Digital Campaigns Accelerate COVAX Adoption – Lessons Learned in Sierra Leone

Posted décembre 6, 2023
Impact Area COVID-19

By Peninah Thande, Social Media Optimization Advisor, PSI; Alfred Samba Makavore, Project Country Manager-EpiC, PSI Sierra Leone; Emmanuel Jah, EpiC Communications Coordinator, PSI Sierra Leone

In the realm of healthcare communication, the power of digital marketing cannot be underestimated. Under the project funded by USAID, Populations Services International (PSI) in collaboration with Sierra Leone’s Ministry of Health (MoH) embarked on a groundbreaking project to leverage digital tools to promote COVID-19 vaccination (COVAX). With a target audience of social media users age 18-65, this endeavor sought to tackle the challenges faced in the implementation of Sierra Leone’s vaccination strategy.

Identifying the Challenges

Understanding the hurdles in the COVAX strategy was vital to tailor the digital marketing plan effectively. The MoH identified the following challenges to vaccine uptake in Sierra Leone:

Low demand for the second dose of COVAX
Access barriers, including transportation costs and access to information
Misinformation about the vaccines and COVID-19
Limited availability of vaccines due to stock-outs

To address these barriers to COVAX, PSI and the MoH identified target online market locations with low , including the districts of Western Area Urban & Rural, and the cities of Bo, Kenema, Makeni, and Koidu. With these target populations combined, EpiC aimed to reach over 1 million people with the COVAX digital campaign.

Building Capacity for Digital Marketing

We started by ensuring that EpiC staff and MOH officials understood the impact of and best practices for using digital marketing to improve health outcomes. The communications staff and MoH members enrolled in the Digital Media for Health Outcomes Course by Yale University; and later joined the Digital Media For Health Outcomes community of practice on Facebook, where health communicators learn and share best practices for using digital media for health outcomes.

Prior to launching the campaign, PSI conducted a comprehensive three-day capacity building session for the Ministry of Health officials, based on a needs assessment done within the MoH. The training encompassed best practices for online health campaigns on all major platforms, creating valuable content, defining the target audience, and utilizing data to make informed decisions.

A close collaboration with the Ministry of Health Sierra Leone from the beginning ensured alignment with the government’s objectives. The Ministry took a leading role in steering initiatives, actively driving efforts to enhance COVID-19 vaccine adoption and counteract vaccine misinformation.

This internal capacity building led to the designing and implementation of an effective campaign plan, starting with the launch of PSI Sierra Leone’s Facebook page, Instagram profile and Twitter (X) profile.

Campaign Design

With the identified barriers to COVAX uptake in mind, including vaccine access, acceptance, and misinformation, we built a campaign to help individuals in the target populations overcome them.

The campaign unfolded in three phases: Phases 1 & 2 focused on vaccine acceptance and adoption, while Phase 3 sought to address vaccine misinformation. To make sure our messaging resonated with people of all ages, we tailored our approach for two primary audience segments: people aged 18-35 years, and people aged 36-65 years. Each segment was targeted using age-appropriate graphics and messaging addressing the specific COVAX misconceptions prominent within each age bracket.

For example, a common misconception among young people was that a lemon & ginger beverage could help prevent COVID-19, while pepper-based beverages were more commonly believed to prevent COVID-19 among older age groups. By segmenting the age groups, campaign messaging was able to effectively counter these misconceptions and communicate the importance of getting vaccinated. We included the local language, Krio, into our creatives and captions. This localized touch was instrumental in making our messages resonate more profoundly within the community.

In tandem with educational material, we also ran a community growth campaign throughout that led to the creation of the PSI Sierra Leone Facebook page growing to 11,000 followers. This platform will help us maintain health communications in Sierra Leone to bolster access to quality, reliable information.

Results and key takeaways – phase 1

The first phase was highly successful, reaching over 1 million people and growing our online community by 11,000 people in Sierra Leone. The average engagement rate for all campaigns was 16.5 percent, well beyond the industry indicating the success of the campaign in promoting COVAX education and countering misinformation.

With the second phase underway, the following are initial takeaways from the campaign’s first phase:

Capacity building for MoH health communication officials ensured the digital campaigns aligned with government objectives and needs.
Pairing the digital campaign with in-person education via the MoH network of health workers and COVID-19 champions localized the campaign by promoting campaign messaging in partnership with relatable community leaders.
Localizing messaging by including Krio and age segmentation helped the campaign resonate with the target audience, leading to high reach and engagement rates.
Digital marketing tools were effective in reaching the intended audience and addressing their concerns on easily accessible platforms.

Next Steps

This project’s success has laid the foundation for future endeavors to leverage digital tools for public health communication in Sierra Leone, including and beyond COVAX. Moving forward, PSI will partner with the MoH to integrate COVAX into routine immunizations, build a national health chatbot, digitize for community health workers, and develop These initiatives are essential in enhancing consumer powered healthcare and strengthening health systems in Sierra Leone.

This project showcases the power of digital healthcare by bridging the gap in COVAX information. By understanding barriers to health and tailoring interventions accordingly, we can use digital tools to reach people where they are, with the resources and information they need to stay healthy.

We will continue to share insights related to the COVAX digital campaign in Sierra Leone. Interested in learning more about the power of digital healthcare? Contact Cristina Lussiana ([email protected]).

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

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In rural Ethiopia, women and girls often face significant barriers in accessing healthcare facilities, which can be located hours away. Moreover, there is a prevailing stigma surrounding the use of contraception, with concerns about potential infertility or the perception of promiscuity. To address these challenges, the Smart Start initiative has emerged, linking financial well-being with family planning through clear and relatable messaging that addresses the immediate needs of young couples—planning for the lives and families they envision. Smart Start takes a community-based approach, utilizing a network of dedicated Navigators who engage with women in their localities. These Navigators provide counseling and refer interested clients to Health Extension Workers or healthcare providers within Marie Stopes International-operated clinics for comprehensive contraceptive counseling and services.

