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Seven lessons from scaling up mHealth in India

2023-03-24T09:00:00+00:00

Our challenge: How do we ensure families in India have timely information about childbirth, childcare and family planning, during pregnancy and in the first year of the child's life?

The innovation: High-quality health information and advice to Indian families - particularly in rural areas – through the growing use of basic mobile phones. Our human-centred design mobile health solution has been scaled to 17 states by the Government of India to empower families and frontline health workers to improve child mortality and maternal health.

Kilkari (a baby’s gurgle) is our mobile messaging service designed to reinforce frontline health workers’ counselling by delivering information to families to help healthier choices and lives. Combined with tools and training for frontline health workers – our Mobile Academy training course, and Mobile Kunji tool to support frontline workers in communicating with families - the service is strengthening this ‘last mile’ of the health system, to increase their knowledge, skills and confidence in communicating, and reinforcing their information. Aiding with all of this is the trusted voice of ‘Dr Anita', the fictional narrator across our suite of mHealth services – Mobile Academy, Mobile Kunji and Kilkari – providing health information, guidance and friendship to families across India.

Kilkari’s free, weekly, stage-based audio messages about pregnancy, childbirth, childcare and family planning are delivered directly to families’ phones as one pre-recorded call per week for 72 weeks, linked to the stage of pregnancy or child’s age and timed for the highest-risk periods, between the second trimester of pregnancy until the child is a year old. Available in five languages – Hindi, Bihari, Oriya, Assamese and Bengali – family mobile phones are automatically subscribed as soon as a pregnancy is registered in the government database.

Following two independent evaluations and analyses from Johns Hopkins University and Stanford University, now published in a special supplement of BMJ Global Health, here are the lessons we learned over a decade of digital development:

Dr. Anita is the fictional narrator of Kilkari, Mobile Academy and Mobile Kunji, providing health information, guidance and friendship to families across India.

1. Mobiles can provide access to health information at scale using appropriate technology

Kilkari is one of the world’s largest mobile maternal messaging services and has reached 24.6 million subscribers across 17 states. Mobile Academy is the largest mobile-based training programme for health workers in the world and has reached over 235,000 frontline health workers across 16 states in India. Amid low levels of smartphone access and ownership among women in low-income and low-literate settings, both services use IVR (Interactive Voice Response) technology to help overcome these challenges.

2. Timed and targeted information can improve modern contraceptive use and immunisation

When Dr Anita gave advice on condom use, people listened: Those who listened to Kilkari were associated with a 3.7% higher use of modern reversible contraceptives; the number rose to 7.3% among those who heard 50% or more of Kilkari content, compared to non-listeners – largely driven by increased condom use. Effects were even larger for families with a male child (9.9% increase), in the poorest socioeconomic strata (15.8% increase), and in disadvantaged castes (12.0% increase). The evaluation also found higher rates of immunisation among infants at 10 weeks (2.8%).

3. A relatively small amount of the relevant content, delivered at the right time, is a cost-effective way of saving lives

Seven Kilkari calls on reversible contraceptive methods, totalling just over 10 minutes and delivered direct to families’ mobile phones, had an effect on those families’ practices. Peer-reviewed analysis of our randomised controlled trial showed that Kilkari has saved nearly 14,000 lives (96% child lives and 4% maternal) and has been declared a highly cost-effective intervention, with the cost per life saved ranging from USD $392 to $953 depending on the intervention year.

4. Design mHealth solutions with an equity lens to reach the poorest communities with mobile phone access

It’s important to think about how communities are using mobile phones, and when. The poorest subscribers, educated to at least secondary level, appear to have had the biggest equity gains from exposure to Kilkari, thanks to design decisions like the ‘retry’ algorithm – which tried mobile phone numbers at different times of the day, to reach families when they had time to listen.

5. Subscription-based business models are challenging in low-resource settings

In the initial years, Kilkari subscribers were charged a nominal fee – but this user-fee model failed to cover marketing costs. Kilkari became a toll-free service in 2016 with call costs covered by the Government of India, enabling greater reach and impact.

6. Digital interventions must be informed by gender intentional design

The gender digital divide in India, and the offline and online norms that create this divide, necessitate a gender-intentional, research-driven approach to designing mHealth interventions. We needed to understand who is left behind by digital interventions - and how to reach and impact those groups through alternate communication channels and platforms.

7. Digital direct-to-beneficiary communications need to be complemented by a mix of other interventions to shift social norms and change deeply entrenched behaviours.

Despite advice that covered a full range of infant and childcare, Kilkari was not found to have had measurable impact on infant and young child feeding practices. Our evaluators found that practices under ‘normative influence’ – where families do not need to engage with the health system, like complementary feeding - saw more positive associations when communication tools like Mobile Kunji were used, providing opportunity for further discussion.

This article was first written in November 2022 and updated in March 2023.

Kilkari is one of only five mHealth services globally to reach over one million subscribers and won ‘Best mobile innovation for women in emerging markets' at GSMA Global Mobile Awards 2019. Learn more about Kilkari on our website, in the BMJ Global Health (third-party site) and at the International SBCC Summit from December 2022.

Calculations on lives saved and cost effectiveness appear in an article by LeFevre, A.E. et al, ‘Are stage-based, direct-to-beneficiary mobile communication programmes cost-effective in improving reproductive and child health outcomes in India? Results from an individually randomised controlled trial of a national programme.’

We are grateful to Stanford University for analysis of our evaluation, and to Johns Hopkins University for conducting the randomised controlled trial.

Sara Chamberlain is currently on sabbatical as India Digital Director; Radharani Mitra is India Creative Director and Global Creative Advisor; and Anna Godfrey is Head of Evidence at ��tv Media Action.

Learn more about Kilkari and its impact.

Out from the shadows: Tackling the stigma of disability in refugee communities

2022-11-30T10:29:05+00:00

A Rohingya refugee camp in Cox's Bazar, Bangladesh. Mrittika Deb Purba/��tv Media Action Bangladesh

Cox’s Bazar is the home of more than 900,000 Rohingya people living in refugee camps, of whom an estimated 12% are people with disabilities. We recently conducted research with people with disabilities living in the camps, to understand what barriers they face in accessing information, participating in decision-making activities, making complaints and giving feedback to the humanitarian agencies working there.

