The fourth commitment which humanitarian agencies sign up to under the states that ‘Communities and people affected by crisis know their rights and entitlements, have access to information and participate in decisions which affect them’. But for humanitarian practitioners, particularly those working in settings where humanitarian access is limited, sharing relevant, accurate information and ensuring communities’ needs and priorities are heard and acted upon can be easier said than done.

Research currently being conducted by ±«Óãtv Media Action to inform a new capacity strengthening project funded by USAID Bureau of Humanitarian Affairs, is finding that humanitarian practitioners in the project’s three focus countries (Nigeria, Somalia and Ukraine) face various challenges communicating with communities affected by crises.

In Somalia, humanitarian practitioners we spoke to are facing challenges getting hold of accurate and relevant information themselves to be able to answer people’s questions, as communication and coordination between local and humanitarian organisations is a challenge. In Northern Nigeria, having capacity to communicate in the right languages to reach internally displaced people who often don’t speak the same language as the host community (see ). And in Ukraine, a recent in May 2022 identified getting information to people with limited access to digital platforms, as a critical challenge. Across the board, humanitarian practitioners feel their organisations have mechanisms in place to collect feedback from communities, but often these mechanisms are not known about, or not trusted by community members, and are therefore underused, especially by those who are illiterate, have limited access to mobile phones, or live in more remote areas.

Media practitioners we spoke to as part of the research said they face challenges getting access to information which is useful and relevant to their audiences, especially finding contacts within humanitarian organisations who are ready to answer audiences’ questions on air. Some also expressed frustration that they feel they are treated with suspicion by humanitarian organisations, or are contacted to distribute organisations’ press releases rather than create engaging and useful content for audiences. The research so far has found limited interaction between media and humanitarian practitioners in the project’s focus areas.

And these communication challenges are reflected at community level. A carried out by Ground Truth Solutions with recipients of cash and voucher programmes in Somalia found that 45% of respondents feel informed about available aid; and only 25% of respondents feel aid providers take their opinions into account when designing programmes. Community leaders within IDP camps we spoke to in Somalia felt that although they frequently communicate their communities’ needs to organisations during assessments, this information is rarely listened to and acted upon. A similar (2021), found that 48% of respondents do not know what aid is available to them, and 49% feel their opinions are taken into account by humanitarian staff. The found that 66% of participants say they need information about how to register for humanitarian assistance.

±«Óãtv Media Action has extensive experience supporting humanitarian and media practitioners to communicate more effectively with communities affected by crisis. Most recently, in Bangladesh, where ±«Óãtv Media Action and have been training practitioners responding to the Rohingya Refugee Crisis under the ‘Common Service for community engagement and accountability’ project since 2017, we have found that trainees place a particular value on training and tools to help them communicate in Rohingya language. In a recent evaluation of the project, practitioners emphasised how training has helped them prioritize and develop communication and listening skills, which managers say has led to better community satisfaction.

“We were not sufficiently sensitive to the Rohingya community culture and there were also language barriers. Their perception of different issues were not clear to us. After getting training, staff have changed their methods, how they behave and talk to the communities.’’ Humanitarian practitioner, Cox’s Bazar Bangladesh

Where possible, ±«Óãtv Media Action’s approach is to train humanitarian and media practitioners together, building the understanding that both have a critical role to play in ensuring communities have access to information they need. As have also shown, a recent study with participants of ±«Óãtv Media Action’s ‘Lifeline training’ in Afghanistan found that the training helped bridge the gap and build understanding and connections between journalists and field practitioners, which they have been able to use in their work.

“The training has changed our relationship with media and journalists. By communicating with social workers and journalists, most of our communication problems are solved. Additionally, the training has increased our capacity in communicating with people in the communities.” Community health worker, Helmand province, Afghanistan

Over the next year, ±«Óãtv Media Action will be working with humanitarian and media practitioners in Nigeria, Somalia and Ukraine to support them to overcome challenges they are facing to communicate effectively with communities affected by crisis in these countries. Learning from the project will be shared and disseminated at country and global level.

Nicola Bailey is senior research manager for Asia/Europe at ±«Óãtv Media Action, based in London. Co-authors are: ±«Óãtv Media Action's Hodan Ibrahim, senior research officer, Somalia; Mohamed Yonis, project director, Somalia; Anu Njamah, head of research, Nigeria and Cian Ginley Ibbotson, project manager, Ukraine.

Read more about our humanitarian response on our website.

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 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 ; 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 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 ±«Óãtv 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: .

These projects have not only worked, but they’ve shown sustainability. By with the state governments in Bihar, Odisha and Uttar Pradesh, we’ve trained 263,000 health workers so far on Mobile Kunji and about 260,000 people have completed the Mobile Academy course.

Mobile Academy is now active in 13 states and we recently transitioned responsibility for the service to the Indian Government to continue its vital work long into the future.

