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Part 4

COVID-19 & Global Health

Disinformation Toolkit 2.0

Misinformation costs lives.

The COVID-19 pandemic has opened the door to an information epidemic or “infodemic” of misinformation related to the causes, symptoms, and treatments of COVID-19, according to the World Health Organization. Further, this epidemic of “misinformation costs lives. Without the appropriate trust and correct information, diagnostic tests go unused, immunization campaigns (or campaigns to promote effective vaccines) will not meet their targets, and the virus will continue to thrive. Furthermore, disinformation is polarizing public debate on topics related to COVID-19; amplifying hate speech; heightening the risk of conflict, violence, and human rights violations; and threatening long-terms prospects for advancing democracy, human rights, and social cohesion.”

Many NGOs are responding to the COVID-19 infodemic, leveraging their experience responding to misinformation that spread rapidly during the 2014-2015 Ebola outbreak in West Africa. Mercy Corps, Internews, Project Concern International (PCI), and Concern Worldwide detail their experience combatting Ebola rumors and how this prepared them for the tidal wave of misinformation that has accompanied the COVID-19 pandemic.

Typically in the health space, practitioners refer focus on combatting misinformation instead of disinformation, as health practitioners typically prefer to avoid the politics of intent and accountability implied by the use of the term ‘disinformation.’ Additionally, mis- and disinformation narratives typically are referred to as ‘rumors’ in reference to the way they spread through communities, just as an infectious disease might.

Many global health organizations are confronting both the COVID-19 and the accompanying infodemic in their work around the globe. This section profiles the work of a few.


COVID Misinformation & Social Media

An April 2020 social media analysis conducted by RTI International found a massive upswing in the incidence of COVID-19 discussion during the early months of 2020, and that mis- and disinformation narratives spread rapidly, woven in with the broader conversation about the disease. Learn more HERE.


Save the Children

Save the Children is a global health and youth-focused NGO that has been active for more than 100 years. Save the Children is the prime for the Global USAID Funded READY project, which aims to augment capacity for humanitarian response to major disease outbreaks. READY consortium partners include John’s Hopkins Center for Communication Programs (CCP), which leads risk communication and community engagement (RCCE) activities. READY has developed several resources, including Operational Readiness Training and COVID-19 preparedness micro-trainings that include RCCE elements.

In addition, READY has developed an RCCE Toolkit that offers NGOs and other humanitarian response actors a suite of guidance and tools they can use to rapidly plan and integrate RCCE into their COVID-19 response. In addition to the work of READY, Save the Children has also developed, implemented, and monitored RCCE strategies in Vietnam, Myanmar, Cambodia, and Guatemala through the USAID Breakthrough ACTION project, which is led by the Johns Hopkins Center for Communication Programs. Through these programs, Breakthrough ACTION and Save the Children have developed strategies that focus on engaging communities and community leaders and groups to have two-way communication with communities for feedback and tracking of rumors, disinformation, and misinformation, all through community volunteers and leaders.

CCP also developed a set of technical global goods, available online to the public and other practitioners. Below some of these resources are highlighted, while the full list of resources can be found here.

  • COVID-19 Communications Network: Houses 429 SBC resources for COVID-19 response, including 68 from other USAID-supported projects.
  • Synthesized Guidance for COVID-19 Message Development: A summarized, indexed reference of accurate, standardized COVID-19 information from trustworthy sources, disaggregated by user groups. The information in this guide is presented in simple, clear language to support message and material development for social and behavior change interventions.
  • Real-Time Rumor Tracking for COVID-19: System Design and Implementation Guide: Written for humanitarian or public health organizations as well as national governments seeking to document rumors in a systematic and dynamic fashion. Reviews the role of rumors in a public health or humanitarian emergency, and includes a summary of the community-based approach taken by Breakthrough ACTION during the COVID-19 pandemic. Also lays out an application of this approach using the District Health Information System 2 (DHIS2) open source software platform.

Gender, Misinformation & COVID-19

Breakthrough ACTION’s guide to Integrating Gender Into COVID-19 Risk Communication and Community Engagement Response highlights the fact that “The COVID-19 pandemic has exacerbated gender and social inequalities around the world.”

This guide recommends that when seeking to counter COVID-19 misinformation, practitioners:

  1. Ensure that rumor tracking systems tap into channels used by both women and men. 
  2. Assess whether rumors fuel gender-based inequalities, stigma, and discrimination and design responsive messaging.
  3. Identify both female and male influencers who can amplify correct info mation in their communities or social circles, including those who can reach marginalized populations.

Learn more HERE.