“Invisible” people in Rohingya camps

During our fieldwork, we realised how hard it was to find people with disabilities to talk to in the Rohingya camps. It was difficult to find people with disabilities in public spaces – as if they were invisible - and when asking other camp residents where we might find people with disabilities, we had to use disparaging terms for them to understand who we meant, as they are often referred to only by their impairments. We also sought support from humanitarian practitioners working with this group, to help us identify potential research participants.

Once we found participants to speak to, we observed that most of their shelters were located either up steep hills, or beside drains. And the roads to reach their shelters were typically unstable and uneven. We wondered: if we are struggling to get to them on foot, then how are people with a physical disability managing to get around? Are they able to move from their shelters? As it was the rainy season, another question came into our minds: if there was a landslide, how fast would people with disabilities be alerted to the danger, and would they be able to move when the roads are slippery and muddy? When we reached their shelters, we noticed that often families would keep women with disabilities (especially those with hearing, vision and learning impairments) ‘out of sight’ in dark parts of the shelter, with little air, which was not the case for men with disabilities. We asked ourselves – why is it that women with disabilities are kept hidden from view by their families?

Barriers aggravate their “invisible” condition

Our research identified that people with disabilities face a series of barriers in accessing information, beginning at home. They often do not know where to get information, which makes them dependent on their family members or caregivers. And even if they know where to go, they are often not permitted to go out alone, as family members fear they will injure themselves on the slippery mud or steep slopes - even if they do not have a physical disability and are able to walk themselves. Instead, family members may try to carry them themselves, or seek assistance from neighbours to carry them; however, neighbours may charge for this help, which families may struggle to afford.

Stigma is another barrier to going out: people with disabilities and their families fear being humiliated by other community members, and have experienced abuse, from being calling discriminatory names to having stones thrown at them. Because of this stigma and abuse, family members are often reluctant to accompany people with disabilities outside, and sometimes people with disabilities may hide themselves from the community.

To minimise these barriers, organisations working to support people with disabilities have mobile teams and door-to-door services to reach people with disabilities with information. However, our research identified further barriers. The mobile teams are often staffed by a limited number of community volunteers, who may be unable to cover the whole camp, and so do not reach people with disabilities who live in more remote areas. When they do reach people’s shelters, they may ask family members or caregivers about the problems or concerns of the person with disabilities, rather than checking with the person themselves. When we asked practitioners working for organisations supporting people with disabilities about this, they explained that family members often have mechanisms to communicate with their disabled family member - for example, if that person is hearing impaired and does not use international sign language. However, this excuse is not relevant for someone with a disability which is not communication related.

Negative experiences at sessions

These barriers, throughout the year, constrain people with disabilities from participating in any meetings in the camps, excluding them from decision-making processes. We did find that some research participants had attended awareness-raising sessions – even though they were organised far from their homes. But some said their experiences were so negative that they were unwilling to attend further meetings.

A 32-year-old woman with a vision impairment told us:

“When we arrived at the meeting, the volunteer said that the meeting was not for me and I requested her to let me enter as I cannot go back alone. She let me enter and asked me to sit in a corner of the room. When they start meeting, I was having problems hearing clearly so I asked my neighbour what she just said. And that time, the community volunteer shouted at me for interrupting her discussion. Her behaviour made me sad and after that day, I never went to any meetings."

Afraid to ask questions

We heard these kinds of examples from both male and female participants with physical, visual, and hearing impairments. These experiences affected their desire to participate and be heard. They told us they often don’t ask questions, because everything is new to them, and they lack confidence asking questions of those they perceive as more educated. Some said they feel shy talking in front of people without disabilities.

We have learned from our research that we all need to increase our efforts to be more inclusive in the way that we communicate with these ‘invisible people’ to ensure that they have the accessible information they need and are able to participate in decision-making forums. Humanitarian agencies are scaling their support for people with disabilities in the camps. But now, in the fifth year of the Rohingya refugee crisis, more effort is required to understand their experiences, fears and needs, and address their barriers, so that they feel confident and empowered to communicate with, and participate in, the wider community.

A fully inclusive response

Humanitarian actors should take steps to make their response fully inclusive: ensuring a smooth and accessible information flow within the camps so that people with disabilities can obtain information without difficulty; supporting experts so they are better able to communicate with people with disabilities; focusing on sensitising and educating communities to reduce stigma against people with disabilities; supporting people with disabilities to participate meaningfully in meetings; and mentoring caregivers to be a strong support rather than a barrier to participation. ��tv Media Action could play a vital role in this work: through developing and sharing relevant content which is accessible for all, and features people with disabilities, and training humanitarian staff on interpersonal communication skills and inclusion, to ensure they are reaching everyone.

Designing for inclusion: From invisible to #Invaluables

2022-08-30T12:05:30+00:00

Cities tend to forget the very people who are their lifeline.

The 12.5 million denizens of Bengaluru, known as India’s Silicon Valley, generate 5,757 metric tonnes of solid waste per day.

But the city’s estimated 30,000 informal waste pickers, who form the backbone of Bengaluru’s waste management system, are invisible and ignored. They live in deplorable conditions with low and unstable incomes, face significant workplace hazards, and are treated with suspicion and contempt.

Funded by the H&M Foundation, Saamuhika Shakti (SaaS, the Collective Impact Initiative), aims to address this situation. ��tv Media Action, an initiative programme partner, turned to social media to create our Pathway to Respect, Identity, Dignity and Empowerment (PRIDE) project for informal waste pickers.

An informal waste picker who featured in our #Invaluables campaign

Lack of recognition

The PRIDE project’s formative research revealed that there is a lack of recognition of the humans behind the process of waste management. While people in the city see waste on the streets, and they are concerned about it, they failed to list waste pickers as important to their lives. On further probing, we found that while people appreciated the work of formal waste collectors, who are hired by the municipality for door-to-door garbage collection, informal waste pickers were still stigmatised. More than half of our study respondents said that informal waste pickers are dirty and shouldn’t be allowed inside residential building complexes.

Street rag-pickers look scary, so we don't go near them!

- Female, 39, housewife, Bengaluru

The pandemic strengthened these negative perceptions. Waste pickers, in turn, confirmed having to regularly deal with discrimination.

’They (the public) scold us. They feel they will catch the disease (COVID-19) from us. They think we have the virus. So, I do not like to go to work.’’

