Talking Books to Facilitate Behaviour Change in Rural Communities in Ghana

Under the pilot programme, CHPS nurses used the Talking Book during their outreach visits to conduct child welfare checks and provide antenatal care; for example, they used the tool to facilitate health education for pregnant women, lactating mothers, and men accompanying their spouses. Similarly, during outpatient department sessions and group education sessions, the Talking Book served as the main tool for health education across five CHPS zones in the Jirapa municipality.

Designed to meet the needs of low-literate populations living in so-called "media dark" areas, behaviour change messages are jointly produced by the beneficiary communities with programme designers in different formats such as drama, endorsement messages by local community influencers, local lessons conveyed via songs, and testimonies from successful behaviour change adopters. Community members, including CHPS nurses, play the pre-recorded packaged audios back by selecting messages of their choices after navigating through a simple menu. Through this menu, functions such as feedback, play forward and backwards, volume control, content switch, and downloadable symbols coupled with voice prompts are built into the Talking Book devices to make them user friendly to community members and programme planners. (Click here to learn more about the technology.)

As part of the introduction of the Talking Book technology, UNICEF jointly with GHS provides training for nurses on social and behaviour change communication, interpersonal communication skills, and the operationalisation and basic maintenance of the Talking Books, which included tips on simple trouble-shouting and repair.

Health, Immunisation and Vaccines, Children

In Ghana's Upper Region, women's access to information has been hampered low literacy levels, poor connection to the internet, and lack of modern communication devices such as radio sets and mobile phones. For instance, only 54.7% of women use mobile phones, compared to 84% of men in the same region, and only 51.2% of households own radio sets, with men having more access than women. Therefore, simple gadgets such as the Talking Books come in handy to bridge the gaps in women's information needs, especially in health facility settings.

According to organisers, the pilot programme contributed to: increased women's attendance to child welfare clinic and antenatal care sessions, increased men's participation in maternal and child health activities, and increased routine child immunisation services, such as uptake of vitamin A supplementation in the beneficiary CHPS zones. Also, the programme contributed to quality health care delivery in that nurses are now able to effectively combine their clinical care and health education duties. Furthermore, language barriers for some CHPS nurses and their communities are no longer a challenge because the messages in the Talking Book are in the preferred local languages of the beneficiary communities.

Since 2013, with UNICEF Ghana support, Amplio Ghana has been providing solutions to promote health behaviour change in rural communities in the Upper West region through the larger Talking Book CHPS initiative. As many as 61 communities with over 40,000 households in the Jirapa municipality have received cross-sectoral messaging on areas including water, sanitation, and hygiene (WASH), health, nutrition and child protection.

UNICEF Ghana will scale up the programme to cover all the 47 CHPS zones in the Jirapa municipality. It is expected that Amplio Ghana will transfer knowledge and skills to the Jirapa Health Directorate to sustain the programme beyond the duration of this action.