Meet Shanika and Embert
Supporting COVID-19 recovery in the Caribbean via SMS
“I don’t know if you recall, but Bob Marley has a very famous song, ‘One love, one heart, let’s live together’ and so forth,” joked Embert Charles, Global President of the World Association for Christian Communication (WACC), about the origins of the campaign message.
“But this was about more than just spreading love; rather understanding the need to be vaccinated, to be reintegrated in one way or another into social and economic activity.”
And yet, in October 2021, only 29 per cent of the population in the Eastern Caribbean region was vaccinated against COVID-19.
This prompted local health agencies to take swift action to scale up vaccination uptake, using digital technology to share reliable, evidence-based advice and guidance to debunk misinformation related to COVID-19 vaccines.
Infodemic in the Caribbean
Although global vaccine rates varied due to supply and availability, the Caribbean’s low vaccination rates can, in part, be explained by widespread misinformation across the region.
“Initially, there was a lot of hesitancy, there was a lot of ambivalence, there was a lot of resistance to accepting the solutions and remedies related to COVID. That was largely due to the confusion and the level of misinformation around the origins and source of the disease,” says Embert.
The ‘infodemic’ – or overabundance of information, including false or misleading information, during a disease outbreak – was described as a major public concern and a threat to the COVID-19 pandemic response at the World Health Assembly in May 2020.
According to the Pan American Health Organization (PAHO), 25 per cent of all COVID-related news in the Caribbean was potentially misleading or inaccurate in the last few months of 2021.
Building trust
But in the Caribbean, trust – especially when it comes to medical issues – is largely built through face-to-face interaction, says Embert.
“Trying to get people to change medical practices and medical behaviours must be done more or less on a face-to-face basis because both medicine and treatment of people are rooted in confidentiality and issues like that,” says Embert.
However, such large-scale, face-to-face awareness raising campaigns are a challenge in the Caribbean, which encompasses 12 different island nations spread out across the Caribbean Sea. Many islands are also made up of remote and hard-to-reach communities, making large-scale, face-to-face risk and awareness campaigns a challenge.
“So, a lot of these campaigns would not have been cost effective because you have to invest a lot [of time and money] in face-to-face initiatives,” Embert says.
That is why ITU and the Pan American Health Organization (PAHO), in collaboration with local health ministries and Trend Media/ Digicel, a national network operator, launched a public health education campaign designed to tackle the high level of COVID misinformation and address vaccine hesitancy using digital communication channels and online platforms in three Caribbean nations: Antigua and Barbuda, Grenada and Saint Lucia.
Using the Be Healthy Be Mobile private-public partnership model – developed by ITU and WHO in 2012 – local telecom operator, Digicel, was engaged to broadcast SMS messages with PAHO-curated content.
Why SMS? A cost-effective and widespread solution
“It was all about increasing this multi-purpose, widespread campaign and just making sure that you reach as many people as possible through as many means as possible,” Embert says.
Over a period of six weeks from October to December 2021 – the first phase of the campaign – two million SMS messages were sent, reaching 150,000 people.
The messages reinforced information from healthcare professionals and trusted healthcare sources, and focused on sharing reliable health information, raising awareness and busting COVID myths, and sharing awareness-raising audio-visual materials produced by PAHO on COVID-19 prevention – and a call-to action to get the vaccine.
“The multiplication of messages is where ICT made a big difference, especially if one has to instantly advise people and provide them with information such as where vaccines are located, the importance [of vaccination] and how they work,” says Embert.
For Shanika John, Health Promotion Officer, Saint Vincent and the Grenadines, the campaign came down to one simple fact: “We created an opportunity for people to have the information on hand,” she says.
At the end of the campaign, vaccination rates increased by one-third, growing from 29 per cent in October 2021 to 41 per cent in December 2021.
In March-June 2022, PAHO and ITU implemented the second phase of the campaign, targeting four countries in the Caribbean, Dominica, Grenada, St Lucia, and St Vincent and the Grenadines, focusing primarily on addressing misconceptions and misinformation about COVID-19 vaccines.
By the end of the campaign, a survey revealed that over 92 per cent of people engaged with the SMS in some way and roughly 78 per cent of respondents said that the SMS campaign had a positive impact on them. Most importantly, nearly 19 per cent of those surveyed said that the SMS campaign helped them to decide to get vaccinated and over 12 per cent said that it helped them to adjust their attitudes and behaviours.
The future of SMS alerts
But despite the success of the campaign, for Embert, there was one clear lesson and take-away: “It is clear that for a campaign to be optimally successful in the regions, both of the major [mobile network] providers must be involved,” he says. Though the telecommunications sector in the Caribbean was liberalised more than two decades ago, the market for electronic communications services is dominated by two multi-national companies operating in the Caribbean region.
But he is hopeful for the future of this kind of alert-based system. “The essential elements of the campaign can be replicated and applied to other types of situations such as natural disasters,” he says.
Hurricane season in the Caribbean typically occurs between June and November. SMS-based alerts can help regional authorities spread safety and best practice messages quickly and effectively to people who live in the hurricane’s path, and to share critical information on recovery and rehabilitation programmes.
“SMS messages act as a reminder, a reinforcement and also as an alert to let people know what’s happening,” said Shanika.
Ultimately, based on the lessons learned, this project provides a way forward for collaboration on similar projects in the Caribbean region, saving more lives in the process.