- Female waste picker, under 18

Research was used to identify segments within social media users among the general population of Bengaluru, based on their attitudes towards informal waste pickers. Our research and analysis showed three broad segments of people:

Appreciators, who valued the role and contributions of informal waste pickers and understood their circumstances
Sympathisers, who displayed an overall sentimentality towards informal waste pickers accompanied by stereotyping of their work
Stigmatisers, who wanted to distance themselves from the waste picking community and displayed extremely negative attitudes

The project decided to focus on appreciators and sympathisers, who were more likely to become early adopters of any changes in attitude or behaviour.

Strategic reframing

In a country with a history of caste-based occupations and discrimination, bringing a change in mindsets is uphill work. The project turned to Professor Judith Butler to understand why some lives are valued and others not, and how marginalisation is contingent on rendering social groups virtually invisible.

Based on the reading of Butler and formative research, the project’s Theory of Change focused on the need to end the invisibility of informal waste pickers if their lives and work were to be properly valued. This involved a reframing of the work of waste pickers as involving special skills and productive labour essential for the city’s survival, as well as recognition of the fragility of social media users’ own lives in the face of environmental hazards. The recognition of this shared fragility is a pathway to creating a social bond that obliges us to care for each other. Establishing the interconnectedness between the lives of social media users and the work of waste pickers was integral to the former valuing the life and work of the latter.

Designing for PRIDE

The project used social media to connect the people of Bengaluru with informal waste pickers, by positioning the waste pickers as ’invaluable friends’, friends they did not know they had. The creative strategy was designed to lift the shroud of invisibility and open the eyes of Bengalureans to the value that informal waste pickers bring to their lives - as professionals, as humans, and as residents living side-by-side in the same city.

A social experiment film explored the concept of friendship and revealed how informal waste pickers share the values normally associated with true friendships. The social experiment was conducted by Radhika Narayan, a popular actor and social media influencer. The film ended with a call to action to join a moderated private community on Facebook called the #Invaluables Facebook group.

Participants in our #Invaluables social media experiment were asked who their dearest friends were - then shown how informal waste pickers fit the description. /��tv Media Action India

The content posted on this group brought Bengalureans closer to the waste picking community, by creating awareness and demonstrating the value of their work to save the city from being buried under a mountain of garbage, and therefore demonstrating their interconnectedness.

Crafting this journey of perception change required a steady stream of relevant content through the week, seizing every opportunity and fact in a strategic manner and converting it into engaging content that would bring this interconnectedness to life. We built the social media strategy carefully, weaving in the use of influencers wherever necessary and taking the conversations beyond social media to discussions on FM radio during regular shows, hosted by prominent city RJs.

The branding, Invaluables, was designed to strengthen the idea of ‘interconnectedness’. The brand identity uses image, colour and text to combine three graphic ideas – the joining of two hands, the use of two eco-friendly colours - blue and green - and the skyline symbolising the city of Bengaluru.

Analysis and impact

Social media statistics show that the first phase of the #Invaluables content reached at least 2.6 million unique people, 21% of the city’s population, with a total of 4.4 million video views and 509,429 engagements (e.g. likes, comments).

The first round of impact evaluation also shows that we have started to shift people’s understanding of waste pickers. There was an improvement in spontaneous awareness of different segments of informal waste pickers, from 10% at baseline to 16% among those exposed to the #Invaluables content. There was no such change within the control group. Analysis also shows greater discussion about informal waste pickers, their work and place in society among those exposed (60%) to the content, compared to those not exposed (49%).

We have demonstrated that an evidence-based, insight-driven, carefully crafted social media campaign can help shift negative perceptions attached to certain occupations and help reduce inequalities. With significant positive shifts in awareness and discussions about informal waste pickers after the first phase of the campaign, we are now confident in taking forward the idea of Invaluables to the next phase of building understanding and appreciation for the critical importance of their work.

Our next phase will demonstrate the connection between the people of Bengaluru and the city’s waste pickers - and why everyone should be aware of and celebrate a Happy Number.

Check out the Happy Number to learn more.

Varinder Kaur Gambhir is director of research, Soma Katiyar is executive creative director and Ragini Pasricha is director of content strategy at ��tv Media Action India.

Learn more about our Invaluables project here: /mediaaction/where-we-work/asia/india/invaluables/

Read our press release about the Happy Number here: /mediaaction/where-we-work/asia/india/happy-number-invaluables/

The Invaluables project is part of the Saamuhika Shakti (collective impact) initiative, funded by the H&M Foundation.

Using compassion to build tolerance through radio drama in Myanmar

2022-07-18T08:47:42+00:00

Tea Cup Diaries recording of customers at tea shop in Myanmar

Within a stone’s throw of Sule Pagoda – one of Myanmar’s oldest and most sacred Buddhist sites – stands a Catholic church, a Hindu temple and a mosque. Worshippers rub shoulders in the nearby streets lined with crumbling colonial homes, Chinese new-builds and the hawkers who sell their wares off the potholed, sun-soaked pavements.

Yet the multi-religious diversity in downtown Yangon masks Myanmar’s darker relationship with religion.

Even when I first moved to Myanmar as a journalist for a local newspaper in 2008, the military regime recognised the media’s power to not only reflect society as it is, but to promote the society they desired. Late on a Saturday evening, we’d sit in the paper’s office, printing presses at the ready, drinking warm Mandalay beer, playing cards and waiting for the cuts from the Press Scrutiny Board (PSB), under the Ministry of Information. Everything from hip hop songs to books had to undergo censorship, and articles that challenged the idea of Myanmar as a homogenous Buddhist society were often the first to go, despite the fact that a significant minority of Myanmar’s 134 ethnic groups are Christian, Muslim or Hindu.

Opening - and intolerance

Later, as the military began its ‘roadmap to democracy’, telephone SIM cards went from US$2000 a pop to US$1; websites were unblocked and private internet companies were finally allowed access to the market, introducing many of Myanmar’s 54 million citizens to the internet for the first time. But alongside this opening came hate speech, fuelling further religious intolerance, particularly towards Muslims.

Even as laws were rewritten and civil society began to flourish, politicians and military actors used distrust of Muslims as a political tool to mobilise fear and sow division. Taxis, shops and offices sported the '969' supposedly ‘Buddhist’ movement, whose tenets include: Do not buy things from a Muslim shop. Do not be friends with a Muslim. Do not marry a Muslim. New laws were introduced to forbid a Buddhist woman from marrying a man from another religion.