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In 2022, 328 thousand malaria cases were recorded by CHWs); 6.5 thousand severe malaria cases were referred to health centers, according to the national health information system.

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Supervisors directly observed how CHWs performed malaria rapid diagnostic tests (RDTs) and administered artemisinin-based combination therapy (ACT). They recorded CHW performance using the digitized checklist, interviewed community members, reviewed records, and provided on-the-spot coaching. They also interviewed the CHWs and tried to resolve challenges they expressed, including with resupply of commodities or equipment immediately or soon afterwards.

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In IM-supported areas of Mali, 36% of CHWs in the first round were competent in performing the RDT, which rose to 53% in the second. 24% of CHWs in the first round compared to 38% in the second were competent in the treatment of fever cases and pre-referral counseling. Between both rounds, availability of ACT increased from 80 percent to 90 percent.

Supportive supervision with interviews and observations at sites improved the basic competencies of CHWs between the first and second rounds, and additional rounds will help to understand the longer-term programmatic benefits.

Taking a market-based approach to scale sanitation in Ethiopia

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During the last six years, T/WASH has worked alongside the private sector and government (Ethiopia’s Ministry of Health, Ministry of Water and Energy, and Ministry of Labor and Skills), among other stakeholders, to increase household access to affordable, quality sanitation products and services. For example, more than 158 thousand households have invested in upgraded sanitation solutions with rapid expansion to come as the initiative scales and market growth accelerates.

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To share the journey to market-based sanitation, representatives of the Ethiopian Ministry of Health and the USAID Transform WASH team took to the stage at the UN Water Conference in 2023.

“Rather than relying on traditional aid models that often distribute free or heavily subsidized sanitation products, market-based sanitation creates sustainable and affordable solutions, integrating market forces and supporting businesses to grow.”

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Promoting self-managed care like Self-testing and Self-Sampling

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Here’s how we got there.

Seven years ago, the landscape of HIV self-testing lacked global guidelines, and only the U.S., the UK and France had policies in place that allowed for HIV self-testing. High disease burdened countries in low-and-middle-income-countries (LMICs) lacked evidence and guidance for HIVST despite major gaps in HIV diagnosis.

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“The men we spoke to [while I was traveling to South Africa for a PrEP project with Maverick Collective by PSI] were not only decidedly open to the idea of taking a daily pill…many were willing to spread the word and encourage friends to get on PrEP too. We were able to uncover and support this new way forward because we had flexible funding to focus on truly understanding the community and the root barriers to PrEP adoption. This is the philanthropic funding model we need to effectively fight the HIV epidemic, and it’s beneficial for all sorts of social challenges.”

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The shortage of skilled health workers is widely acknowledged as a significant barrier to achieving Universal Health Coverage. To address this challenge, PSI supported ministries of health to develop a digital ecosystem that brings together stewardship, learning, and performance management (SLPM). The ecosystem enhances training, data-driven decision-making, and the efficiency of healthcare delivery.

Here’s what it looks like in practice.

In July 2020, PSI Angola, alongside the Angolan digital innovation company Appy People, launched Kassai, an eLearning platform that targets public sector health workers in Angola. Through funding from USAID and the President’s Malaria Initiatve (PMI), Kassai features 16 courses in malaria, family planning, and maternal and child health – with plans to expand learning topic areas through funding from ExxonMobil Foundation and private sector companies. A partnership with UNITEL, the largest telecommunication provider in Angola, provides all public health providers in Angola free internet access to use Kassai.

Kassai’s analytics system to follow learners’ success rate and to adjust the course content to learners’ performance and needs. Kassai analytics are integrated with DHIS2 – the Health Management Information System (HMIS) of Angolan MOH, to be able to link learners’ knowledge and performance with the health outcomes in the health facilities. The analytics track learners’ performance by course and gives visibility by health provider, health facility, municipality, and province. Each course has pre-and post-evaluation tests to track progress of learning, too.

By the end of 2022, there were 6,600 unique users on the Kassai platform and 31,000 course enrollments. PSI Angola’s partnership with UNITEL, the largest telecommunication provider in Angola, allows for free internet access to learn on the Kassai for all public health providers in Angola. Building on its success for malaria training, Kassai now also provides courses in family planning, COVID-19, and maternal and child health. This reduces training silos and provides cross-cutting benefits beyond a single disease.

Implementing the SLPM digital ecosystem brings numerous benefits to health systems. It allows for more strategic and efficient workforce training and performance management, enabling ministries of health to track changes in health workers’ knowledge, quality of care, service utilization, and health outcomes in real time. The ecosystem also supports better stewardship of mixed health systems by facilitating engagement with the private sector, aligning training programs and standards of care, and integrating private sector data into national HMIS. Furthermore, it enables the integration of community health workers into the broader health system, maximizing their impact and contribution to improving health outcomes and strengthening primary healthcare.

Digital Campaigns Accelerate COVAX Adoption – Lessons Learned in Sierra Leone

Identifying the Challenges

Building Capacity for Digital Marketing

Campaign Design

Results and key takeaways – phase 1

Next Steps

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Digitalizing contraceptive counseling to reach rural women and girls in Ethiopia

Building community health worker capacity to deliver malaria care

Taking a market-based approach to scale sanitation in Ethiopia

Promoting self-managed care like Self-testing and Self-Sampling

Using peer coaches to counter HIV stigma in South Africa

simplifying consumers’ journey to care in Vietnam

Engaging the private sector for disease surveillance in Myanmar

Training health workers in Angola

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