The use of video job-aids to improve the quality of seasonal malaria chemoprevention delivery

Abstract

Mobile phones are increasingly used in community health programmes, but the use of video job-aids that can be displayed on smart phones has not been widely exploited. We investigated the use of video job-aids to support the delivery of seasonal malaria chemoprevention (SMC) in countries in West and Central Africa. The study was prompted by the need for training tools that could be used in a socially distanced manner during the COVID-19 pandemic. Animated videos were developed in English, French, Portuguese, Fula and Hausa, illustrating key steps for administering SMC safely, including wearing masks, washing hands, and social distancing. Through a consultative process with the national malaria programmes of countries using SMC, successive versions of the script and videos were reviewed to ensure accurate and relevant content. Online workshops were held with programme managers to plan how to use the videos in SMC staff training and supervision, and the use of the videos was evaluated in Guinea through focus groups and in-depth interviews with drug distributors and other staff involved in SMC delivery and through direct observations of SMC administration. Programme managers found the videos useful as they reinforce messages, can be viewed at any time and repeatedly, and when used during training sessions, provide a focus of discussion and support for trainers and help retain messages. Managers requested that local specificities of SMC delivery in their setting be included in tailored versions of the video for their country, and videos were required to be narrated in a variety of local languages. In Guinea, SMC drug distributors found the video covered the all the essential steps and found the video easy to understand. However, not all key messages were followed as some of the safety measures, social distancing and wearing masks, were perceived by some as creating mistrust amongst communities. Video job-aids can potentially provide an efficient means of reaching large numbers of drug distributors with guidance for safe and effective distribution of SMC. Not all distributors use android phones, but SMC programmes are increasingly providing drug distributors with android devices to track delivery, and personal ownership of smartphones in sub-Saharan Africa is growing. The use of video job-aids for community health workers to improve the quality delivery of SMC, or of other primary health care interventions, should be more widely evaluated. Author summary During the COVID-19 pandemic, it was important to ensure that core malaria prevention strategies continued. Seasonal malaria chemoprevention (SMC) is the monthly administration of chemoprevention drugs to children to prevent malaria in areas with highly seasonal malaria transmission. In partnership with 13 National Malaria Control Programmes in West and Central Africa, we developed a user-friendly training video to support safe delivery of SMC during COVID-19. The use of the video was evaluated through a case study in Guinea and an online workshop with the programme coordinators. SMC drug distributors found the video covered all the essential steps and was easy to understand. However, not all key messages were followed as social distancing and wearing masks were perceived by some as creating mistrust. Programme coordinators found the video useful as it reinforces messages and can be viewed many times. Video content needed to be adapted to the local setting and narrated in local languages. Not all distributors use android phones but many SMC programmes now provide drug distributors with android devices to use during SMC delivery, so that video job-aids could be more widely used.