Corona Management System (CMS)

Ekanem itoro effiong currently works as a Program Officer with Corona Management System, focused on Advocacy, Communications and Social Mobilization. As a UNICEF trained Communications for Development specialist, he works to support states to potentiate the State’s engagement with community mobilizers and stakeholders, as well as engagement with the different cadres of traditional rulers towards strengthening community ownership and participation in the planning and delivery of health services. He has led our support to Bayelsa State Emergency Routine Immunization Coordination Center (SERICC) in the implementation of the revised community engagement strategy and our support for the State in the plans for the implementation of the Community Health Influencers, Promoters and Services (CHIPS) program. He also works to provide on the job mentoring of the State Advocacy, Communications and Social Mobilization structure, towards ultimately improving demand for Reproductive, Maternal, Newborn and Child Health services across the State. 

During this pandemic, there has been a massive increase in demand for information, as is expected during a time of crisis. This has been further compounded by rumours, misinformation and fake news. It is typical that at a time of chaos, individuals and communities will ultimately resort to sources that they have consistently trusted. This will be especially pronounced in rural areas and peri-urban slums, where trust issues continue to dominate the demand side of the COVID19 containment.

Our project will positively influence the behaviours of the thousands of inhabitants in rural communities, through strengthening the availability of information on COVID19 from sources that these community members trust.

Our solution aims to improve thousands of inhabitants livelihood, increase access to accurate COVID-19 information, increase utilization of family planning services.

As at 24th June, 2020, 21371 cases have been confirmed, 7338 cases have been discharged and 533 deaths have been recorded in 35 states and the Federal Capital Territory with over 3065 cases confirmed and 123 deaths in the Niger-delta region (NCDC)

It is widely documented that Women face more severe consequences during humanitarian crises especially in regions with extractive industries. The COVID19 pandemic espouses these consequences even more, as the public health measures for the containment of the virus place women at increased risk of gender-based violence, unplanned and unwanted pregnancies, and interrupted income especially for women in the informal sector, among others. These challenges are expected to be worse for women in rural communities facing additional humanitarian challenges. During this pandemic, there has also been a massive increase in demand for information, as is expected during a time of crisis. This has been further compounded by rumors and misinformation

Our team is working to deploy Interactive training and mentoring sessions for community health workers (CHWs) using WhatsApp and open source ChatBots, so they can provide better public healthcare in rural communities. Current training programs are run by medical professionals and require the CHWs to aggregate at a training, which may be inconvenient and is not advised in this era of physical distancing. These limitations would be overcome with online sessions where trained experts train multiple health workers remotely, supported by a crisis chatbot.

The format and deck for the trainings will be developed using a human centred design built on co-creation with the users, prototyping, feedback and re-iteration, towards improving the capacity of these CHWs to effectively engage their communities on COVID19. The training will involve delivery of a defined curriculum to groups of CHWs followed by a Q/A session, and then a demonstration of improved knowledge through a pre and post-test.

Our idea will test the hypothesis that the behaviour of community members will change because the demand for accurate information on COVID19 and Infection Prevention and Control (IPC) from communities will be met by CHWs, if they are trained using interactive technology, through a human-centered design process. 

Our proposed idea will put women and community health workers, small-holder farmers in regions with extractive industries at the center of the intervention, to understand these women as income earners and as users of health services more closely and to leverage a participatory approach to co-design a solution that enables these women to keep working fully throughout the COVID19 response and during the COVID19 recovery phase and beyond

The format and deck for the trainings will be developed using a human centred design built on co-creation with the users, prototyping, feedback and re-iteration, towards improving the capacity of these community health workers to effectively engage their communities on COVID19. The training will involve delivery of a defined curriculum to groups of health workers followed by a question and answer session, and then a demonstration of improved knowledge through a pre and post-test.

Corona Management System (CMS) is collaborating with the Nigeria Center Disease Control, with focus on working with all partners working within the risk communications pillar of the Incident Coordinating Center. While working at the frontline we noticed there has additionally been a massive increase in demand for information, as is expected during a time of crisis. This has been further compounded by rumours, misinformation and fake news. So both the team and selected community members brainstormed around potential solutions to address myths and misconception

The importance of risk management and effective risk communication cannot be overstated. the largest public health problem created by the accident,” attributing that profound impact to the “lack of accurate information,” or improper risk communication.  The risk from how people perceive risk, is as real as the physical danger itself. To win this virus war and impending social disruption, there is a need for effective risk communication and community engagement  (RCCE) – an essential component of health emergency and response activities. Exposure to information and messages that downplay the magnitude of the disease and attribute the cause of disease to God’s vengeance lower perceived disease severity and susceptibility and thus, increase risky behaviour in the community.