In the midst of this, ��tv Media Action – which set up its office in the country in 2013 - launched the Tea Cup Diaries, a drama designed to encourage religious and ethnic inclusion. While Facebook was being mobilised to spread hate speech and vitriol against the Rohinyga, a Muslim minority, the Tea Cup Diaries used the most-listened-to radio in the country to reach the Bamar Buddhist majority with stories about people from different religions facing the daily trials of life – trying to earn a living, struggling to care for their children and falling in love.

Tea Cup Diaries recording wedding of the character Aye Aye.

Lessons learned

We continued to navigate this difficult space through the official military ‘operation’ in August 2017 against the Muslim Rohingya people, which forced almost 725,000 people to flee to neighbouring Bangladesh. We built on the trust we had already established with our audiences to continue our storylines.

In February 2021, the military claimed back the power it had tentatively started to share, leaving many of the people of Myanmar at war with their own military and Tea Cup Diaries came off air, though it is still active on Facebook.

Over the years, Tea Cup Diaries promoted religious and social inclusion within a space where the very concept of national identity and unity is fiercely contested.

Here are five lessons we learned for communication practitioners working on religious and social inclusion.

1. Focus on what unifies people

Our research told us people’s biggest challenges were economic worries, fear of unemployment and financial insecurity – regardless of ethnicity or religion. This helped shape the drama’s premise, which charts a family struggling with the issues audiences face every day —money, livelihoods, and their family’s future. By drawing on common fears, hopes and dreams as the bedrock for the narrative, audiences saw people of different backgrounds facing similar dilemmas, reminding them of how they share common experiences. The lead characters were a Bamar Buddhist couple, in line with the intended audience, but other main characters were from a diverse range of backgrounds.

2. Understand the religious context

When we dug into what people thought about other ethnic and religious groups and how they interacted, we discovered people often lived ‘side by side, but not together’.

Not many people had casual friendships with people from different religious or ethnic backgrounds and where people did interact, it usually happened outside the home, in local tea shops, at work and, for young people, at school. This meant many people did not have the opportunity to understand what different religions practice and believe, which made them vulnerable to widespread misinformation and hate speech. This helped shape the story of the drama, which charts a couple starting their own tea shop on the outskirts of Yangon—a place where a diverse range of characters would realistically mingle, interact, and chat.

Our research also told us there was a perceived hierarchy of religions—especially among the Bamar Buddhist majority. They felt Hinduism was most similar to Buddhism. They related less to Christians, and felt they had least in common with Muslims. They did not feel Rohingya Muslims were even part of the country.

Our drama therefore approached different religions differently. To challenge misunderstandings about Christian beliefs, James, the young tea shop waiter, was a central character over several years. The audience watched him grow up, get baptised, go to Bible camp and sing hymns at Christmas. Our introduction to Muslim characters was more gradual. They initially featured as secondary characters, becoming more central as the audience warmed to them.

3. Use formats that invite audiences to step into another’s shoes

When James, the young tea shop waiter, knelt in his church, the audience were able to hear him praying. For some in our audience it was the first time they’d been given the opportunity to understand Christianity from what it might sound like inside a believer’s head. As one woman from Labutta described in our qualitative research: ‘I got to know that they (Christians) pray to their God, Jesus, in difficult times. It’s mostly the same as what I do when I get sad; I pray and count beads.’

Dramas and soap operas are particularly powerful at inviting audiences to step into another person’s perspective. Research suggests that when audiences are immersed in a fictional narrative, they often experience attitude and belief change in line with those expressed in the story (Green, 2021; Nabi & Green, 2015). Given the sensitive nature of religious and social inclusion, drama offered our audiences an opportunity to understand people from different backgrounds - not just through theoretical knowledge, but by getting to know their struggles, desires and fears up close and personal.

4. Use feedback from audiences to shape production decisions – particularly around highly contested themes

Given the sensitive nature of some of the issues, and the changing socio-political landscape – including the Rohingya crisis in August 2017, continued armed clashes between ethnic groups, increasing levels of fake news and misinformation fuelling ethnic and religious tension - it was important to keep abreast of how audiences were engaging with Tea Cup Diaries.

Every two to three weeks, audience panels helped our production team understand how audiences were reacting to and engaging with the drama, so they could adapt quickly to emerging trends. In particular, they helped us understand how far we could press different inter-ethnic and inter-religious relationships. For example, our audience grew fond of a storyline involving a romantic relationship between Sam (a Karen Christian man) and Htet Htet (a Bamar Buddhist woman). But a friendship between Inn Gine (a Buddhist woman) and Naing Gyi (a Muslim man) did not develop into a romantic relationship, as it was clear from the audience panel that this would not yet be acceptable.

5. Deeply engage your audience

Attitudes towards different religions are often deep-rooted and take a long time to shift. But, while research participants had mixed views on storylines with inter-ethnic and inter-religious friendships and relationships, our survey analysis found the more engaged people were with the programme, the more likely they were to accept such relationships, compared to those who do not listen. Listeners who were more engaged with the drama were 1.6 times more likely to discuss issues relating to ethnic and religious tension, compared to less engaged listeners. Listeners who were highly engaged were 1.9 times more likely than non-listeners to demonstrate higher levels of acceptance towards inter-ethnic and inter-religious relationships. And people who regularly listened to Tea Cup Diaries were 1.6 times more likely to have higher levels of knowledge about religions other than their own compared to non-listeners.

In a context as fractured as Myanmar, where the media is all too often a tool for sowing distrust and division, the Tea Cup Diaries drew on that most traditional of Buddhist qualities – compassion – and in so doing, opened up space for greater tolerance and understanding.

Becky Palmstrom lived and worked in Myanmar from 2008-2009 and again from 2011-2015. She was part of the Rohingya refugee response in Bangladesh, 2016/2017 and is currently a senior advisor on governance and rights for ��tv Media Action.

This blog draws heavily on ‘Using Audience Research to Understand and Refine a Radio Drama in Myanmar Tackling Social Cohesion’ by Sally Gowland, Anna Colquhoun, Muk Yin Haung Nyoi & Van Sui Thawng (leads to third-party site)

��tv Media Action is committed to highlighting and celebrating religious diversity and inclusion in our programming and our ways of working.

Why women in journalism need to be considered in pandemic and conflict recovery

2022-03-04T15:21:50+00:00

Ukrainians sheltering in underground bomb shelters and metro stations rely heavily on news through social media and messaging platforms - our partners are continuing to share trusted information under difficult conditions, and women journalists face particular challenges.

The war in Ukraine is the most recent and explosive example in a wider trend of backsliding of democracy that is taking a toll on women and their inherent rights.

