Above: Health workers in Laos watch instructional videos from the Global Health Media Project to improve their birthing skills. Photo: Pascale Chantavong
“The R’shi women in Northern Laos traditionally cut the umbilical cord with a bamboo knife, put charcoal under it while cutting, and then put hot cobwebs on it,” said Pascale Chantavong, who works with the NGO World Renew. “They would tie the umbilical cord to the mother’s foot, afraid that it could go back inside, and give the baby a bath soon after the birth.”
Chantavong used videos from Global Health Media Project’s newborn care film series to demonstrate a safer way to cut the cord, and to explain how drying the baby thoroughly and providing skin-to-skin contact on the first day, instead of a bath, promotes infant health more effectively.
When Chantavong trains birth attendants and village health volunteers in rural Laos, she needs to demonstrate how and why they should replace long-practiced customs with newer approaches that have proven to be more effective in lowering infant mortality rates. In an area with limited education and low rates of literacy, she recently met this challenge using Global Health Media’s simple, clear and relevant web-based training videos.
“When I discovered Global Health Media resources I was thrilled—really thrilled,” she said. “A birth or the range of warning signs in newborns cannot easily be demonstrated live. A picture or a role play can be helpful, but never as much as seeing a real birth unfold before your eyes, or seeing how a newborn really looks when he or she lacks energy or has jaundice. The videos bridge the gaps resulting from language barriers and the abstract explanation of real problems.”
Global Health Media’s Newborn Care Series includes 27 videos on topics ranging from conducting a newborn exam to taking a venous blood sample. The videos may be downloaded for free from the organization’s website, where all are available are in English, French, and Spanish. Most of the videos are also available in Swahili and Nepali, and a number have been translated into other languages for special uses and projects including Urdu, Hindi, Lao, and Luganda. A growing list of organizations are also narrating the videos in their local languages to be used in their own trainings. When Chantavong found the videos she needed, she dubbed them in Lao with the help of her husband and others.
Film team directing the shoot in Nepal. Photo: Global Health Media Project
The videos have been watched in more than 225 countries and territories and downloaded more than 25,000 times by organizations all over the world. These include leading global health organizations who have made the videos integral to their training and service delivery in low-resource settings. MSF/Doctors Without Border has downloaded the videos in 21 countries, Save the Children in 16 countries, and World Vision International in 15 countries.
The wide appeal of the videos is not only in their clear “how-to” presentation and step-by-step instruction of skills, but also in their use of live footage to teach the recognition of clinical signs. According to Subarna Mukherjee, community advisor for Last Mile Health in Liberia, “In previous trainings, frontline health workers were taught how to recognize breathing problems, for example, using sound tapes. This made it difficult for them to understand a range of symptoms associated with breathing problems, lessening their confidence when dealing with a suspected case. Watching the Global Health Media Project video ‘Breathing Problems’ brought clarity to their comprehension, and was the next best option to actually witnessing a case firsthand.”
Recent research has begun to document the effectiveness of video training of frontline health workers. The Makerere University School of Public Health in Uganda received support from Grand Challenges Canada to test whether videos could be used to effectively communicate maternal, neonatal and child health messages. The study—in Eastern Uganda—convincingly demonstrated the important contribution that videos can make in teaching mothers basic information about health care.
The video “Danger Signs in Newborns” was narrated in Lusoga for more than 600 mothers who participated in the research. According to principal investigator Juliet N. Mutanda, the study documented a dramatic increase in the number of women who could identify danger signs in a newborn after the video training, compared with a control group that did not use the video.
The success of the Newborn Care Series has led to a proposed new film series on the care of small babies in collaboration with the American Academy of Pediatrics and other members of the Survive and Thrive Global Development Alliance. Nearly one million newborns die each year because of complications of being born too soon or too small, yet many of these deaths could be prevented with simple interventions in caring for these babies. This video series would be used to help improve health workers skills in caring for preterm and small babies so that more of them survive and thrive.