Rapidly responding to COVID-19 using mobile technology and behaviour change tools
Our most powerful tool to combat COVID-19 is to change behaviours (e.g. handwashing with soap, social distancing). In Kenya we are remotely empowering mothers in low income communities to become change agents who encourage their communities to practice positive health and hygiene behaviours that combat COVID-19. We are reaching mothers through the mobile phones they already own to build their knowledge, confidence and motivation to take action to combat COVID-19. This online community of mothers is called U Afya where internationally recognised behaviour change methods are applied in innovative ways to deliver deep, ongoing, customised engagement that delivers real world change in low income communities.
“I have learned a lot of things I didn’t know about COVID-19, now I can become a teacher to others who don’t understand.”
Background: nutrition, health and hygiene behaviour change
U Afya is an online community of over 6,000 mums and mums-to-be living in informal settlements in Nairobi, Kenya. Funded by TRANSFORM (FCDO and Unilever partnership) since 2017, the U Afya mobile platform motivates mothers to practice positive nutrition, health and hygiene behaviours that improve their own and their families well-being. U Afya has driven measurable shifts in knowledge, attitude and practice. Recognising that a lack of confidence and self-efficacy, rather than a lack of knowledge, were the primary barriers to mothers changing their behaviours the U Afya behaviour change strategy delivered digital tools designed to boost mothers confidence in a localised, relevant way.
When COVID-19 struck we knew that the U Afya network of mums offered a powerful opportunity to deliver a rapid response to the COVID-19 pandemic. From mid-July to late September 2020 we leveraged our U Afya community to:
- Generate awareness on how COVID-19 is spread and how mothers can protect themselves and their families;
- Drive prioritisation of handwashing and other hygiene behaviours, and build mothers sense of self-efficacy;
- Actively motivate mothers and establish real-world hygiene behaviours.
Using our tried and tested, evidence-based approaches in innovative ways and context-specific human-centred design we delivered a mobile accessible digital platform that encouraged deep, ongoing, customised engagement to help mums in low income communities make real world changes to improve their well-being. From mid-July to late September 2020 our results were:
We rapidly scaled the size of our digital community of mums and used e-learning tools to increase their knowledge without face to face interaction.
- 1,593 new mums signed up to be full members of the U Afya community – taking the total to over 4,500 mums
- 549 learners started the Happy Healthy Home e-learning course
- 80% course completion rate
- 96% correct responses to interactive knowledge test activities
We mobilised our trusted network of mums as change agents to tackle misinformation in vulnerable communities.
- 441 mums pledged to act as COVID-19 Ambassadors to raise awareness in their communities about positive behaviours to combat COVID-19
- 308 of these mums took part in detailed WhatsApp orientation
- Pledging to be an Ambassador drives deeper personal commitment and engagement with hygiene content: 77% of Ambassador mums completed the Happy Healthy Home course and 48% completed the Handwashing Challenge
We motivated mums to enact real world positive behaviours through fun, interactive and relevant motivational tools.
- 3,779 real-world actions reported by mums
- 2,631 of these actions were repeated – indicating on-going behaviour
- 276 mums took a handwashing pledge
- 502 mums took part in the Handwashing Challenge
We empowered mums to remotely support each other on the digital platform and actively engage in dialogue around the messaging and content.
- 2,400 comments on our localised COVID-19 content
- 67 in-depth personal stories shared
How We Did It: Our Rapid Response to COVID-19
In response to COVID-19, we leveraged our U Afya in platform and adapted existing content, tools and approaches and built new ones.
1. Launched new COVID-specific behaviour change content captured in a dedicated site section, to reinforce knowledge and build confidence
Through this section, U Afya mums can access bite-size facts directly addressing local myths and misconceptions, practical guidance on how to protect themselves and their families – tailored for mothers, and can download and share simple infographics on the 3 most effective ways of COVID-19 prevention: handwashing with soap, social distancing and wearing a mask. They are also directed to our existing hygiene content, such as the Happy Healthy Home e-learning course on household hygiene.
Rather than passively absorbing content, they actively interact with the community, building confidence and supporting each other. The mums share their experiences in a peer forum, and interact with fun and creative challenges. A favourite amongst the community was an invitation from our Community Manager Liz to join her in sharing their mask selfie:
The content is designed utilising techniques drawn from behaviour change models such as the socio-ecological model, behaviour centred design, the behaviour change wheel and the extended parallel process model for risk communication.
All content and messaging is fully localised into Sheng as appropriate for this audience and context, and is mindful of local feasibility of behaviours such as social distancing, the evolving regulatory environment such as full or partial lockdown, and the realities such as lack of access to running water. As with our tried and tested U Afya approach, the content is designed to be very relatable for mothers in low-income communities, aiming to build their confidence and includes content such as tips for kids at home.
“It’s worth every moment, very educative indeed. [Ok emoji] And motivating.“
2. Launched new behaviour change tools and repurposed existing ones, to stimulate and capture real-world behaviour
As well as learning, U Afya mums can interact with a range of digital tools and content designed to stimulate and capture real-world behaviour, including pledges, self-reported action tracking and sharing of personal stories. We have also repurposed the flagship U Afya 10 day Handwashing Challenge, which guides users through a set of fun daily challenges to help them establish and maintain handwashing behaviour.
“It was a challenge at first but now it is easy and fun washing our hands. My daughter now enjoys the challenge and we wash our hands daily.”
3. Repurposed the U Afya Ambassador programme to focus on COVID-19 to drive personal commitment and amplify U Afya’s reach within communities.
For our superuser U Afya mums, the Ambassador programme offers the opportunity to deepen their own engagement with the content, and to amplify the reach of the messaging to their peers beyond U Afya.
Those who express an interest in becoming a COVID-19 Ambassador are oriented through live moderated WhatsApp sessions, to help them maximise the benefit of their interaction with the COVID-19 prevention content as well as encourage them to link with other mothers in their communities -, therefore growing the grassroots movements of young mothers protecting themselves, their families and their communities.
“I wouldn’t miss the opportunity of [being an] ambassador.”
Learning and Insights
Through the U Afya community, we have gathered a wide range of insights to inform our current and future work. These include:
- Mothers can be empowered via remote, digital tools to become catalysts for change in their household and communities. Motivation tools should be bespoke to appeal to the motivations of the target group – for UAfya mums their motivation was their strong resonance with the concept of shared responsibility to care for their families.
- Confidence is essential to drive action and behaviour change and peer support between mothers increases confidence, motivation and implementation of positive behavior change. For the UAfya mothers their lack of confidence and self-efficacy, rather than a lack of knowledge, was the primary barrier to behaviour change so the platform targeted this in a localised, relevant way.
- Mothers already on the UAfya platform were highly motivated to support new members to participate – making our existing community of mothers a powerful tool for supporting mothers who were new to the platform.
- Online communities can be supported and motivated to proactively reach offline communities to drive positive behaviour change. UAfya mothers were successfully mobilised to conduct outreach into their wider community on how to combat COVID-19. Mothers successfully used the knowledge and confidence they gained via UAfya to drive positive behaviour change among members of their community who did not have digital access and so would otherwise be un-reached by digital interventions.
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