Even before this conflict, speeches, statements, and media content that reinforce gender inequality had increasingly become a political tool used to gain popular support, further undermining women’s rights.

Newsrooms already reflected this power imbalance, and COVID-19 only exacerbated the problem.

Now, as the war grinds on, we know that female journalists are at higher risk – and often at even greater disadvantage in their newsrooms than before.

Surveys have shown that women in the newsroom, particularly those with child care responsibilities, were already at a greater disadvantage. They report unequal pay, unequal hiring and promotions processes, and discriminatory allocation of work.

War and displacement will only exacerbate and entrench these inequalities.

All journalists, but particularly women, may become targets of misinformation, online abuse and hacking. Violence can be indiscriminate, most journalists are working without protective equipment, and some journalists have been killed already in this conflict.

Deeply rooted gender norms mean that there is an expectation that women take on household and child-caring responsibilities. In many parts of the world, if women aim for a career in journalism, this is considered by their families and wider society as an “extra”. This was particularly evident during lockdowns. “If something has to give, the career of the woman had to be dropped first,” said one Ukrainian female journalist we worked with.

Today, many women working in media in Ukraine find themselves torn between risking their lives to stay and do their jobs, or take their families and flee. Men of fighting age are not legally permitted to leave Ukraine. The impact will be years of family separation, career disruption, higher rates of poverty and ill health.

Women who were professionals in Ukraine may find themselves in lower paid or more menial jobs outside their home country. We are hearing first-hand accounts of senior female journalists and editors having to leave their city or even their country with their children, alone – this will have a tremendous impact on both their futures, and on the quality and range of coverage their media houses are able to produce.

This threatens newsroom equality in the longer term. Even before the conflict, Ukrainian female journalists told us that sometimes they had to miss training if it required travel, due to their child-caring responsibilities, putting them at further disadvantage compared to their male colleagues. This becomes an even more critical issue if it means missing important physical and online safety briefings that could make all the difference to their security.

Media organisations at home and internationally should actively reach out to female journalists ensuring they do not miss out on opportunities to help ensure they can cover the news safely.

Female journalists’ perspectives matter, particularly during war time

Our research also tells us that female journalists were already often prevented from covering subjects considered the exclusive domain of male journalists – such as politics and, now, conflict. They may be pigeonholed in journalism roles, more often covering topics of a social nature or that are otherwise considered “feminine”. This is deeply problematic and leads to an absence of women’s voices and perspectives on issues that directly and indirectly influence their rights. How events affect women, and what information they need in order to respond, is a critical component of coverage in any crisis.

There is a need for both media organisations and donors to better protect and support women in their journalism careers - now and in the future.

There are few genuine due processes for recourse, if women are harassed or otherwise have their rights infringed in the workplace. An estimated half of female journalists in Ukraine have faced sexual harassment in the workplace, mostly perpetrated by their colleagues and contributors through sexual jokes and verbal sexual abuse. This can only be expected to increase in times of high pressure and real risk.

Female journalists say that gender equality is still often perceived as a donor requirement or tick-box exercise, rather than a pillar of achieving effective democratic governance and social equity.

Media representatives we work with say it can be difficult to engage women in leadership roles in the newsroom, and there is a lack of support and mentorship to help women to tackle challenges and discrimination. Many female media practitioners remain at a junior or editor level, with correspondingly lower pay grades. Progress was stunted by COVID-19, and will be more so by the current war, leaving staff with less time for conversations about career progression and how to address the gender gap.

In the long term, newsrooms and donors need to ensure they are creating an environment in which women can fully participate in the workforce and in public discourse.

Both male and female journalists and media practitioners can bring gender concerns and analysis into topics and stories they cover. Policies to support and help protect female journalists, and ensure they are treated fairly in the workplace, will enable women in the newsroom to thrive, to raise social concerns and bring their own perspective to issues.

First COVID-19, and now the current crisis, have put many women’s livelihoods and economic security at risk – in journalism as well as in other sectors. Restoring these livelihoods, empowering them to return to the workforce, and allowing their issues to be better represented in the media will all be essential.

How women are represented in media is also important. Content that is stereotypical, sensational, or lacking in professional and ethical standards can further restrict women’s freedoms and increase their sense of insecurity and vulnerability.

Now and in the longer term, donors should consider the following in support for independent media:

Ensure female journalists are equally included in all safety briefings, actively reach out to them and ensure they have protective equipment to help them to cover the war safely;
Support the creation of internal policies ensuring gender equality and protection achieving the highest possible standards of fairness, clarity, and transparency. This includes policies for sexual harassment, and the use of gender quotas in recruitment;
Support the creation of gender policies aimed at improving balance and representation in content to help uphold the rights of women and girls during the conflict;
Provide training, mentoring, and networking opportunities to female journalists and media practitioners, to help mitigate the disadvantages they face in accessing senior and decision making levels.
Ensure efforts are made to reach out to, and understand caring responsibilities of, female journalists, and how they could be supported through funding and when organising workshops and training.
Use a solidarity-based approach that positions men and women as agents of change, and include men in the debate.

Across all of our training and mentoring work with public interest media, ��tv Media Action aims to improve the balance and participation of men and women. We mentor female journalists in senior positions at partner media outlets to enable them to successfully navigate change and reforms within their organisation. And a cross-cutting theme is ensuring that media content is inclusive, considering the need to tell the stories of those who are misrepresented or less represented in the media, and to uphold their rights.

With public interest media under threat around the world, we are committed to continuing our efforts to ensure that women’s voices are meaningfully represented - throughout media organisations, and in the content they produce – to properly reflect the audiences they serve.

Online violence against women and girls in Nepal: what we have learned

2022-03-02T16:40:00+00:00

Our researchers conducting interviews in Nepal

Cases of online abuse against women and girls have spiked in recent years. However, the legal and policy initiatives to address it do not seem to delve deep enough into the grave and changing dynamics of online violence in Nepal, or how this perpetuates gender-based violence in the offline world.

The development in internet and communication technologies has connected people in a way that was unimaginable a few decades ago. On one hand, this has opened endless opportunities to exchange ideas, share information and stay in touch with loved ones; on the other, it has given birth to new dangers that humans have never faced before. One such danger is the rise in online violence. As found by Plan International, women and girls are the main victims of trolling, abuse and hate speech everywhere in the world.