Third, create relatable and accurate content to help to build trust

In Bangladesh we learnt that community health workers were struggling to communicate effectively about sexual health to young women and men, which limited the impact of their advice.

So we developed a smartphone app. It shows Dr Natasha, a real doctor, talking about some of the key sexual, reproductive, and maternal and child health issues their clients were facing. By using appropriate language tailored to their audiences, we made sure the content was relatable, accessible, and engaging – which mattered especially in areas with low literacy levels.

Our research showed us that health workers felt more trusted by their clients and were more successful in persuading them to adopt healthier practices, such as attending antenatal care visits. As one of the health workers described, “Most of my clients were not interested in listening to my suggestions before using the job aid. But now they are convinced as they see there is symmetry between Dr Natasha’s information and my own”.

We found the app also helped to give them credibility to dispel myths around issues such as contraception and family planning.

Fourth, go beyond training on health topics and train on how to communicate

Community health workers cover a wide variety of health issues on their visits. Our research often reveals the benefits of refreshing or deepening their knowledge, but also of them gaining new skills on how to communicate within a family setting. We found in remote parts of Ethiopia, communicating with the men in the family is often overlooked because family health is still seen as a woman’s responsibility.

So we ran training for Health Extension Workers which focused on how to create safer feeding and playing spaces for children under three, during which participants learned how to communicate effectively with, and actively involve, both women and men in the families.

We found role play really helped during training because it encouraged Health Extension Workers to practise how to have compelling two-way conversations.

And finally, break down the barriers between communities and health workers

Mistrust and suspicion between communities and health workers is common in many of the places we work. Through our research, we often hear about these difficulties and then aim to create safe spaces for communities and health workers to come together, get to know each other, and discuss often sensitive issues.

In Nigeria we facilitate discussions around polio vaccinations and routine immunisation as part of our community drama radio recordings which are performed in front of a live audience. And, working with different partners, we accompany women during antenatal care check-ups to record what happens. By sharing real-life experiences in our radio programmes, it helps to build understanding and trust in health services amongst the public. 

In Tanzania, we trained and worked with radio partners to facilitate lively community events that were recorded and broadcast in weekly radio shows to audiences across the country. The events were designed to build understanding about maternal and newborn health issues and encourage interaction with health workers. By facilitating conversations, we found people gained understanding and confidence to access health services. We also saw increased male engagement in maternal and newborn health care.

Looking forward

In summary, we’ve learnt to not only help build the skills and confidence of community health workers, but also to help improve engagement between them and members of their communities. Through creative communication and human centred design, it is possible to create more effective tools fit for the difficult environments health workers operate in. And in doing so, we’re able to help health workers and communities work better together.

Informed by our experience, ±«Óãtv Media Action plans to continue this important work towards the , to build stronger health systems for people around the world.

 

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Emebet Wuhib-Mutungi and Genevieve Hutchinson 
Senior Health Advisors for ±«Óãtv Media Action
On Twitter: @ewuhib / @genevieveh77

 

The projects featured in this blog were carried out in conjunction with: national government ministries and departments of health, DFID, UNICEF, The Gates Foundation, UNFPA, Options, Abt Associates, Viamo, Care International, the Grameen Foundation and our media partners.

As a child and throughout my teenage years in northern Nigeria, I saw men in our neighbourhood shopping for the food needed by the family. To my young mind, this was fascinating, and I thought “how helpful and thoughtful of them”.

It was only later I came to understand that, for cultural reasons, women were not expected to be seen in public. But deep down, I still couldn’t understand it.

As an adult I have dealt with stereotypical expectations around women in politics. I’ve heard statements such as women are not “naturally” oriented towards governance or politics, or that “politics is a man’s thing”. Our system in Nigeria seems to give this credence by not making adequate efforts to encourage women to be active in politics.

I remember when Sarah Jibril, the first female presidential candidate, failed to make it past the party primaries in 2011 and got only one vote. I asked myself then, half seriously - is there something about the woman that makes her unsuited to such key a role in society?

Fast forward to the present: I understand that the behaviour of the men and women I saw while growing up helped to perpetuate ideas about the way men and women “should” behave. Worldwide, women are still the focus of only 10% of news stories and comprise just 20% of experts or spokespeople interviewed.

As a social researcher I have designed and implemented studies to understand what audiences in Nigeria want from shows like the drama Story Story and the radio discussion show Talk Your Own, and I evaluated their impact. We saw a pattern in our findings. Fewer women than men tended to listen to our programmes and were engaging less frequently in politics than men. To understand this better, we designed a study to speak to young girls and women across five states in five geo-political zones of Nigeria.

Involve your target audience

We used a market research technique called co-creation, whereby customers or product end-users (in our case, potential audience members) are involved actively in inventing the product.

