The torrent of information online about COVID-19 can be overwhelming, especially when news is updated on an hourly basis. During the month of March 2020, when the initial cases of COVID-19 were reported in Laos, the government, especially the Ministry of Health and the World Health Organization (WHO), have been working overtime to disseminate information on combatting COVID-19.

Along with official news and information from valid sources and trusted organizations,  misinformation has also been circulating, increasing the challenges in keeping society informed about public health information, especially the people with disabilities.  

In Laos, there are more than 160,000 people living with disabilities, and approximately  78,000 are visually impaired. With such constraints, this vulnerable group may face barriers in accessing and identifying verified information.  

The UNDP Accelerator Lab in Lao PDR is looking for practical ways to keep people with visual impairments informed regarding COVID-19. With support from the Center of Communication and Education on Health (CCEH), WHO, and Lao Telecom (LTC), we were able to come up with an innovative solution to help this group access vital public health information. 

One Call Away is a one-week special service by CCEH and LTC that disperses automated voice messages about COVID-19, to this target group, across the country. This pilot aims to test several ideas, including: 

1. If well-designed, automated voice calls and texts could help inform people with disabilities, 

2. whether this type of initiative could significantly inform people who have limited access to smartphones and the internet.

Here is what we learned from this collaboration.

Empathy is crucial:

One approach our team uses to engage stakeholders is Design thinking. This is an iterative learning process aiming to understand users, challenge assumptions, and redefine problems. We apply design thinking to identify alternative strategies and solutions that might not be instantly apparent with our initial level of understanding. 

Design thinking consists of five steps such as:

·         Empathy: Understand users

·         Define – Identify needs, problem, and insights

·         Ideate – Challenge assumptions and create ideas for innovative solutions

·         Prototype – Start creating solutions 

·         Test – Seek solutions  

These processes revolve around a deep interest in developing an understanding of the users, for whom we’re designing the products or services, as well as target users.

For the empathy step, we conducted phone interviews, along with a day-long chat with community members and observed their daily lives. In the blind community, communication is built around trust among members, and mobile phones have been useful tools, to communicate with one another.  

From our work, we learned that on a daily basis, members provide support to one another through phone calls and voice messages, sharing news, songs, and upcoming events. With this initial understanding, we have been able to connect with directors of the Blind association both in the capital Vientiane and the city of Luang Prabang, to learn how people access to COVID-19 information.  

Unlike sign language videos on COVID-19 for deaf communities, such posters in Braille  haven’t yet been developed. Due to this, people with visual impairments have not received official information on COVID-19. The only source of information they can access is through news shared among group chats, such as LINE and WhatsApp, where accurate information is hard to identify, which may lead to catastrophic consequences.

A significant feature of the empathetic approach is to empower ownership. So, we put affected people at the core of the discussion and let them lead. We learned that directors of blind associations are the most trusted in their communities. Therefore, we asked them to take lead in collecting information, through their weekly update call with members, and asking for consent of members on receiving news and sharing their contact information with MOH and LTC.  

Directors will inform members to expect messages on COVID-19 from MOH and LTC, emphasizing that this comes from official sources. This call could also help the blind association update contact information or location of their current and new members on their data base. Within less than a week, we received a good amount of information about members, to pilot our first response. The figure below illustrates the differences between a non-empathetic approach and an empathetic approach. We could see that the latter helped deliver messages to more members, as community was built around trust.

New insights from nontraditional partners

Collaborating with LTC to design a way to share information with visually impaired people has been a reflective journey. Our prior understanding of patterns and methods of communication among this group helped us and our partners, design a proper intervention. We learned that the traditional approach of sharing information via village speakers on COVID-19 hasn’t been effective, especially among this group of individuals. The village speaker’s approach, for example, has been effective to encourage the head of village to take lead in disseminating information to village members. This approach, however, has some barriers, especially for those who live far from the village. Even though it’s a “PUSH” strategy in practice, the information hasn’t been distributed evenly.  

So, we have worked with LTC to design a more effective way to share messages to people in need. We have learned that LTC has been using PUSH marketing strategies to target people living in rural areas, for several years. This strategy is to “push” marketing voices and text messages to clients that they cannot reach through social media marketing. This method also made it easy for senders to see whether their message has been delivered. With this learning, we decided to apply a similar method to share information with members of the blind association on COVID-19, where automated voice messages were sent three times a day for one week.

While the loudspeaker in a village can be cost-saving and decentralized, automated phone calls can be more effective because we can directly share voice or text messages to target audiences. To test, our lab randomly surveyed 10 members of the blind communities asking about their reaction and feedback on the voice messages they received. 

Eighty percent of them were satisfied with the call and believed that the message was simple and informative, while 20 percent suggested the call could be a bit longer and more frequent. Within that same week, the team at the 1-6-6 COVID-19 hotline informed us that they have received a few phone calls from blind callers asking about prevention and where to get tested.

The figure below shows the difference between two PUSH strategies:

Our work with nontraditional partners on COVID-19 responses helped us leverage the advantage of collaborative actions and learning. This has reinforced the concept of our global labs where innovation can take place anywhere and be done by anyone. Our experiment on one COVID-19 response was small in scale but helped us to identify a key challenge and put bandages on the right spots. This innovation will not only be beneficial for the COVID-19 response, but could also support other potential development projects.

Written by:

Khavi Homsombath, Head of Experimentation, Accelerator Lab, UNDP Lao PDR

The views expressed in this article are those of the author alone and not the United Nations Development Programme.

Here is a sample of our automated voice message:

https://soundcloud.com/khavi-homsombath/covid19-lao