This scenario is not different in Nepal, where the rates of digital adoption are high. With increasing internet and social media users, we are witnessing a rise in cases of online abuse and violence against women and girls, which can take the form of physical threats, stalking, sex trolling, sexual harassment, and Zoom bombing. In January 2022, there were around 14 million social media users (with Facebook being the primary reported platform) and social media penetration has increased by 2 million since January 2020.

Virtual victims – the physical and emotional effects.

Between 2016 and 2020, a total of 5,574 online harassment cases were reported to the Cyber Bureau of Nepal. The prevalence is estimated to be much higher than reported. We spoke with around 80 adolescent girls and boys about their experience of online abuse as part of our recent research study for a gender equality project, funded by Foreign, Commonwealth and Development Office (FCDO). We were surprised to find that quite a few adolescent girls that we spoke to either had experienced sexual harassment on different social media platforms themselves, or knew someone who had. While only few boys mentioned experiencing or knowing someone (either boy or a girl) who have experienced this.

"I have experienced online sexual abuse. At one time I was even asked to share a picture of my breasts. This incident made me feel uncomfortable," one of girls told us during a focus group discussion.

Regardless of the nature (online or offline), violence takes a toll on the physical and mental health of survivors. Violence against women and girls still remains a culturally accepted practice, deeply rooted in harmful gender stereotypes and attitudes stemming from the continued acceptance of patriarchal societal norms.

As digital technologies play an increasingly central role in our everyday lives, some research suggests that women are often blackmailed by their partners or former partners, especially when couples in relationships share their passwords. Blackmail is mostly conducted through photoshopping women’s images, where men misuse women’s pictures to create new accounts to trick other men.

Silencing girls’ voices.

In a society like ours, where women and girls are expected to act in a particular way, our research found they tried to cover up any sort of violence, as they feel they will get blamed for sharing their personal life on social media sites. They fear that sharing such incidents can have a devastating impact on their mental health, reputations, relationships, access to education and employment, or even expose them to physical violence. Most of the time, women are questioned about their online behaviours, and a huge burden is placed on them to accept that they were at fault for putting themselves in a vulnerable position.

From our conversations with adolescent girls during our research study, we found that often they did not share these incidents with anyone, not even with their friends. As a solution, they simply ignored and avoided the perpetrators by blocking or unfriending them on their social media platforms. We discovered that these girls feared the consequences of sharing with their families and friends. They did not trust their friends to keep their secrets, and they thought they would be blamed for the incident if they shared it with their family members. This is also why many cases of violence against women and girls go unreported in Nepal.

"No. There is no way we will share such things with others because people we share such things (cyberviolence incidents) will not keep it to themselves. I have experienced a similar scenario previously, where I shared something with one of my friends, and she shared it with others too. So, we cannot trust anyone to keep our secrets," says a girl from our focus group discussion.

As part of our research, we also spoke with government officials, women rights activists and representatives from non-governmental organisations working on women and girls' rights. Many of the participants raised concerns such as the increasing use of social media to connect to the potential victims of human trafficking. Previously, traffickers used to travel to villages to connect with their potential victims. But these days they can connect and befriend potential victims through a simple friend request on social media platforms, liking or commenting on a post, before they meet in person.

What have we learned?

The key takeaway from our recent study was that adolescent girls using social media platforms are more at risk of experiencing online sexual abuse than boys, and for us, this highlights that their safeguarding should be a priority. We also identified an urgent need to engage with adolescent girls, and their friends and families, to help break through the barriers and fears associated with sharing their experiences.

Similarly, it is also very important to understand that internet platforms – while insecure - are not the only cause of such violence. Low levels of digital literacy contribute to the issue, and not least, the bad behaviour of people who hide behind online profiles and misuse these platforms. At last year’s UN Generation Equality Forum in Paris, four of the world’s largest tech companies – Facebook, Google, Twitter and TikTok – made bold commitments to tackle the abuse of women on their platforms and improve women’s safety.

Our findings point to the need to inform and empower women and girls in Nepal about the safe use of internet and digital media platforms, so that they can protect themselves from potential harm online.

Moving forward with holistic action

Considering the severe impact of online violence, Nepalese laws already have some provisions aiming at control of such activities. When a complaint is registered, Nepalese police are required to immediately search for the alleged perpetrator by tracking their IP address. Then, depending on the severity of the case, they either make the two parties compromise to resolve the issue, or file a case. However, there are many loopholes in the system. We feel that both legal changes and understanding the root causes are required to address this violence.

Actions must go beyond calling for improvements to the platforms’ own Community Standards, and their reporting systems and policies on removing content that breaks the rules. We also recognise this is an uphill struggle, particularly in non-English languages where the bots are not trained to recognise local languages, slang and dialects, and often end up removing legitimate content instead.

But we know that media and communication is in a unique position to challenge social norms and help address the root causes of why these cases go undiscussed and therefore unreported. In India, Myanmar, Tanzania, Zambia – using media and communication - we’ve seen positive changes for women and girls by engaging, informing, and sparking conversations on taboo topics both online and offline.

Our innovative Sexual and Reproductive Health Rights project in Myanmar called Ma Shet Ne (Don’t be shy!) was designed to help open discussions and break down barriers. We found that sharing interviews with female celebrities who spoke openly about the issues they had faced, and equal representation in content, helped to challenge the gender divide that had previously stopped women speaking out. Audiences were significantly more confident than non-audiences to talk about relationships and sexual health offline with medical professionals, friends and partners – a key achievement.

In Nepal, we recognise that creating safer environments like this, where women and adolescent girls can confidently share their experiences with friends and families without fearing the consequences, is vital. So far, we have supported local radio stations to produce digital content on various gender-based violence issues through training, editorial guidance and support to build the capacity of our local partner stations. But much more needs to be done.

Addressing online violence requires collective efforts. Broad-based, multi-sectoral partnerships need to be established to reach out to families and communities at scale. It is also important to bring systematic changes in mentality where it requires social institutions such as education, media, religion, the judiciary and political systems to be gender sensitive. With the advancement of digitalisation, it is crucial that women and girls are well informed. Sharing positive stories of those who have used formal support mechanisms and found help - and not suffered social discrimination as a result - is necessary to enable this shift.

We believe that collective efforts including stronger cybersecurity, media to support gender equality, changing attitudes and changes to legalisation all need to happen to address this problem.

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Learn more about:
Our work in Nepal and with women and girls
Our new promise on Equity, Diversity and Inclusion

How can digital technology empower women without worsening inequality?

