For more than 20 years, VillageReach has worked with governments to create solutions that improve health systems and healthcare delivery. VillageReach’s COVID-19 response used a suite of digital solutions to help combat the pandemic by disseminating accurate and timely health information for community awareness and providing remote training for health workers. The Johnson & Johnson Foundation joined a worldwide community of donors who have supported this work, which has played a critical role in helping to reduce misinformation and rumors about COVID-19, protecting the general population and supporting health workers in the Democratic Republic of Congo (DRC), Malawi, and Mozambique.
From March 2020 through June 2021, this work delivered notable results:
Information for community awareness—a lifeline for family health
Knowing when and where to seek quality healthcare is essential to improving health outcomes. In remote and rural communities, distance often prevents people from accessing the health information they need.
Health Center by Phone (HCBP) is a digital solution that extends the reach of the healthcare system to every community. It provides access to certified health and nutrition information and services via a confidential toll-free hotline, giving people the power to make informed decisions about when to seek care at a health center. The hotline is staffed by professionally trained health workers who provide information and referrals. It also offers multilingual options to help ensure that language and literacy are not barriers to access. Additionally, the solution tracks and aims to predict emergent health needs, receives community feedback, and provides data quickly to help government make decisions about cost-effective health improvements.
“One essential piece of the hotline is to document all the interactions that we’re having with different community members in order to inform possibilities to strengthen the service, so that at the end of the day it becomes a more holistic as well as integrated solution,” says Upile Kachila, VillageReach Senior Manager for Digital Solutions, Malawi. “From the conversations we’ve had, we’ve been able to identify knowledge gaps as well as potential interest areas frequently requested by clients themselves.”
HCBP was first implemented in Malawi, where it is known as Chipatala cha pa Foni (CCPF)—a 24-hour toll-free hotline which VillageReach officially transitioned to government ownership and is now managed by the Malawi Ministry of Health. In 2020, VillageReach provided the Ministry of Health with additional support to leverage this existing digital platform to provide accurate and up-to-date information to callers and to address the impact of COVID-19 in limiting access to routine healthcare. This support was critical to address the increase in call volume, which increased by 542% between February 2020 and March 2021.
Long-term support from the Johnson & Johnson Foundation for CCPF in Malawi has helped VillageReach expand the solution to Mozambique and DRC. HCBP solutions were tailored for COVID-19 responses in each country to include mobile voice messages on COVID-19 and other health topics, and a dial-in option to retrieve pre-recorded messages on several health topics, including COVID-19.
In DRC, VillageReach worked with the Ministry of Health and Praekelt.org to launch an AI-powered chatbot which provides communities with COVID-19 updates via WhatsApp and Facebook. In Mozambique, VillageReach worked with the government to upgrade a health hotline known as AlôVida, run by the Ministry of Health and Fundação para o Desenvolvimento da Comunidade, to address the need for COVID-19 information, as well as to improve services to increase community access to health information.
Both Malawi and Mozambique are exploring adding a similar chatbot feature that would provide rapid approved responses to frequently asked questions via a text-based help desk on WhatsApp.
“Our goal is to give callers a choice on how they can access information to make informed health decisions,” says Timoteo Chaluco, VillageReach Visibility and Analytic Network Advisor, Mozambique. “Based on the needs of the country, Health Center by Phone can include any or all of the components like hotline operators, interactive voice recordings or WhatsApp messages powered by artificial intelligence. There is also opportunity to replicate the solution in other countries to protect more people in more communities.”
Bridging the distance gap with remote training for health workers
In addition to HCBP, VillageReach’s COVID-19 response developed a mobile-based solution, accessible on any type of phone, that incorporates distance learning and uses voice recorded messages to disseminate information about COVID-19 to health workers on the frontline of health care delivery, particularly in underreached communities.
“Health workers vaccinate, treat infections, monitor health and share health information,” says Carla Toko, VillageReach Manager for Advocacy and Communications, DRC. “We believe that if we empower them with information on COVID-19, we could more quickly disseminate accurate information about how the virus spreads, how to protect the community, and to make sure that health workers know how to protect themselves.”
Together with government and technology partners, VillageReach designed course content materials and evaluation tools, and created a series of voice recordings on COVID-19. The lessons covered topics such as COVID-19 symptoms, precautions to mitigate risk, and when to seek testing. To gauge the level of understanding of the material covered, recipients used their phone keypads to answer questions about the content at the end of each module.
The information was disseminated to over 15,000 health workers in DRC, Malawi, and Mozambique. VillageReach conducted mid-point evaluations to inform continuous improvement of the remote training modules. New dynamic dashboards provide improved visibility of data points, such as the number of health workers reached, how many answered their phones and completed each lesson, and their performance on the quizzes.
The training received strong buy-in and interest from governments in DRC, Mozambique and Malawi: in DRC, remote learning for health workers tripled its footprint from five to 15 provinces; in Mozambique, at the request of the Ministry of Health, the training was expanded to community leaders and teachers; and in Malawi, VillageReach and the Ministry of Health developed a training certificate program with incentives.
Increasing impact to protect more people and support more health workers
VillageReach has identified opportunities to use HCBP to create real-time visibility of vaccine acceptance and demand trends, with plans in the pipeline for regular and timely data collection and analysis on behavioural, social, and structural drivers of vaccination uptake to inform evidence-based planning. The platform also offers potential to incorporate social listening and adverse event tracking, and to explore disease outbreak prediction. Additionally, the Malawi Ministry of Health is interested in expanding the platform to include telemedicine services and connect it to the overall emergency response system.
In terms of remote training for health workers, VillageReach plans to add new modules on a variety of health topics, such as the COVID-19 vaccine, and to integrate the solution into countries’ health hotlines and government training programs. In Malawi, the government has expressed interest in making this a component of their curriculum and the country’s continuous professional development efforts.
“One goal of our COVID-19 response is to ensure that 75% of our activities have life beyond the pandemic,” says Upile Kachila. “There is tremendous potential to grow these programs with new health topics, expanding to new geographies and enhancing the solutions’ technical capabilities. As we look beyond the COVID-19 pandemic, there is so much potential within the digital health space that is untapped and that could not only strengthen public health systems, but also build the capacity of health workers and ultimately empower communities with accurate health information at their fingertips.”