  • Virtual Pretesting During COVID-19: Tips and tricks to use digital platforms to conduct pretests of public health messaging virtually, to ensure content and images are accurate, credible and will motivate the behavior changes needed to prevent the spread of the disease and mitigate its impact.
  • Using Social Media to Disseminate COVID-19 Information: Details the steps and considerations programs can take to develop an overarching social media strategy to disseminate COVID-19 messages and combat misinformation. This document also provides a list of relevant tools and resources for implementation.
  • Managing Nutrition Myths and Misconceptions During COVID-19: Covers social and behavior change strategies for combating misinformation and supporting programs in responding to COVID-19 related misinformation that affects nutrition.
  • Using SMS and IVR Surveys During COVID-19: Technical brief intended to serve as guidance for systematically administering Short Message Service (SMS) and Interactive Voice Response (IVR)-based surveys to collect data1from a stratified sample of participants. Includes a number of reference documents and resource people to contact for additional information.

Internews

Internews is a global NGO that empowers people worldwide with the trustworthy, high-quality news and information they need to make informed decisions, participate in their communities, and hold power to account.

As part of the Rooted in Trust project, funded by USAID’s Bureau of Humanitarian Assistance, Internews is countering the unprecedented scale and speed of the spread of rumors and misinformation about COVID-19. The project is global in reach and operates across priority countries, including the Philippines, Afghanistan, Lebanon, Mali, Sudan, the Central African Republic, and Colombia. In terms of approach, Rooted in Trust is grounded in a deep understanding of hyper-local information ecosystems based on empirical research and deep community engagement, including the Social Media Influence Mapping approach. This approach promotes impact on the global and local levels and focuses on vulnerable communities first affected by COVID-19.


Ebola and the DeySay Rumor Tracker

Internews’ experience responding to COVID-19 misinformation builds on prior work combatting Ebola misinformation in 2014. In addition to approaches such as public testimony, events, debates, and radio bulletins, to counter rumors about Ebola, Internews led the development of the DeySay rumor tracking system alongside The Liberian Red Cross, UNICEF, and PCI.

According to a 2015 report, when the Ebola crisis was still active, “DeySay begins with an SMS short code, provided by UNICEF free of charge to hundreds of health workers, NGOs and volunteers on the ground throughout Liberia. When anyone connected to the system becomes aware of a rumor, they text it via the short code to a central coordination hub in Monrovia. The information is then collected, analyzed for trends, and disseminated to local media partners in the field with details about the rumor so they can stop its spread. Once the system is fully functional, aid workers and social mobilizers in the relevant regions will be put on alert so they can go door-to-door to calm anxieties and correct misinformation. In conjunction with the rapid response system, DeySay also produces a weekly newsletter for local media throughout the country and partners on the ground.” Learn more HERE.


Rooted in Trust employs a technique called Social Media Influence Mapping to tune in to conversations about COVID-19 from specific vulnerable groups such as migrants, LGBTQ+ groups, refugees, women, and people in specific geographical regions and language groups. By mapping and analyzing these conversations, Internews is able to collect rumors, listen to community perceptions on COVID-19, and better understand the specific, narrow, and often private channels where quality information can be shared to have a targeted impact. This approach is led by key local organizations and contacts in each environment, and messaging is implemented by local risk communicators and local media.

More tools, including guides, webinars, and podcasts are available on the Rooted in Trust website.

PATH

PATH, a global health NGO that partners with public institutions, businesses, grassroots groups, and investors to solve the world’s most pressing health challenges, has documented how misinformation has exacerbated the challenge of combatting COVID-19 in a number of country contexts. PATH’s ‘human-centered design’ approach to combatting misinformation, built on deep engagement with local populations and health institutions, has included both high- and low-tech strategies. In Kenya, “digital technologies are not the only way to share timely health information on COVID-19—and are often not the best way. Many communities do not have reliable internet connectivity or power, so limiting outreach to digital connections prevents them from accessing information in a timely manner and will only further entrench inequity. Instead, PATH deploys a mixture of high- and low-tech approaches to reach communities.” According to Edward Anyanda, coordinator, Kakamega County MNCH Alliance, a key partner to PATH in Kenya, “within semi-rural and rural [areas] like our county of Kakamega, knowledge within the community is often passed through gossip… [Misinformation thrives] mostly because the common channels that pass information aren’t fully compatible with the communities’ needs; for example language and interactive engagement styles.”

COVID-19 misinformation has also presented major challenges in the Democratic Republic of Congo (DRC) according to Guy Bokongo, PATH’s advocacy and policy lead in DRC: “Some Congolese suspect that the pandemic is a ruse—a ploy for more funding from international donors, which corrupt politicians could then divert to their own pockets.” According to Guy, many of the 13 million people in the capital city of Kinshasa are struggling, “they don’t care about the name of the disease, let alone technicalities about its transmission.” In response, Guy and his team are creating videos in which trusted locals share correct information about COVID-19 and why it matters to local people. According to Guy, the most effective spokespeople are high-level officials who have themselves recovered from COVID-19. “People are really surprised that someone close to the head of state could be affected. Now these recovered people are known and influential.”

