborative effort between EGPAF teams in Cameroon, Kenya and Zimbabwe, and FIND and Unitaid initiative. The CCA project aims to support the Ministries of Health (MOHs) in these countries as they face the challenge of increasing access to novel solutions that reduce and contain COVID-19 transmission. The CCA project started in October 2021, when COVID-19 infection rates in sub-Saharan Africa reached an all-time high. EGPAF in all three countries was tasked with spreading accurate knowledge about the risks of this emerging disease and how to protect the community. The work of Community Health Promoters (CHPs) in particular is critically essential to realize the goals of the CCA project, especially as infectious diseases emerge in communities that are unaware of modes of transmission and available testing sites.

Community Health Promoters: A Collective Backbone of the Healthcare System

CHPs are highly influential figures within the communities that they serve and often live in, providing health education and guidance to the full spectrum of community members supported by EGPAF clinical sites. CHPs are the first to know the state of the collective health climate and use that information to provide a range of verbal communication skills to pass on knowledge to the larger community and strive to reach clients who live far from facilities and are not able to regularly visit local facilities. Their role is best described as the mouthpiece for the doctors and nurses that work inside of the facilities, but they also act as an earpiece to hear, receive, and assess the verbal needs of potential clients. CHP teams consult with facility teams twice a week to gain a sense of what areas should be strengthened, expand knowledge of proper health-influencing behaviors (HIBs) and dispel misinformation. As EGPAF expands its efforts in demand creation for COVID-19 screening and testing, training CHPs was a critical step in achieving that goal. EGPAF trained CHPs on key COVID-19 prevention measures, how COVID-19 spreads, and where community members can get tested for COVID-19.

Community Health Promoters and their Melodies

The CCA project in each country has a separate strategy for building CHPs autonomy and confidence in the dissemination of COVID-19 prevention measures to community members. In Zimbabwe, music is a key strategy in the toolbox of approaches to limit community spread of COVID-19. Communities often gather in large numbers for meetings. Women who attend these meetings while their husbands are at work often help spread that meeting’s message further for those who are absent. CHPs native to the community they work in write songs highlighting new health influencing behaviors to follow. The songs are intending to build awareness and continue discussions around this newly emerging disease. Notes gathered from weekly facility meetings between nurses and the promoters are converted into inspiring, catchy verses paired alongside local melodies that are easily identifiable. CHPs use the songs as opportunities to spread health influencing behaviors on how to prevent the spread of COVID-19 while also cultivating a climate of joy and conscious responsibility over health issues that affect the entire community.

Because local CHPs are simultaneously known as politically engaged public figures and business owners, their words are given a certain level of legitimacy and respect that transcends the efforts of health promoters from external international organizations. External international organizations attempts to change health behaviors and expand knowledge surrounding infectious disease have been poorly received in the past, notably with much less retention and acceptance of messaging according to EGPAF Zimbabwe in-country officers. Local CHPs especially have helped ease anxieties through their proclamations of consistent clear, accurate, and up-to-date information. CHPs efforts have influenced social behavior changes at large in favor of building COVID-conscious communities that seek routine COVID-19 screening and testing.

CHPs sing and spread knowledge on how to reduce COVID-19 transmission. Promoters know that when clients hear the loud cry of COVID chants from the street, they become more attentive to the messaging, more likely to pick up and remember life-saving precautions, and more willing to incorporate these messages into their interpersonal decisions. Clients often listen closely to the lyrics, and become newly inspired to get tested, accept and follow treatment protocols, and encourage friends and family to do the same. The songs developed by CHPs have long lasting effects. Most clients sing the song to themselves by the time the CHPs leave. Through song, important messages on COVID-19 continue to spread as the lyrics linger their minds.

Hanna Tesfasyone, Senior Project Officer of the CCA project, reflected on the impact of these dynamic efforts stating: “ I strongly believe community health promoters are the foundation of any successful public health intervention. I truly appreciated how promoters communicated in a local language and tailored their message in song form to resonate with the community they served which I believe made the information more accessible and increase the likelihood that the community members will act on the information disseminated. So many lives were saved through CHPs key messages of COVID-19 prevention. I strongly recommend programs consider incorporating community engagement and music as a medium for disseminating vital information to the community they serve.”

Conclusion

The CCA project demonstrated the vital role of local CHPs in combating COVID-19 and other infectious diseases in sub-Saharan Africa. By using unconventional methods to inspire the flow of health awareness, their connection to the communities, and their creativity, CHPs deliver accurate and relevant information to the people who need it most. They also facilitate access to testing and treatment and encourage positive behavior change. The CCA project shows how CHPs’ roles can be adapted to different contexts and how CHPs can use various strategies, such as music, to reach and inspire audiences to screen and test for COVID-19. CHPs are not only the mouthpiece and earpiece of EGPAF Zimbabwe messaging to protect against COVID-19, but also the backbone of the healthcare system to ensure there are community to facility linkages. EGPAF Zimbabwe hopes that the Zimbabwe Ministry of Health and Child Care officials will take this innovative approach using music to disseminate vital health information and integrate similar methodologies into practice within their local health environments.