Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment
Abstract Background Rural Afghan populations have low skilled birth attendance rates and high maternal and infant mortality. Insecurity and armed conflict, geographic barriers, and cultural norms often hinder women’s access to facility-based reproductive, maternal, newborn, and child health (RMNCH)...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | Conflict and Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13031-020-00302-z |
| _version_ | 1828453205168619520 |
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| author | Leila C. Dal Santo Sayed Haroon Rastagar Shafiqullah Hemat Sayed Omar Alami Subarna Pradhan Jenae Tharaldson Lisa S. Dulli Catherine S. Todd |
| author_facet | Leila C. Dal Santo Sayed Haroon Rastagar Shafiqullah Hemat Sayed Omar Alami Subarna Pradhan Jenae Tharaldson Lisa S. Dulli Catherine S. Todd |
| author_sort | Leila C. Dal Santo |
| collection | DOAJ |
| description | Abstract Background Rural Afghan populations have low skilled birth attendance rates and high maternal and infant mortality. Insecurity and armed conflict, geographic barriers, and cultural norms often hinder women’s access to facility-based reproductive, maternal, newborn, and child health (RMNCH) services. Community health workers (CHWs) are critical agents for behavioral change in this and similarly fragile settings, where RMNCH information exposure is limited by low literacy and mass media access. We assessed the feasibility and acceptability of a computer tablet-based health video library (HVL) to enhance CHW counseling on RMNCH topics in three rural Afghan districts. Methods The HVL was introduced by trained CHWs in 10 pilot communities within one rural district in each of Balkh, Herat, and Kandahar provinces. We used a mixed-methods study design to assess exposure to and perception of the HVL 6 months post-introduction. We surveyed married women (n = 473) and men (n = 468) with at least one child under 5 years and conducted in-depth interviews with CHWs and community leaders (shuras and Family Health Action groups) within pilot communities (n = 80). Program improvement needs were summarized using quantitative and qualitative data. Results Higher proportions of women in Balkh (60.3%) and Herat (67.3%) reported viewing at least one HVL video compared to women in Kandahar (15%), while male HVL exposure was low (8–17%) across all districts. Most HVL-exposed clients (85–93% of women and 74–92% of men) reported post-video counseling by CHWs. Nearly all (94–96% of women and 85–92% of men) were very interested in watching videos on other health topics in the future. Participants recommended increasing the number of videos and range of topics, using tablets with larger screens, and translating videos into additional local languages to improve the HVL program. Conclusion The HVL was a highly acceptable tool for relaying health information, but coverage of female audiences in Kandahar and male audiences broadly was low. The HVL should better engage men and other key influencers to engineer local solutions that directly facilitate male HVL exposure, indirectly improve women’s HVL access, and support collaborative spousal health decision-making. A larger efficacy trial is warranted to measure the HVL’s effect on knowledge and health-related behavioral outcomes. |
| first_indexed | 2024-12-11T00:05:09Z |
| format | Article |
| id | doaj.art-6522b9bb824b497fb3ababca82078f60 |
| institution | Directory Open Access Journal |
| issn | 1752-1505 |
| language | English |
| last_indexed | 2024-12-11T00:05:09Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Conflict and Health |
| spelling | doaj.art-6522b9bb824b497fb3ababca82078f602022-12-22T01:28:21ZengBMCConflict and Health1752-15052020-08-0114111510.1186/s13031-020-00302-zFeasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessmentLeila C. Dal Santo0Sayed Haroon Rastagar1Shafiqullah Hemat2Sayed Omar Alami3Subarna Pradhan4Jenae Tharaldson5Lisa S. Dulli6Catherine S. Todd7Global Health, Population, & Nutrition Division, FHI 360FHI 360/ HEMAYAT projectHealth Promotions Department, Ministry of Public Health, Islamic Republic of AfghanistanFHI 360/ HEMAYAT projectGlobal Health, Population, & Nutrition Division, FHI 360Global Health, Population, & Nutrition Division, FHI 360Global Health, Population, & Nutrition Division, FHI 360Global Health, Population, & Nutrition Division, FHI 360Abstract Background Rural Afghan populations have low skilled birth attendance rates and high maternal and infant mortality. Insecurity and armed conflict, geographic barriers, and cultural norms often hinder women’s access to facility-based reproductive, maternal, newborn, and child health (RMNCH) services. Community health workers (CHWs) are critical agents for behavioral change in this and similarly fragile settings, where RMNCH information exposure is limited by low literacy and mass media access. We assessed the feasibility and acceptability of a computer tablet-based health video library (HVL) to enhance CHW counseling on RMNCH topics in three rural Afghan districts. Methods The HVL was introduced by trained CHWs in 10 pilot communities within one rural district in each of Balkh, Herat, and Kandahar provinces. We used a mixed-methods study design to assess exposure to and perception of the HVL 6 months post-introduction. We surveyed married women (n = 473) and men (n = 468) with at least one child under 5 years and conducted in-depth interviews with CHWs and community leaders (shuras and Family Health Action groups) within pilot communities (n = 80). Program improvement needs were summarized using quantitative and qualitative data. Results Higher proportions of women in Balkh (60.3%) and Herat (67.3%) reported viewing at least one HVL video compared to women in Kandahar (15%), while male HVL exposure was low (8–17%) across all districts. Most HVL-exposed clients (85–93% of women and 74–92% of men) reported post-video counseling by CHWs. Nearly all (94–96% of women and 85–92% of men) were very interested in watching videos on other health topics in the future. Participants recommended increasing the number of videos and range of topics, using tablets with larger screens, and translating videos into additional local languages to improve the HVL program. Conclusion The HVL was a highly acceptable tool for relaying health information, but coverage of female audiences in Kandahar and male audiences broadly was low. The HVL should better engage men and other key influencers to engineer local solutions that directly facilitate male HVL exposure, indirectly improve women’s HVL access, and support collaborative spousal health decision-making. A larger efficacy trial is warranted to measure the HVL’s effect on knowledge and health-related behavioral outcomes.http://link.springer.com/article/10.1186/s13031-020-00302-zAfghanistanCommunity health workerMaternal and child healthCounselingSocial and behavior changeFragile states |
| spellingShingle | Leila C. Dal Santo Sayed Haroon Rastagar Shafiqullah Hemat Sayed Omar Alami Subarna Pradhan Jenae Tharaldson Lisa S. Dulli Catherine S. Todd Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment Conflict and Health Afghanistan Community health worker Maternal and child health Counseling Social and behavior change Fragile states |
| title | Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment |
| title_full | Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment |
| title_fullStr | Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment |
| title_full_unstemmed | Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment |
| title_short | Feasibility and acceptability of a video library tool to support community health worker counseling in rural Afghan districts: a cross-sectional assessment |
| title_sort | feasibility and acceptability of a video library tool to support community health worker counseling in rural afghan districts a cross sectional assessment |
| topic | Afghanistan Community health worker Maternal and child health Counseling Social and behavior change Fragile states |
| url | http://link.springer.com/article/10.1186/s13031-020-00302-z |
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