2022-02-25T15:26:28+00:00

As use of mobile technologies surges in low and middle income (LMICs) countries, a pressing question has emerged: can the digital revolution be harnessed to empower women – socially, economically and politically - without creating deeper social and gender divides?

This is a particularly critical question in India, where the rates of digital adoption are high – but where the gender gap in digital is among the largest in the world. According to the GSMA, 75% of men but only 55% of women owned a mobile phone in 2020; when it comes to smartphones, the gap is even greater, with only 25% of women owning smartphones compared to 41% of men.

In 2019, ��tv Media Action began working on the Digital Women’s Economic Empowerment Project: A Research and Learning Agenda. Our focus has been on women’s collectives, which have shown significant promise as a platform for empowerment. Our objective has been to identify if and how digital technology could enhance pathways to women’s empowerment in collectives, without making existing inequalities and gender-based conflict worse.

The promise of collectives

Systematic reviews of evidence from countries around the world, including from self help groups in India, have shown promising outcomes for women’s economic and political empowerment, mobility, and control over family planning. In India, the scale of the opportunity is substantial: Some 47 million member-households have been mobilised into four million self-help groups since 2011, and the National Bank for Agriculture and Rural Development’s Self-Help Group Bank Linkage Programme now covers 138 million families through 11 million groups.

Evidence reviews have also identified three important pathways to empowerment in self-help groups: the accumulation of social capital, human capital, and financial capital.

A key driver is the expansion of women’s social networks , as they join small groups of 10-12 women and begin benefiting from ‘bonding social capital’ – the social support and trust that cohesive, homogenous groups can provide. Once women start interacting with the wider collective, they begin building “bridging social capital’ – that is, interacting with women from different backgrounds who act as role models and provide access to new ideas and opportunities.

Women in a self-help group show their mobile phones. Even though India is the world's largest market for social media platforms, users are overwhelmingly male. Photo credit: Sara Chamberlain, ��tv Media Action.

Limits on progress

However, there are constraints on the transformative potential of women’s collectives in India:

Geographically isolated groups have few opportunities to engage beyond their immediate circle with the wider collective;
Women have limited channels to request and receive targeted information, resources, and services from the wider collective;
Grassroots members have limited opportunities to make their voices heard in the wider collective;
The lack of access to high quality, standardised, flexible learning opportunities;
Members tend to be older and less educated, and younger women are under-represented;
There are limited opportunities for consultative decision-making, and leadership may not be transparent.

Digital technology could be a game changer

Chat applications and social media platforms, as social networking tools, could help women’s collectives overcome many of the constraints they face – for example, by:

Reducing geographical isolation, enabling women to interact more regularly with their wider collectives.
Improving internal information dissemination and consultative decision making by collective leadership.
Improving the bottom-up flow of information from grassroots members to collective leadership to transnational partners, amplifying marginalised voices.
Diversifying group membership by attracting younger women.
Helping collectives trying to scale to overcome challenges of transparency and leadership ossification by offering new growth pathways to young and emergent leaders.

Collectives could also use digital technologies to accelerate the accumulation of human capital by providing flexible, personalised digital learning to members, and the accumulation of financial capital by providing greater access to government entitlements and markets for their products and services.

Self-help groups in India pose a major opportunity for digital technologies that can empower women. Photo credit: Sara Chamberlain, ��tv Media Action

Low tech digital solutions have delivered results

There are already examples of low-tech digital solutions achieving some of these goals for disadvantaged women in India, including for women in collectives. For example:

Mobile Vaani, an Interactive Voice Response (IVR) social media platform for rural communities in India, enables women in self help groups to call a number to record an audio message about their community, or to listen to messages left by others. Over 100,000 unique users have been calling Mobile Vaani every month in the states of Bihar and Jharkhand, discussing a wide range of issues and sharing information, including health information during the COVID-19 pandemic.
Haqdarshak equips women in self help groups who already own smartphones with an application to support claims for government entitlements, helping 600,000 people claim entitlements in 22 Indian states.
��tv Media Action has used IVR to deliver impactful, cost-effective audio learning to rural, low-income women at scale in India for almost a decade – for example, delivering free health information to over 10 million families, and successfully training 200,000 frontline health workers in 13 Indian states in collaboration with the Indian government, as outlined in The BMJ.
During the pandemic, ��tv Media Action began collaborating with capacity building organisations - for instance, PRADAN to provide IVR-based learning in agricultural best practices to marginalised women farmers in self help groups in the state of Bihar, and with Chaitanya WISE to support digital adoption and digital literacy in self help groups in Madhya Pradesh.

The gender digital divide

However, the transformative potential of digital to support women’s empowerment in India is constrained by the gender digital divide, including on social media. In 2018, LIRNEasia estimated that only 9% of women aged 15–65 were using social media in India, compared with 22% of men. In addition, although India is now globally the largest market for platforms such as Facebook, Instagram, and YouTube, these are still heavily skewed towards male users. For example, according to estimates from publicly available advertising data, only 8% of Twitter users and 24% of Facebook users in India were women, as of January 2021. Even though more women began using the mobile internet during the pandemic, with usage increasing from 21% in 2019 to 30% in 2021, social media use did not reflect this: Facebook usage among women increased by just 1% during the pandemic, and Twitter usage among women fell by 6%.

Social media users in India tend to be younger, better educated, wealthier and urban

Wealth and education are the strongest determinants of access to and use of mobile phones in India, but age and geography also matter. In 2018, a study by LIRNEasia found that only 5% of social media users in India had only a primary school education or had never been to school, and only 11% lived in rural areas. The same study found that only 10% of 36–45-year-olds had used social media in 2018. Although social media use among adolescents in India has increased since then, the gender gap is the most extreme in this age group. For example, a survey by the Population Council in Bihar and Uttar Pradesh in 2018–2019 found that 33% of 15–19-year-old girls who had completed fifth grade or higher had used social media, compared with 70% of boys in the same age group.

Women and men also behave differently on social media in India. Men tend to be more active participants in digital groups than women, with the most active users being men with other forms of social privilege. Most women (92%) use social media to stay in touch with existing friends and family, rather than to make new friends (38%), which could limit their access to new ideas, opportunities and ways of doing things – the accumulation of bridging social capital.

