Through the UK aid-funded Ascend West and Central Africa programme, Sightsavers and partners already work with the Ghanaian government to control and eliminate five neglected tropical diseases (NTDs). But when COVID-19 struck and NTD activities were suspended, the staff, systems and expertise Ascend supports were redirected to strengthen Ghana’s response to the pandemic.
Working alongside the Ghanaian government, the Ascend coalition conducted in-depth analysis, scoping sessions and focus groups, to identify critical areas that required targeted COVID-19 response activities. From this work, two areas emerged: people in cross-border communities and children.
This work, which is helping more than 10 million Ghanaians stay safe from coronavirus, has supported the training of hundreds of health professionals and volunteers to take on temporary roles on the coronavirus front line. As well as the development of COVID-19 behavioural change communication campaigns – one designed to resonate with communities on the Togo/Ghana border, and the other to appeal to children across the country.
An example of this approach is a video aimed at young people in Ghana, which was shared on social media:
The Ascend West and Central Africa programme aims to protect millions of people in 13 countries from neglected tropical diseases.About the programme
Border areas are particularly important to Ghana’s COVID-19 response. Not only are people in these areas at risk of the virus, they also come into contact with highly mobile groups, making them more vulnerable. In March, when borders between Ghana and other countries closed, stranded travellers continued to move between them, possibly to keep in touch with family members living on the other side or so they wouldn’t miss trading and economic opportunities. Due to this, testing for the virus was not initially available for these people, increasing the likelihood of transmission in these border communities.
Mahmoud Abdulaziz, managing district coordinating director for Nkwanta North District in the border region of Oti, is responsible for health services there. He says: “Because of the closure of the borders, people have created different unapproved routes. So even if a [testing] team is set up at the approved routes, then you have people using the unapproved route entry into the district, [and it is]… very difficult to be able to screen those who use the unapproved routes.”
“What we are doing is to liaise with the communities that have access to these [un]approved roads, and for them to be able to help… [by providing] community volunteers,” adds Mahmoud. “[They are then] identifying people who are using these routes, then inform[ing] the customs or the immigration, and also the chiefs and leaders, so that these individuals can be… screened.”
Sightsavers and partners have been supporting NTD work in these cross-border districts for many years. This meant a network of skilled community volunteers and health workers were already in place to trace and screen those moving across borders, and to raise awareness about COVID-19 in their communities. But first, this trusted network needed training.
Nii Ablade Nortey is one of the many health professionals who has stepped up to help with the COVID-19 response in border communities. Normally head pharmacist at Worawora government hospital, he put himself forward to train teachers and front-line health workers from 12 border areas to respond to the crisis.
“The aim [of the training] is to… build and develop the skills of the people who are more front-line on issues related to COVID-19,” says Nii. “We want to give them that education to build on their skill.”
As well as learning how to manage cross-border screenings, about 800 health workers have been trained to spot people with coronavirus symptoms and refer them to testing. They have also been trained to conduct contact tracing and shown how to implement and communicate prevention measures, such as social distancing, tackle COVID-19-related stigma and dispel rumours about coronavirus.
“Since it [coronavirus] started, if I even look at social media, we’ve had a lot of misinformation,” says Nii. “So it’s very important for us to have a forum where you bring in these critical people, and then you feed them with the right information so that they go out there and do the right thing.”
David K Agbavor, district health promotion officer for Kadjebi District in Oti, says the training confronted misconceptions about COVID-19 that even he held.
He says: “I was lacking a lot of things, I didn’t understand the whole concept, or how the virus is transmitted… although I read about it on the net, but it wasn’t all that clear. Through the training I was able to understand a lot of things, all the techniques of approaching, and the protocol that [must be] put in place [to] prevent transmission.”
The COVID-19 behavioural change communication campaigns that Sightsavers and partners have supported in these communities use information centres and local radio – the two most popular information sources in the area – to broadcast information about coronavirus in local languages. This method reaches more than 1.7 million residents.
People such as David are essential to this work as they help to spread the messages of the campaign.
“A community centre [awareness raising structure] is just a structure built with four horns [speakers] mounted on like sticks… at the top, then connected with a DVD player or audio player,” says David. “Anytime we receive any jingle I’ll go and buy [a] pen drive and copy it on, and give the jingles to them [the structures] to play. Then I go and supervise them and see whether they’re playing it or not.
“If I’m in a car, then I’ll use the public address system and be talking. I’ll play the jingles while I’m moving from community to community, where cars can go easily. And also we give the jingle to the mosques, the Muslim community. After they have finished prayers, then it will play.
“They’ve totally changed [people’s opinions], because sometimes people didn’t social distance or use masks… at first, they were not taking the instructions or… not following the protocol… all those things they’re now doing.”
Head teacher Amoah Mensah-Shelter also participated in the COVID-19 training to ensure the children in her school, their families and others in her community stay safe.
She is one of 200 teachers in Ghana who have been shown how to keep their schools COVID-19-safe, how to teach children and families about crucial preventative measures, and how to refer anyone with symptoms for testing.
“Health issues are in my heart,” she says. “I… decided to get involved because when the issue first came I needed… a way to learn more about what the virus entails so I can communicate it to my community.”
The COVID-19 behavioural change communication campaign, that was designed to target children, was created using age-appropriate language, characters, stories, music and humour, and appeared on television, radio and social media across the country. But teachers such as Amoah are also essential to ensuring children take part in practical activities that ensure messages about the virus get through.
“Our students resumed about two or three months ago, so we had training with them, together with their parents,” says Amoah. “We have signs that show the right way to wash their hands – I made sure the students did the drawing themselves so it would be easy for them to implement.
Amoah says the work of her and others on the COVID-19 front line is paying off.
“At this point, in my community about 95% have heard about the virus,” she says. “I saw a lot of people getting involved in the training, and I see a lot of people going around with masks on.”