Behavioural change (hygiene) communications in a COVID-19 era: the case of Lao PDR

Never before has this generation seen a health pandemic of such scale. Amid all these uncertainties, what we know is that some people are more at risk of being harmed. While movement of people (goods and services) is severely hampered, we must not stop the search for creative ways to assist governments in containing the further spread of the virus and in safeguarding WASH gains already realised.

Last month, SNV and the Government of Lao PDR, with support from the Australian Government’s Water for Women Fund, launched its COVID-19 response for rural households in the Savannakhet province. The partnership’s response is part of SNV's Sustainable Sanitation and Hygiene for All (SSH4A) programme in Lao PDR: an integrated rural sanitation approach, which includes behavioural change communication campaigns for handwashing.

Placing potentially disadvantaged groups first

Analysis of SNV's baseline data and formative research (gender; disability) (publication forthcoming) in Savannakhet highlighted the need to enrich behaviour change campaigns with a conceptualisation of inclusivity and ethnicity to ensure that everyone:

• is reached by behavioural messages and service improvements that resonate with their realities,

• equitably benefit from improved WASH outcomes, and

• are free from potential harmful risks (due to inherent biases in institutions and/or poorly conceived WASH activities).

Although advancements in communications and technology have brought our realities closer and accelerated the speed by which information is shared – the fact remains that some groups (and whole areas) still do not have access.

As in many areas in the world, information poverty [1] is still an issue. Not only for communities living in the rural and remote areas of Lao PDR. Groups that are potentially left behind by mainstream information management, content and messaging style could also include ethnic groups and people with disability.

An incredibly diverse country that is home to the youngest population in Southeast Asia, Lao PDR is known to be among the most ethnically diverse countries in Asia. It is also estimated that almost a sixth of the population live with a disability as a result of extensive aerial and ground fighting during the Second Indochina conflict (1964-1973).[2]

Making life-saving information accessible to all

On 24 March, the first two COVID-19 positive cases in the country were reported. Expecting a possible spike in new cases due to the repatriation of Lao workers, the Government of Lao PDR and its development partners were quick to respond. Almost immediately, the government formed the COVID-19 National Taskforce (led by the Ministry of Health with representation from various ministries) and developed its National Preparedness and Response Plan. One of the taskforce’s key intervention areas was to ensure that reliable information reaches the entire population.

Under the government's leadership, various UN Agencies and INGOs – including SNV – were mobilised to action. A wide range of materials were generated, but many were found more suitable for urban audiences with access to multiple information channels (e.g., smart phones/internet, TV, newspapers, online news and social media).

Noting this gap, SNV in Lao PDR, with financial support from DFAT, worked out the details of its BCC campaign around three population segments: 1) people living in rural/remote areas with no or limited access to reliable electricity (TV access), internet service, newspapers, and other mainstream and social media channels; 2) people who cannot read and write, and 3) groups who converse in their own ethnic language.

A BCC production like no other

In just over a month, SNV’s team in Lao PDR rolled out multiple BCC materials. This despite their own mobility being restricted. Throughout, the planning, conceptualisation and production phases of all BCC materials were managed at a distance.

Two drama sketches for radio. The first of SNV’s drama sketches was launched days leading up to Pimai (Laotian new year).[3] Initially conceived to be broadcasted five times a day across three districts in Savannakhet, provincial authorities decided to expand broadcast reach by airing messages by the hour, province-wide. Village loudspeakers and mobile trucks were activated to reach remote areas with no radio coverage.

The success of the first drama sketch saw the translation of the second sketch (from Lao Lum and Bru, to Hmong and Khmu languages), and a partnership with MOH and the UNDP’s community radio programme. Reaching 10 of Lao PDR’s 18 provinces, the second sketch [4] was broadcasted daily, over two weeks.

A song that cuts across cultures.[5] Songs ‘travel’ through social media, TV, mobile trucks with loudspeakers, community radio, and through oral tradition (people singing songs themselves). Working with a professional production outfit and celebrities in Lao society – SNV produced the ‘Stop Stop Covid’ song in line with key government messages on COVID-19 reinforcement measures. Music reaches a great number of people, cutting across age groups, specific physical abilities, income levels, etc.

A music video and animation that visualise messages of the ‘Stop Stop Covid’ song to expand the reach of messages to groups with hearing impairments, and children. Similar to many countries, celebrities in Lao PDR have great pull in influencing their viewers to adopt new practice. The music video is also accompanied by subtitles and sign language. The animation on the other hand is accompanied by an image of hygiene heroes to speak to the creative imagination of children.

Ten days since launch date, over 600,000 people have already viewed the music video/animation in the social media pages of the production agency and celebrities (Facebook and YouTube). Hundreds of thousands more are being reached through national TV, mainstream and community radio, and advertisements in national papers.

The early success of SNV’s BCC campaign contributions to the Government of Lao PDR’s COVID-19 response is, once again, validating many programming aspects that SNV has long been promoting. These are the centrality of evidence-based research for effective (and targeted) planning and the importance of a government on the lead in co-developing and scaling-up inclusive sanitation and hygiene programming.

Prepared by: Anjani Abella with Le Thi Thuy Huong and Gabrielle Halcrow

Photos: (banner) Rural district in Savannakhet province (SNV/Silvana Summa) | Radio and TV production photos (SNV in Lao PDR)

Notes
[1] Information poverty is defined as ‘that situation in which individuals and communities, within a given context, do not have the requisite skills, abilities or material means to obtain efficient access to information, interpret it and apply it appropriately’. See J. Britz, ‘To know or not to know: a moral reflection on information poverty,’ (Abstract only), Journal of Information Science, vol.30 (issue 3), 2004, pp. 192-204. 
[2] Read SNV news, Accessible toilets: an urgent need for a sixth of Lao PDR’s population to learn about how SNV is engaging people with disability (and Disabled People’s Organisations) in improving the sanitation conditions of everybody.
[3] Radio 1: Stay@Home Pimai (in Lao Loum – the official language and Bru – a common ethnic language in Savannakhet) | For many Laotians, Pimai is an occasion for family and/or friends to gather in large reunions. Staying at home was unheard of. In this sketch, sister Lar reminds her brother Khamphaeng to comply with the government’s order to stay home for everyone’s safety. The sketch focuses on family-oriented values, which are shared across different ethnicities. A sister-brother dynamic was specifically chosen to convey more equal and open relations.
[4] Radio 2: Magic words for COVID prevention – stay at home, wash your hands, cover your mouth, avoid crowd | The second spot broke down technical advice to simple, accessible language using popular Lao catchphrases and humour.
[5] McGill University, ‘Music cuts across cultures,’ Science Daily, 7 January 2015, (accessed 4 May 2020).