Kintampo health research centre - ie & c activities of Obaapavita Study

The Information, Education and Communication (IEC) section was incorporated into the כbaapaVitA study to improve compliance and also to explore factors that may hinder the taking of the capsules given to women weekly. It was also to help put in reminding strategies about capsule taking and to educate and sensitise the general public about the project. This became possible after formative research was carried out from June 2000 in Kintampo site.

The results of the IE&C formative research were presented at a workshop in April 2000 attended by KHRC staff, communications experts and GHS/MOH staff. The content of the IE&C messages and potential promotional strategies were outlined at the workshop and a creative brief describing each proposed promotional strategy was then produced. The brief was presented to advertising companies; communication experts, musicians and theatre directors and they developed the creative brief and put in tenders to produce material. The study team selected two advertising agencies, a radio station with experience in producing advertisements aimed at rural populations, a behaviour change communication expert with experience in running communication and counselling training, and an independent song writer. The materials were then designed and extensively pre-tested with the target populations.

This report is a summary report for IEC activities for the year under review. It includes the IEC activities done in the four sites. The year under review was a very busy year for the IEC team as there was the need to intensify education of women about the placebo arm of the project. This took the form of radio discussion programmes on the four radio stations used frequently (Classic FM and ASTA FM in Techiman, ADARS FM in Kintampo and Royals FM in Wenchi A fifth Radio station, Jerry son FM in Nkoranza became part of the radio stations used for the study area), visits to junior and senior secondary schools in Techiman, Wenchi and Nkoranza districts as well as organizing seamstresses and hairdressers and re-explaining the objectives of the project to them. Community meetings were also held in some selected communities to re-educate the entire community about the project and to stress the placebo arm of the project. The team also educated study subjects about the duration of the project now that it has been extended to 2008 and how they feel about being in a project for a long period. This happened in all four sites.

There were also field visits to all the IEC supervisors in the sites to give them support in their data collection. This also provided direct contact with the study subjects who are chosen at random each week to be interviewed about their capsule taking. This enables the team to interact with these women to know their problems and to share their concerns.

Regular activities

There were also monthly focus group discussions carried out in the sites to document problems and concerns that women have about the trial, and to address them immediately. Notable among the problems for the year were the concerns raised that most of the study participants did not know that half of the כbaapaVitA capsules that they take do not contain vitamin A. This was addressed immediately through regular radio discussion programmes where the general public get the chance to call and ask questions as well as contribute to the programme; visits to churches and mosques, community meetings as well as hairdressers, dressmakers etc. A few women also complained about irregular menstrual flow, which they incorrectly attributed to the כbaapaVitA Capsule.

For the year under review, some of the IEC materials used were changed. For instance new jingles were produced to replace the old ones.

Zelee Hill (ZH), the IEC Technical advisor from the London School of Hygiene and Tropical Medicine (LSHTM) visited the Centre in August to help with cleaning of the adherence data collected so far. She trained CT in the use of Stata and also trained the IEC supervisors together with floating supervisors on the skills to conduct Focus Group Discussions (FGD) and organizing community meetings.

Achievements

The team has through radio programmes and community meetings improved the knowledge of the study subjects as well as the general populace about the fact that the כbaapaVitA project is a research being carried out, the objectives of the project and most importantly that not all the כbaapaVitA capsules contain vitamin A. Many of the study women now know a lot about the project but there is still, room for improvement. Fieldworkers are also given periodic training on how to interact with the subjects and also address their problems and concerns.

Misconception, problems and challenges

The greatest challenge that the team is faced with is the claims by some subjects in the study that the capsules are for family planning purposes. Others also said it increases their sexual libido whilst some believe it increases birth weight leading to caesarean sections during delivery.

A few of our subjects complain of irregular menstrual flow and bleeding too much during their monthly period. Some women incorrectly attribute this to the כbaapaVitA. Some also think it makes them eat too much, thereby increasing their weight. Whilst some see this as a positive sign, others also thought it makes them grow fat, which they do not like. In all of these challenges, the team is not relaxing in its efforts to educate people about these misconceptions.

Way forward

There is the need to intensify our education programme for the study subjects as well as the general public to combat trial fatigue as the project has been extended for four more years. There is also the need to stress to our study participants that the Project is a study and that we are testing to see if vitamin A could help reduce maternal morbidity and mortality in other to help inform policy.

Project funder

This project is funded by DFID as a part of the כbaapaVitA study.

Contact: Charlotte.Tawiah@ghana-khrc.org

Activities Of the Information, Education and Communication (IEC) unit of ObaapaVita Study.