TB Behaviour Change Communication Project in Ghana

The GSMF TB campaign recruited already existing peer educators, who had been trained as HIV/AIDS peer educators and were already active in an HIV/AIDS campaign covering 25 major transport hubs in all regions across the country. Various two-day tuberculosis workshops were held in 10 regions across Ghana to train these peer educators in tuberculosis-related information. In total, the project trained over 130 peer educators nationwide.

The workshop topics included:

• The nature of the disease
• Some statistics that peer educators could appreciate
• Types of TB
• How TB is spread
• How TB is not spread
• TB laboratory tests
• How to prevent and treat TB

The dissemination of information on TB through peer education started immediately after training. GSMF received information, education and communication (IEC) materials from the National TB Programme to be distributed as part of the peer education work. A comprehensive timeline was developed with a hub manager assigned to carry responsibility for implementation in each transport hub. Over the four months of the project, every peer educator was expected to conduct one-on-one education sessions with at least five people in a week. Bus-talks and other smaller forums were also organised to disseminate TB-related information. According to reports from the programme hub managers, peer educators reached out to more than 8,400 people though one-on-one outreach. More than 1,260 bus-talks were held with each bus-talk reaching an average of 10 people in a bus.


In addition to the one-on-one outreach, the bus-talks, and small group forums, peer educators took turns in conducting mass education using a mounted public announcement (PA) system in the transport hub. GSMF also incorporated the TB campaign into an ongoing HIV/AIDS project they were running to educate hairdressers and dressmakers about HIV/AIDS. According to GSMF, it is estimated that, in total, the peer education component reached more than 35,000 people during the period of implementation.


In addition to peer education, seven giant billboards were erected in strategic locations around the country to boost public education on TB. The design and messaging of the billboards were developed to complement the National TB Programme campaign and were all approved by the National TB Programme. All messages for the billboards were pre-tested and generally aimed to erase the stigma of TB, emphasise the free treatment being offered by public facilities, and encourage early treatment-seeking behaviour.

Health

Despite the success of the project, GSMF reported some constraints. According to GSMF, the reading materials as well as visual materials to facilitate the peer-to-peer interventions were not enough. Peer educators also wore HIV/AIDS-branded polo-shirts which they used for their HIV/AIDS campaign activities. Feedback from the peer educators showed that it would have been more appropriate for them to have worn TB-branded polo-shirts.


As a way forward, GSMF is developing a 101 Questions and Answers booklet on TB, which seeks to capture all questions encountered by peer educators during the course of their work.


GSMF also realised that, although there are a number of non-governmental organisations (NGOs) in the field conducting various TB campaigns, they have little or no communication or contact with the relevant public sector facilities which are responsible for treatment. GSMF would like to create a platform to facilitate a public-private partnership to ensure that TB recognition, treatment, and community support are effectively coordinated.


GSMF International is a Ghanaian private non-profit organisation with headquarters in the Republic of Ghana. Established in 1993, GSMF grew out of a social marketing programme supported by United States Agency for International Development (USAID), under a bilateral agreement with the government of Ghana. This programme began in 1985 and was managed by the Washington, DC, United States-based Futures Group International.