Volunteers and mothers discuss handwashing before the distancing measures came in.
For the past two years I have been working with colleagues Professor David Swann of Sheffield Hallam University and Dr James Reid of the School of Education at the University of Huddersfield along with our partner, St John Zambia, to design low cost maternal and child health interventions. Faced with the threats posed by the Covid-19 pandemic, the team are responding by utilising songs to empower volunteers working in local health clinics in resource constrained communities across Zambia. Building on our long term relationship we are working with frontline workers to facilitate the co-production of educational songs on preventing the spread of the virus.
You can see and hear the songs here: https://vimeo.com/405184935
Building on significant support from the University of Huddersfield, at the beginning of 2020 David Swann, James Reid, Barry Doyle and St John, Zambia, were awarded a grant by the UK Arts and Humanities Research Council to explore the potential of lullabies and songs in reducing adolescent maternal and infant mortality in Zambia. The project developed as an urgent response to President Edgar Lungu’s declaration in 2019 that maternal and prenatal deaths constituted a Public Health emergency in Zambia, with 10 to 15 women per week losing their lives in pregnancy due to preventable, non-communicable causes. However, by early March 2020, before the first cases of Covid-19 in Zambia, we shifted the focus of the project from developing educational messages about maternal and child health (MCH) to key messages about hand washing, social distancing and how to manage antenatal and postnatal care in a time of crisis.
Although evidence from the global north and richer economies indicates that SARS-Cov-2 (the virus that causes the Covid-19 disease) hospitalises and leads to the death of more men than women this does not account for the particular socioeconomic vulnerabilities of women in resource constrained contexts. For them the epidemic could see a general reduction in spending on wider health provision (even maternity and reproductive services), increased caring responsibilities, loss of income, and increased incidences of gender based violence. Significantly, therefore, Covid-19 has the potential to further increase the vulnerabilities of pregnant women and new mothers in Zambia where, in 2017, maternal deaths accounted for 17.2% of all deaths among women in the age group 15-49.
David and Jim in a workshop, St John Zambia HQ, Lusaka, June 2019
Following a number of discovery workshops with the women volunteers in our partnership, we discovered songs as an appropriate and zero-cost medium for imparting information about MCH care. Our work responds to the recent call by Soumya Swaminathan, Chief Scientist at WHO, to highlight the role and experience of women in designing health and welfare interventions. In doing so, it provides a disruptive alternative to the cyclical pattern of predictable and unsustainable approaches that do not account for the role of women in the frontline of the pandemic. Our interdisciplinary strategy in developing an approach with women for women is accessible and inclusive, especially for the 32% of women in Zambia who are illiterate. Songs offer intrinsic flexibility and the potential for sustained impact as they eliminate the need for public/ private donor investment or printed materials that can often impede the traction of new approaches and their implementation at scale.
Barry with Morrice (2nd right) and volunteers Danny (1st right) and Davies (2nd left)
Although the worldwide lockdown has stopped us visiting Zambia since the beginning of March, our strong partnership with St John, Zambia and its National Coordinator, Morrice Muteba, and a close relationship with St John volunteers cemented over the past eighteen months, has allowed us to co-produce these songs with urgency, understanding and, hopefully, life-saving effect.
Funding: UKRI, GCRF: Life-Saving Lullabies: Reducing adolescent maternal and neonatal deaths in Zambia. Project reference: AH/T011947/1. https://gtr.ukri.org/projects?ref=AH%2FT011947%2F1