Women's access to mobile phones is often controlled by men, so face to face communication is also essential. Photo credit: Sara Chamberlain, ��tv Media Action

The role of gender norms

Gender norms - offline and online – are another constraint. Women’s use of mobile phones and the internet are often supervised and monitored by men, which limits the agency and freedom that digital technology could provide women. Technology-facilitated gender-based violence is rife in India, and nearly always against women. Research suggests that over 58% of women internet users have faced online sexual harassment of some form, most commonly on social media. While India has legislation on cyberbullying, cyber-stalking and online sexual harassment, victims of online gender-based violence do not usually seek legal recourse. Social media platforms have been grappling with the issue of online violence since their inception. However, despite best efforts, online violence and harassment remain pervasive issues.

Implications for designing social media interventions for women

The gender digital divide on social media platforms in India, and the offline and online norms that create the divide, necessitate a gender-intentional, research driven approach to designing social media interventions for women’s empowerment.

We need to begin with a gender analysis of who has access to digital technology and why, and who is excluded and why.
We also need to understand women’s level of digital skill among the population we aim to serve, as well as their usage habits and the factors shaping their use, including the implications of shared and supervised mobile phone use for privacy and data protection.
We need to design differentiated digital strategies, using appropriate digital channels and tools, to meet a diversity of needs.
We need to use women-centred design methodologies to co-create solutions with women who represent different segments of the target population, to improve accessibility, usability and relevance.
We must remember that face-to-face communication remains key to women in the target population who don’t own, or have meaningful access to, mobile phones – or the skills or permission to use one.
We require processes to respond to online harassment and violence that may be triggered by your intervention.
And we need to be patient. Test and re-test because there is the potential to do as much harm as good.

The third paper in our learning series offers more insights: ‘Why aren’t women part of the conversation? A study of the gender gap in social media use in India, its causes and the implications for women’s empowerment’

Learn more about our Digital Women's Economic Empowerment learning and research agenda here. The project is funded by the Bill and Melinda Gates Foundation and includes partners at Chaitanya WISE, PRADAN, the University of Southern California at Los Angeles, and the University of Denver, Colorado.

Examining awareness of disability in Nigeria

2021-11-29T16:27:30+00:00

Seeing, the saying goes, is believing. But how true does this hold when it comes to disabilities that are not immediately apparent?

As humans, those of us who can see make sense of the world around us with our eyes – leading to, perhaps, an unthinking look of disapproval for a person without a visible disability who uses the disabled parking bay, or an individual who walks into the airport requesting wheelchair assistance. But it’s important to remember that when it comes to disability, there is often more than meets the eye.

Disability has been recognised as a public health issue by the World Health Organization, and over one billion people, or 15% of the global population, are estimated to be living with some form of disability, including invisible impairments such as anxiety, depression, chronic illnesses, and vision and hearing impairments.

However, there is a lack of data around the number of persons with these invisible disabilities, and how they are recognised and perceived in the societies in which they live. Without this data, we cannot fully understand the challenges and stigma they face, making it even harder to foster understanding and begin to overcome the barriers they face to employment, education and inclusion in society.

Researching disability in Nigeria

��tv Media Action recently had an opportunity to conduct research around disability in Nigeria. We implemented an 18-month project to tackle stigma and discrimination around all kinds of disability – both visible and invisible - in Nigeria, under the Inclusive Futures programme funded by the UK Government’s Foreign and Commonwealth Development Office. Our radio drama, Story Story, used a fully inclusive team of Nigerian writers and actors to bring these issues to life and challenge prejudice and stigma – but to do so effectively, we needed to fully understand the local context.

The cast of Story Story record an episode in Abuja, Nigeria.

According to the 2018 National Demographic and Health Survey, seven percent of Nigerians have some form of disability - but we wanted to delve further. In July 2021, we surveyed over 5,000 Nigerians in five states, Enugu, Kaduna, Kano, Kogi and Lagos, and the Federal Capital Territory (FCT), to find out how people understand disability, and their perceptions of someone with a disability.

Awareness of invisible disabilities is lower than for visible disabilities

We asked people whether they were aware of different disabilities, and found that a lower percentage of Nigerians mentioned less visible impairments, such as autism (10%), than they did more visible impairments, such as physical disability (60%) or blindness (75%).

Only around two in 10 people surveyed were aware of psychosocial disabilities, such as depression or anxiety. And albinism was mentioned by just one in 10 as an example of disability, although Nigeria’s prevalence rate of albinism is among the highest in the world, with over two million persons with albinism living in the country.

Although people with albinism are often visibly identifiable – and indeed often subject to discrimination and even ostracisation from society in Nigeria – our data suggested there is low awareness of albinism as a form of disability.

Under the Convention on the Rights of Persons with Disabilities, people with albinism are considered people with disabilities due to their often severe vision impairment; they are also vulnerable to skin cancer.

But participants (mainly those without disabilities) in focus groups explained that they do not believe anyone with albinism is a person with disability, because they do not believe them to be impaired in their senses or body parts.

Similar to our study findings, a 2018 SCOPE report notes that when asked about disability many people may think of ‘visible’ impairments, such as using a wheelchair, rather than ‘invisible’ impairments, like mental health problems or hearing impairments.

Overall, our research found not only are Nigerians surveyed less aware of invisible impairments, they are also less comfortable around people with such impairments. Our study found that out of four different visible and invisible impairments, those surveyed were least comfortable around someone with a psychosocial disability such as schizophrenia. It was beyond the scope of our research to explore why, but it is likely that low awareness and understanding of invisible disabilities is a contributory factor.

What next after these findings?

What do these findings mean for people with invisible disabilities in Nigeria? Our findings raise a few critical questions – is enough being done to raise awareness on less visible impairments, like psychosocial disability, and to provide education on how to interact with people with disabilities and include them equally in Nigerian society?

Our radio drama series, Story Story, has had an impact on listeners’ perceptions of people with disability. An evaluation showed that, after controlling for a range of factors such as education, age and gender, regular listeners and those engaged with the drama held more positive attitudes than non-listeners.

However, there is still work to be done. Our evaluation did not demonstrate a significant association on increased awareness of different types of disability, showing that there is more work needed in this area – particularly around disabilities that are less visible.

Our findings are a reminder that we should never make assumptions about disability, as it can be hidden. Better data allows us to understand the needs of, and challenges faced by, people with invisible disabilities. And understanding is the first step toward changing perceptions and addressing societal stigma and barriers.

Akunna Penny is ��tv Media Action's Nigeria research manager, based in London, and Manju Gautam is research officer based in Kathmandu.

To learn more about the insights uncovered from this research please see the full briefing: Using radio drama to tackle disability discrimination in Nigeria.