PATH has taken a human-centered design approach to messaging during the COVID-19 crisis in Kenya and the DRC, but also in Uganda and India. In each of these contexts, PATH has sought to incorporate deep local research and engagement with a flexible outreach approach, “looking beyond digital—using traditional media, trusted community leaders, and analog connections to reach rural communities. Printed materials like billboards, posters, and guidelines for health facilities reinforce messaging on radio and television using influential community champions. PATH engages with community leaders, who are important partners in elevating the voices of their people and helping respond to concerns from local communities. Even simple activities such as using vans equipped with loudspeakers can share information in remote communities on COVID-19, help dispel misinformation, and connect individuals with essential health services. It is by using all the tools at our disposal and working directly with ministries of health and community leaders that we can ensure trusted, evidence-based information reaches everyone.”

As of March 2021, PATH, in the process of conducting research on vaccine acceptance, using machine learning to capture and analyze sentiment and misinformation trends about vaccines in a variety of country contexts across Sub-Saharan Africa.


COVID Misinformation, Human-Centered Design & the 9 Principles of Digital Development

Many global health organizations have turned to human-centered design (HCD) based approaches to create COVID-19 interventions that are tailored to local populations’ preferred methods of interpersonal and mass communication. HCD is a design methodology that incorporates deep ethnographic-style research and engagement among stakeholders, and an iterative approach to the design of solutions. While HCD is tech agnostic—applicable whether the resulting solution leverages new technologies or not—it is considered highly conducive to building locally-tailored tech tools, tech-enabled messaging campaigns, and intervention strategies with a tech component.

9 Principles of Digital Development distill the core concepts of HCD and synthesize them with ‘lean start-up’ approaches used by Silicon Valley tech companies to help global development and public health practitioners build tech tools that are more effective and more sustainable, including tools relevant to the fight against COVID-19 misinformation. These guidelines are endorsed by more than 250 organizations including NGOs, donors, multi-laterals, and private companies, including PATH, Save the Children, Internews and others mentioned in this document. Learn more HERE.


World Vision

World Vision, a Christian NGO that works in nearly 100 countries to help children, families, and communities reach their full potential by tackling the causes of poverty and injustice, has leveraged
a pre-existing WhatsApp-based network of faith leaders to combat COVID-19 misinformation. This approach leverages World Vision’s global learning and experience in the health sector, as well as deep local connections to faith leaders, who “are often the most trusted and authoritative voices in the communities” they serve.

Esther Lehmann-Sow, World Vision’s Partnership Leader for Faith and Development, explains that World Vision runs “WhatsApp groups in countries right across Latin America, Asia, Africa, Middle East, and Eastern Europe. These are moderated by mentors to ensure accurate and up-to-date information is conveyed. This approach has previously helped us increase awareness, improve uptake of recommended behavior, and decrease stigma around HIV and AIDS, Zika and Ebola.” Further, World Vision works “with faith leaders so they can use their influence on parents and local governments to adopt behaviors that protect and provide for children. In this case, faith leaders are playing a key role in our efforts to protect children from the potentially catastrophic secondary effects of COVID-19.”

According to World Vision, the WhatsApp groups—which operate much like a telephone tree—reach an estimated 88,000 people, many of whom receive core public health messaging tailored to local communication channels and patterns and often in partnership with leaders from other faiths for broader reach. In Sierra Leone, for example, Pastor Peter Kainwo and his district’s Chief Imam, Alhaji Mustapha Koker, began planning for the arrival of COVID-19 before it was detected. “We began speaking to each other’s congregations and then moving our sermons to radio and television when we needed to isolate. But for many poor communities, they do not have access (to radio and television) so we bought megaphones and speakers, and with the blessing of authorities, started visiting villages, and educating them in this way. We have written jingles for the children so they can remember important messages.”

Additional Health-Focused Tools & Methodologies

  • Coronavirus Facts Alliance via Poynter: The Poynter Institute’s #CoronaVirusFacts / #DatosCoronaVirus Alliance maintains a database of more than 9,000 fact checks related to COVID-19 and the global vaccination effort. These fact checks relate to stories across more than 70 countries and are provided by more than 100 fact-checkers.
  • Mitigating Medical Misinformation: A Whole-of-Society Approach to Countering Spam, Scams, and Hoaxes: Created by Harvard University’s Shorenstein Center on Media, Politics and Public Policy, this brief targets a broad range of actors, including the public health sector, civil servants, media workers, technology companies, and civil society organizations, and proposes a unified methodology for documenting disinformation and responding in concert with actors across the spectrum of stakeholders.