Q&A: The potential impact of video-based education on health care workers

A health information officer accesses a video on neonatal resuscitation at the Onikokodiya primary health center in Nigeria. Screencap from YouTube

ABUJA, Nigeria — Thanks to satellite-generated networks, health care workers now have the option of applying solutions relying on app-based mobile technology in even the most rural areas of developing countries. These videos have become life-saving teaching tools, giving rural health care workers access to invaluable information at the touch of the button.

But this access wouldn’t be possible without satellite technology. In theory, videos can be downloaded to tablets via Wi-Fi networks. However, in rural Africa, finding networks fast enough to download video would require driving many hours, making it impossible to access relevant trainings in the event of an emergency.

Having access to satellite connectivity makes trainings far more effective, according to Okey Okuzu, founder and CEO of InStrat Global Health Solutions. “After every video, we provide a multiple-choice test to see user retention,” Okuzu said. “The results of the tests are immediately transmitted to us via satellite, and help us to identify training gaps.”

What is the International Partnership Programme?

The UK Space Agency’s International Partnership Programme — part of the U.K. government’s Global Challenges Research Fund, supporting the U.K.’s official development assistance commitment — is a £152 million ($198 million) multiyear program launched in 2015. It uses U.K. organizations' space knowledge, expertise, and capability to provide a sustainable, economic or societal benefit to undeveloped nations and developing economies.

By installing satellite technology in rural villages to create a mobile network, a project implemented by Inmarsat, a commercial satellite operator, and InStrat Global Health Solutions, through the UK Space Agency as part of the U.K. government’s International Partnership Programme, was able to bring app-based video-trainings to medical extension workers in rural Nigeria. The areas where they work are often so remote that workers rarely have the opportunity to participate in other trainings. By watching the medical training videos, workers gain access to the latest medical knowledge, without ever having to leave their villages.

The organization behind the training films, Medical Aid Films, was set up in 2007 by a group of midwives and gynecologists, who were inspired by the experience of midwife Fiona Laird. Laird had worked in a refugee camp in Darfur, Sudan the previous year, where she saw many babies dying because their umbilical cords were being cut by unsterilized knives.

According to Sophie Scott, production manager at Medical Aid Films, Laird realized that there was a lack of knowledge about basic hygiene. Her response was to set up a film company that would help train health care workers via medical videos.

To date, the organization has produced around 300 films in 23 languages on a whole range of categories — from Ebola response to emergency obstetrics, sexual reproductive help, newborn child health, and maternal care.

Devex spoke to Scott about how these videos are produced, the challenges in making them, and how those challenges were overcome.

The conversation has been edited for length and clarity.

Why is it better to train health care workers via video, rather than in-person?

Video training is more efficient and impactful. An in-person training only reaches the people who attend it, but video trainings have the advantage of being accessible to anyone who has the technology to watch them. And unlike in-person training, which only happens once, the video can be watched over and over.

While doctors have skills and training to save lives, a local attendant might know how to deliver a baby, but not what to do if the woman hemorrhages. These videos are for her.

Watch the video to find out how satellites are saving lives in Nigeria.

The medical videos are also formatted to enable learning and skill development — they are not documentaries: Everything is tightly scripted and reviewed by an expert medical team, in line with the latest medical guidelines. Research and evaluation is also carried out before, during, and after production of the video. Working with the ministry of health in each country is vitally important.

How do you make sure you are producing the content that health professionals need?

We always work very closely with partners — it’s an audience-driven process. Often partners will come to us and identify the topic, audience, and the kind of film they want to make. We discuss the overall editorial brief with the partners, the learning outcomes, the creative and relevance of using local languages. Then we develop a script, and once the script has been approved by the partner, we begin production. The partner is really an integral part of the entire process. In our partnership with InStrat, our team tested the material, to ensure it was appropriate and relevant, and to gain vital audience feedback.

What has been the biggest challenge in making these films, and how did you navigate those challenges?

Harnessing satellite tech for public health

By using apps installed onto tablets, health care workers in Nigeria are able to access video trainings, conduct disease surveillance, circumvent the laborious standard paper system, and upload patient data directly onto the cloud. Devex takes a look at a new partnership helping to revolutionize health coverage in remote villages in some of the country’s rural areas.

Ensuring complex terms are explained simply is always a challenge. With a film, you can’t pre-suppose that people have knowledge of medical terms — we unpack medical terminology and explain things in a way that can be easily understood.

We work closely with partner organizations to ensure that whatever material we produce is highly relevant and appropriate for its audience. For instance, we have just worked on a suite of films for a Nepali audience. By working closely with our partner, One Heart World-Wide, we ensure the material we have produced reflects its audience in terms of dress, skin tone, locations, what foods people might eat, whether people would give birth on a bed or a mattress; that sort of thing.

It can also be quite difficult to show complex medical procedures, and we often rely on animation. For example, postpartum hemorrhage is a life-threatening condition, so the priority is always ensuring that the mother is receiving medical care. Because a lot of the training around the condition focuses on what the health worker needs to do in order to stem the flow of blood and stabilize the patient, it's much easier to illustrate through animation — particularly aspects such as examining the placenta.

Results from video-based training of Community Health Extension Workers to measure effectiveness. View a large version of the chart here.

What potential applications do you see for your work in the future?

Now, thanks to cheaper smartphones and better coverage due to wider 3G and satellite networks, video content can be widely available. We are very much interested in scaling this. Video trainings are likely to be used a lot more in the future, even in the most remote corners of the world people have access to smartphones. And thanks to more advanced technology, the cost of making films is quite inexpensive — it’s a lot more cost effective to translate films into different languages rather than trying to run training programs.

Read more about the impact of satellites in development work on our Satellites for Sustainability site.

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