House-hold level visits as a delivery channel:
Using household-level visits as a delivery channel involves staff (such as frontline hygiene promotion staff) travelling to each household to share information, have discussions, or undertake behaviour change activities. You should decide on whether this method is appropriate for your context based on the extent of community-level transmission of COVID-19, government guidelines and your organisation’s risk assessment. All in-person work involves higher levels of risk than mass media or other remote ways of communicating with your population. If you choose to utilize household-level visits, it is important to make sure appropriate safety measures are put in place. The changing dynamic of the pandemic may mean that even if house-to-house visits are safe to do now, they may become unsafe later, so it is best for them to be combined with other delivery channels.
The benefits of household-level visits are that they can be personalised to the household and are often more engaging. More than any other mode of communication, it enables proper dialogue and can be easily changed or adapted at minimal cost. Typically in-person visits allow organisations to address a broader range of determinants of behaviour (e.g. you can help families make changes to their physical environment so that behaviours are enabled). The effectiveness and quality of in-person interactions are very dependent on the capacity of staff. Good interpersonal programming therefore requires lots of training and ongoing support which can be time consuming. In-person work during the pandemic is likely to be most effective and feasible if it focuses on particular regions or populations that are likely to be at high risk or who are particularly hard to reach, as it is not normally feasible at national level.
Here are some tips and considerations if using household-level visits as a delivery channel:
Train delivery teams properly on the key messages to be delivered and the plan for activities. One way to do this is to develop an instruction manual for hygiene promotion teams.
Try to avoid content that is only focused on education or information sharing.
Pilot your proposed activities with a small number of households first and seek their opinions on the process and how it could be improved. Improve the activities accordingly.
Develop a list of common questions and answers about COVID-19 that can be given to frontline staff so they are able to answer questions from the community with clear, factual and updated information. You may need to revise this list at the end of each week.
Plan for team meetings where staff share experiences and learn from each other about what is working or not working. Adapt your programming based on this.
Consider whether you may need to visit households more than once as this may be more likely to influence behaviour.
Key Stakeholders as a delivery channel:
Key stakeholders are people, groups or organizations within a community that have some influence, are normally involved in information sharing, or who come in contact with many other people (e.g. village leaders, religious leaders, bus drivers, health workers, school teachers, celebrities). These key stakeholders are always important to engage in your programming, however at the moment, key stakeholders can also be trained to become frontline COVID-19 prevention actors. Key stakeholders may also contribute to the work you are doing through other delivery channels.
The benefits of working with key stakeholders are similar to doing in-person work in general – they can be personalised and engaging, they enable proper dialogue, and can be easily changed or adapted. However, at this time there are several other key benefits of working with key stakeholders to deliver prevention programmes. Given current movement limitations, working with community-level actors is much safer than getting staff from an organisation to travel to and from communities on a daily basis. Engagement at the community-level through the use of key stakeholders can also target populations that may otherwise not be reached by other delivery channels. For example, WaterAid Pakistan is using female community resource persons (CRPs) to conduct household visits in rural communities to ensure information is able to reach women. If selected well, key-stakeholders are likely to be known and trusted voices in the community, and they are likely to be similar to the target population and therefore seem more legitimate or better able to speak to their circumstances. For this reason, engaging these individuals can be particularly useful in trying to establish new social norms around preventative behaviours. Working via key stakeholders may also enable two-way learning and the collaborative improvement of programmes, this in turn may contribute to building longer-term capacity and resilience within communities.
Working via key stakeholders is not always easy. It can be difficult and time-consuming to identify appropriate individuals to deliver your message, to establish these partnerships, and to encourage people to undertake this COVID-19 prevention work among their other priorities/responsibilities. It can also be challenging to provide quality control and support for their work if this is being done remotely.
Here are some tips and considerations if using key stakeholders as a delivery channel:
Consider who you are involving and how this individual or group may be perceived locally (i.e. just because someone is a village leader it doesn’t necessarily mean they are liked or trusted)
Consider whether remuneration should be provided if substantial work is being asked of individuals but be cautious of setting up precedents that may be hard for other actors to follow
The WHO has recommendations on how to work with religious leaders and faith-based communities to promote COVID-19 prevention behaviours. This example from World Vision in Afghanistan shows this in practice. In Sudan a network of thousands of youth volunteers (previously primarily working on sexual and reproductive health) have been mobilised to conduct household level visits around COVID-19. There are also multiple global examples of celebrities becoming engaged in COVID-19 prevention work. For example, the Indian government decided to use a famous Bollywood actor to promote their messages, while the Tanzanian Government utilised government representatives and music stars to help convey COVID-19 information.
Want to know more about maximising different delivery channels for communicating about COVID-19?
Editor's note
Author: Anika Jain
Review: Katie Greenland, Lara Kontos and Kondwani Chidziwisano
Version date: 23.09.20