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Using AI to Tackle Misinformation on Vaccines and Family Planning

According to the World Health Organisation (WHO), vaccination prevents nearly 2–3 million deaths a year. One of the major causes of skepticism in select African countries is mistrust towards the government. As a result, almost 30 million children under five suffer from Vaccine-Preventable Diseases (VPDs), making the journey to vaccine confidence and access crucial in the African context.

Quilt.AI in collaboration with the Breakthrough ACTION team at the Johns Hopkins University Center for Communication Programs (CCP), designed and implemented a campaign in Guinea aimed at parents of children under 5 with a focus on childhood vaccination, family planning, and COVID-19 health practices. According to the WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) in 2020 only 47% of children in Guinea received the first dose of the measles vaccine and 64% received the first dose of diphtheria, tetanus, and pertussis (DTP) vaccine. These statistics, coupled with a steady decline in childhood vaccine administration in Guinea, raise the long-term alarm.

Breakthrough ACTION Guinea rolled out the “Parents Fiers” (Proud Parents, in English) campaign in three phases between October 2020 and July 2021. In the first phase, the Parents Fiers campaign aimed to understand parents’ online behaviors around vaccination and family planning. These insights informed outreach in the second and third phases through a mass media and online nudge campaign.

Understand Parent’s Online Journey around Vaccines and Family Planning

Quilt.AI conducted a digital ecosystem analysis, analyzing search behavior and social media discourse among Guinean parents on vaccination and family planning. This helped the team understand behavioral barriers and enablers among parents, including the types of messaging to prompt an increase in knowledge and decision-making.

To identify the social media discourse on childhood vaccination, family planning, and COVID-19 health practices, we studied 1,000 posts across platforms such as Twitter, Facebook, and Instagram. Additionally, we collated and analyzed 1,200 keywords with 30,410 unique searches in English, French, and Arabic to provide a baseline for measuring the effectiveness of the campaign.

After analysis of the online discourse among Guinean parents, two distinct themes emerged:

  1. Mistrust of government and fear of experiments
  • Vaccine safety concerns stem from deep-rooted, societal trust issues. A common theme that appears is a lack of trust towards the Guinean government and the perceived West. This manifests in the form of skepticism around safety concerns, and the belief that vaccines are being experimented on Africans.
  • Fake news exacerbates the already prevalent fears and suspicions around vaccines. For instance, in April 2020, a video of children reacting adversely to a schistosomiasis vaccine went viral. This was taken out of context and misrepresented as COVID-19 vaccine testing, which further fed into Guinean fears

2. The impact of religion and male-dominated discourse

  • While misinformation on birth control does persist online, it is not rampant. What remains commonplace are posts on the immorality of birth control and abortion. These acts are considered to hurt religious sentiments.
*Comments and posts were translated from French to English on Facebook
  • Conversations around birth spacing, specifically on Twitter, are dominated largely by men. This is possibly due to literacy rates among women (21.96%, versus men at 43.64%) and their access to online spaces to discuss issues such as family planning.

Segment Parents’ Online Behaviors to help target Campaigns

Through the online discourse analysis, we were able to segment parents in Guinea into four distinct categories:

1. Rejecters: These are parents with a strong stance against vaccination and modern medicine. They typically indulge in fear-mongering on platforms such as Facebook and speak of the horrible side effects of medicines.

2. Traditional: These parents harbor strong views which subscribe to religion and tradition. Their hesitation is typically rooted in the fear of God and shame from the community. They use religious teachings to stifle progressive narratives on social media.

3. Transitional: These parents have exposure to vaccines and contraceptives with a majority of them reading up on the benefits of vaccinating as well as birth spacing. Despite the information they receive, there is still hesitancy when it comes to immunizing their children or using contraceptives.

4. Progressive: These parents are well equipped with knowledge on vaccinations and family planning. This segment also actively shares and circulates information on relevant topics in the form of educational articles, hashtag movements, or in the form of their own personal stories.

Launch a Mass Media Campaign

Breakthrough ACTION Guinea developed an initial mass media communication campaign using CCP’s best practices. This included the creation of archetype segmented target group profiles along with messages, creative briefs, visuals, and radio scripts. Guinea’s Ministry of Health (MOH) played a critical role in the development and validation of the campaign.

Among the segments, the transitional parents are likely to be impacted the most due to their degree of openness and overall interest in health and education. Nudging them towards appropriate information channels is most likely to have a positive impact on their health decisions.

A Blueprint Campaign to Nudge Parent’s Behaviors Online

Based on insights derived from the first two phases of the campaign (digital ecosystem analysis and the initial media campaign), Quilt.AI and Breakthrough ACTION Guinea launched two targeted campaigns over a period of seven days. We measure this nudge campaign in impressions and reach. An impression is counted as the number of times an instance of an ad is on screen for the first time; reach measures the total number of unique individuals who view the content. Those users in the 25–34 years age range formed the most impressions, with 49% of 502,210 total impressions, or 246,083 impressions. Those users in the 18–24 years age range formed 34% of total impressions, or 170,751.

Examples of top-performing ‘Family Planning’ posts:

Reach: 18101
Reach: 14217

Examples of top-performing ‘Vaccination’ posts:

Reach: 42160
Reach: 10458

Lessons Learned

Based on the engagement with campaign content, we were able to gauge important insights that might are useful for future campaigns in Guinea:

  • Amplification of existing voices is likely to create more impact: During the analysis, we noticed that Guineans are more trusting of their peers and adequate priority must be given to them. The campaign can redirect people to existing Facebook groups that have followers and can facilitate discussions.
  • Online discourse needs to be directed towards visible social media pages with thousands of followers: There must be an emphasis on sharing individual experiences as this is something most people related to. Influencers too can help disseminate information related to family planning.
  • Localize campaign messages: The digital ecosystem demonstrates how misinformation is rooted in local religious and colonial beliefs that must be corrected. Messages to counter them must be rooted in local language and cultural references. This could mean information about how vaccines are tested worldwide and being used across people from different cultures and races.
  • Amplify allies’ voices: Advertisements for contraceptives directed at spouses were not well received in the comments. Since men dominate conversations around family planning and are decision-makers at home campaigns can use male allies to counter those against family planning or vaccines.
  • Messages and Images are key: Future messages should consider addressing the role/perception of the West to reduce any concern or threat Guineans feel about vaccines. Messages with call to actions also had a higher engagement. Images help draw in audiences and posts with Guinean children and families received major traction.

These insights are critical in launching initiatives to counter misinformation online. Vaccine hesitancy is one of the top threats to global health and the Internet only facilitates the spread of misinformation at a larger scale and speed. However, the digital space can be effectively leveraged to positively influence people’s behaviors and perceptions.

Originally published at https://www.quilt.ai on October 15, 2021.

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