As a part of the planned intervention, our team is currently collaborating with the Nigeria Center Disease Control, with focus on working with all partners working within the risk communications pillar of the Incident Coordinating Center and we have conducted an analysis of the audience perception survey around covid-19. The findings are quite interesting and are based on the EPPM framework which underpins the risk communication strategy for the Covid-19 response. 

Our team lead for this project, Dr. Chijioke Kaduru holds a Master of Public Health degree, a Bachelor of Medicine and Bachelor of Surgery degree and a Bachelor of Science degree, working in public health for over ten years, with seven of those years working in Ghana and Nigeria. He is a Public health Physician who works on providing Sub-National Health Systems Strengthening technical assistance to the States we support, driving the conceptualization, implementation, monitoring and evaluation of State-led interventions in Malaria, Routine Immunization and Reproductive Health. He also focuses on strengthening Communications for Development systems at sub-national level.

Our team lead has previously worked as a Technical Assistant on the World Bank/GAVI supported National strategy for immunization and primary healthcare systems strengthening, as part of the drive to end polio, strengthen routine immunization and improve primary healthcare services. He has also previously provided consultancy services a broad range of health, gender and development issues for both Government and the Health Cluster partners, over the last decade.

We expect our solution to succeed because it builds on documented evidence and best practices of community engagement and demand generation, whilst innovatively introducing a different design model.

Risks and mitigations:

Key Risks

Potential Management Strategies 

 Stakeholder buy-in

To mitigate against lack of support and cooperation from management, we will deploy strategic advocacy and leverage on existing relationships developed over the last decade working in the Niger-Delta region

User willingness to co-create

Our use of a human-centred design puts the users of our solution at the centre, and gives these women ownership of the design and implementation of the solution

Current lack of perceived efficacy to act on COVID-19 could be a deterrent to participation

Approach to mapping and engaging the smallholder families will specifically highlight project objectives targeted at strengthening risk perception and perceived efficacy to act on COVID-19

Overtime, I realized that a lot of timidity comes from a lack of self-love and self-confidence. I began watching endless ted talks about confidence, openness, and outreach. From this I have created an image for myself that defines how I live. “Be so confident and so grounded in yourself, that you are able to love others regardless of division, jealously, or judgment.” I try to live by these words every day. To be proud of whom I am, and what I have to offer the world. And by becoming confident in my life, I am able to inspire confidence in others. I am able to show others their potential and goodness regardless of how different they are than me. I am able to be genuinely happy and proud of others when they do better than me. I am able to reach out to others regardless if others will judge me for doing so. Confidence in myself has inspired me to be a better person, to live a better life, and to make the world a better place.

This idea is different because it incorporates a human-centered design into the training of community health workers, and it deploys easily accessible mobile technology. The intervention builds on existing evidence on the role of Community Health Workers as a trusted source of information. It also dovetails into the current National drive in Nigeria to rapidly improve risk communications, supported by a quarterly program appraisal for performance management and action survey funded by the World Bank, and which allows disaggregation of program survey data to the level of the communities for monitoring of interventions.

Our solution also prioritises scalability beyond COVID19, as a potential innovative solution for the training of community health workers on an array of issues. This pathway for scale is also at the heart of sustainability for our solution through a pipeline of value add for trainings of community health workers for vertical programs in health. Programs like Immunization, Family Planning and Nutrition would potentially take up this solution, as a cost-effective approach to scaling trainings across community health workers.

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We aim to positively influence the behaviours of the thousands of inhabitants in rural communities, through strengthening the availability of information on COVID19 from sources that these community members trust within the first three years

The project cannot be delivered without support from the Facility, as
the support will provide the financial resources to convene these communities of practice and to support capacity building and development of the resilience we would like to see among these women 

• We currently have funding from the 26th round of the Grand Challenges Explorations, an initiative of the Bill and Melinda Gates Foundation, with this funding supporting us to explore the use of Community Theatre to increase demand for vaccinations in the Niger-Delta through a human-centred design;
• We currently maintain funding from the United Nations Foundation Family Planning 2020 partnership, with this funding supporting us to explore mechanisms to improve health outcomes through task shifting;
• We currently implement innovative strategies using performance management dashboards to support sub-national program management and implementation of health system interventions, on the World Bank Saving One Million Lives Program;
• Our team are currently supporting the Incident Coordination Centre of the Nigeria Centre for Disease Control, specifically supporting Risk Communications and Community Engagement.

These interventions form the basis for our planned intervention on to strengthen risk communication leveraging community health workers and using a human centered design.

Our solution also prioritises scalability beyond COVID19, as a potential innovative solution for the training of community health workers on an array of issues. This pathway for scale is also at the heart of sustainability for our solution through a pipeline of value add for trainings of community health workers for vertical programs in health. Programs like Immunization, Family Planning and Nutrition would potentially take up this solution, as a cost-effective approach to scaling trainings across community health workers.

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The Leadership of the State Ministry of Health

The State Primary health care development board

Community health extension workers 

Relevant Gatekeepers