“One of the reasons anzilisha is so successful is the way it has empowered community health volunteers (CHVs) with DigiSomo Talking Book devices,”
These are the words of Henry Mukuna, the Luanda Sub-County Senior Public Health Officer in Vihiga County. “DigiSomo Talking Book helps CHVs to deliver accurate information to villagers in far-flung and remote places. Standardized messages have been installed in the devices and many times CHVs don’t have to speak; they just let the DigiSomo Talking Book do the talking.”
Digisomo is a beautiful little talking book. It has a touch surface bearing appropriate illustrated buttons for all its functions. It also has a loud speaker. With it a user can record one or several messages, play it, select among several recorded messages, and regulate volume among other several impressive functions. DigiSomo Talking Book is portable and small enough to be comfortably carried in a tiny bag. And since it is meant to be used in remote locations where electricity might be a problem, it uses battery cells for power. This kind of power source is virtually available in every kiosk in Kenya’s remote countryside. In its simplicity and handiness, DigiSomo Talking Book is a work of genius and a creation of Amplio which is being used by Centre for Behaviour Change and Communication (CBCC AFRICA) to implement the anzilisha program in 5 counties in Kenya.
“To understand just how Digi-Somo Talking Book perfectly fits anzilisha needs, consider the 10 components of anzilisha. The community health workers would have had to store all that information in their heads. As a matter of fact, they used to return with questions and need for clarifications all the time. That’s in the past. Now their work can be as simple as introducing a topic and letting DigiSomo Talking Book say the rest,” Mr Mukuna elucidates.
DigiSomo Talking Book is a hardy piece of equipment manufactured to be durable. Its hard rubber covering suggests it can withstand rough handling. It can also last a full month with a new pack of battery cells if it were used daily, according to one CHV. “When a CHV in the field receives a question that she/he cannot answer, they are able to record it in the DigiSomo Talking Book and replay it later with a health worker for feedback and clarification,” Mukuna says. From the words of those who have used it, the talking book seems like the kind of invention of which people say, “How did we ever do without it?”
Digisomo Talking Book has greatly aided the work of CHVs, making it easier for them to not only spread their work to more community members but also increase efficiency in reporting health. By freeing them from having to store a relatively large amount of information in their heads and the burden of using it correctly, DigiSomo Talking Book leaves the CHVs large reserves of energy and memory to deploy in covering other health aspects. These include participation in group activities such as supporting mother-to-mother groups, identification of people such as pregnant women who skip ANC appointments, mothers who have not started attending ANC, pregnant women not taking IFAS and malnourished children. Through their efforts, Mukuna says, there is a marked behaviour change by community members to talk about health. This is especially true where the health of mothers and children is concerned. Because of anzilisha, there is greater improvement in breastfeeding, health facility deliveries and taking IFAS during pregnancy, which are some of the areas of emphasis for anzilisha.
Anzilisha has done a lot more, besides DigiSomo Talking Books. Mr Mukuna says Anzilisha has greatly aided his work as a health officer. “My work is predominantly that of promoting preventive medicine. We are based at the community level where we distribute Long-Lasting Insecticidal Nets (ILLNs), give health talks on nutrition, malaria prevention, sanitation, good housing, and rodent and insect control, among others. Anzilisha dovetails with that perfectly. The programme has complemented my work through its emphasis on maternal, child health and nutrition that includes growth monitoring, iron and folic acid supplementation, antenatal clinic visits, exclusive breastfeeding, complementary feeding and other child health-related interventions.”
Anzilisha has also boosted ante-natal health stocks (IFAS and CHX) which encourages mothers to attend clinic and practise exclusive breastfeeding. Anzilisha is a 5-year project (2016-2020) funded by Nutrition International whose objective is to reduce anaemia, low birth weight, maternal and new-born mortality as well as stunting. Activities in this project include training of CHVs, community sensitization, health system support, and capacity building of healthcare workers. In these and many other ways, Centre for Behaviour Change and Communication (CBCC) in partnership with the County Government implements evidence informed behavior change strategies to improve knowledge, attitudes and practices of caregivers and social influencers regarding maternal and child health.
Mukuna mentions one other area where CHVs are especially handy. Working with the health facilities, CHVs can be informed of mothers who have defaulted attending ante-natal clinic (ANC). They go to the villages to follow up and urge the mothers to attend. The CHVs also work the other way round: when they come across health cases in the community, they are authorised to refer them to a health facility.
“With Anzilisha, we have trained 70 CHVs in the use of DigiSomo Talking Book and 100 on the use of Iron and Folic Acid Supplement (IFAS),” Mukuna adds. “We have further trained 68 mothers in mother-to-mother support groups which have translated into approximately 680 members because each has created a group of about 10 women. Besides, we have trained 30 father-to-father groups who are each forming a group of 10 fathers to promote male involvement in ante-natal care for mothers and children.”
Together with anzilisha programmes on national TV and community radio, the complete package now means whenever the health officials visit villages, they can hear clients acknowledging that the messages they were being given by the health officials tallied with what they had seen on TV or heard on radio. This co-operation has formed a complete ecosystem of health services, messaging, and accessibility to health services that is improving the lives of villagers in Luanda.