Working in groups, we encouraged unguided discussions and used practical exercisesand  to explore issues of concern, perceptions of governance and ideas about what a governance-focused programme should include. Something I particularly enjoyed was the collaboration between the women themselves, researchers, programme producers and project managers. It resulted in valuable feedback to help us improve our programmes and give women and girls a chance to have their voices heard.

We found that women aged over 36 in particular, think that few women get involved in decision- making, and feel they do not have a voice. “They look down at us people and they don’t involve people that they think are illiterate,” said one participant.

Younger women claimed to feel disconnected from politics as they have no opportunity to meet with the leaders (traditional and elected) and felt decision makers did not seek their opinions. Across the board, women lacked faith in the political system – citing poor leadership and a failure to fulfil promises made by politicians during election campaigns. They saw evidence of poor governance all around them – including a lack of basic amenities in their communities. A few participants mentioned that state-owned media tended to portray even an ill-functioning government in a positive light.

The co-creation research was part of a conscious effort to attract more female audience members, which included revising the content of our programmes to appeal to women and younger people. , for example, launched a new youth segment – My Life, My Story – featuring teenage girls sharing their life experiences. At the end of the project,  showed that the programmes steadily attracted a higher proportion of female and rural listeners: by 2016 women accounted for 43% of the audience compared with 35% in 2013.

I want my daughter(s) and girls all over to have a voice – and not just a voice, but a voice that counts in the governance and decision-making processes that affect their lives. Therefore, understanding and helping women (in any small way) to find a voice is not just another deliverable in my line of work, it is something that matters a lot more to me!

2. How free do people feel to speak their minds?

We asked people in three Asian countries (, , ), four African countries (, , , ) and the  whether they could 'say what they think'. A majority felt at least somewhat free to speak their minds in all but one of the countries: .

But across the eight countries in our , we found that many people don’t feel they can criticise those in charge. Around a third of , , Bangladeshis and ‘feel people like them are free to talk negatively about the government in public’; in and this drops to under one in four.

Nepal is the only place we looked at where a majority (65%) feel at least those in charge. Nigerians are the next most comfortable with openly complaining about their leaders, say they could – though only half that number felt very liberated to do so.

3. Who are the keenest voters?

In six countries, we also asked whether people had voted in the last general election: Bangladesh, Myanmar, Palestine, Sierra Leone, Tanzania and Nigeria.

came out top, with 90% reporting having voted in the last general election, closely followed by at 87% and at 86%. (A quick note – we conducted our Burmese survey in 2016, after the of Aung San Suu Kyi's National League for Democracy in 2015.)

Turnout was lowest in and the , where 42% and 45% respectively said they’d cast a ballot in the last national election.

Of course, people don’t just get involved with public life through voting. Meetings, protests, and various forms of communication are all types of political participation. The previewed below shows that while only a small proportion of people have been in touch with government officials, nearly two thirds have teamed up with others in their community to solve a problem.   

4. How do people feel about those who are different to them?               

Historically, Kenya has been the site of . Yet even against this background, well over 80% of Kenyans and think it's important to and (see below).  

In a country with over 100 ethnic groups, believe that peace relies on mutual respect between people from different ethnic, religious and social groups. Similarly in Nigeria – which has wrestled with religious divides – nine tenths of the population believe that people from different backgrounds have ‘’.

However, a large majority of both and feel that some differences between groups are ‘just too difficult to overcome’.

5. How are people adapting to environmental change?

Building on our project – which examined 33,500 people’s everyday experiences of climate change – we’ve more recently asked Tanzanians and Bangladeshis about how they’re coping with changes to the world around them.

In the drought-ridden areas of Dodoma and Morogoro in Tanzania, more people think has decreased than increased over the past ten years. as to whether rainfall is higher or lower than it was a decade ago.

Getting their information predominantly , Tanzanians are making some – though not a lot – of in light of the environmental challenges they face. Popular responses include  and .

In Bangladesh, , and are all commonly seen to have increased in the past decade. for getting information about water, food, energy and extreme weather, considerably more so than the radio, newspaper, friends and family.

of the population have changed how they live in response to environmental changes; is the most common way of shaking things up. 

In addition to all of the data, the portal also hosts a number of other resources:

For extra guidance on navigating the portal, take a look at our ‘’ section, as well as our ‘’ and ‘’ videos. 

Those interested in how we collected the data should refer to the methodologies and questionnaires available on the right-hand sidebar of each of the thematic pages (, , ).   

The portal is also home to reports which summarise and analyse data available on the portal. For example, we've produced a exploring how to better connect with the least politically engaged Kenyans. This is just a flavour of what’s to come, similar reports analysing our governance data in other countries will follow in the coming months.

On each thematic page, there are reports and tools to support practitioners to use media for development. For example, we’ve featured the communication toolkit from our project, which includes a on how to talk about climate change in an accessible and engaging way, as well as (with ) for co-creating a communication strategy with partners and your target audience.

 is ±«Óãtv Media Action's Head of Research Programmes, overseeing research across Africa, Asia and the Middle East.