Information Ecosystem Mapping: A method to inform context-specific digital health promotion interventions
In recent years, improved access to the internet and internet-connected devices have accelerated the adoption and use of digital technologies such as social media everywhere. For MSF, this development means a plethora of new opportunities to engage with members of the communities where we work.
Our teams have traditionally provided health promotion orally or in printed format (posters, leaflets, etc.). However, MSF is now increasingly leveraging social media and other online platforms as complementary avenues for sharing information and advice on good health practices, treatment, and care.
Despite the great promise of social media for health promotion purposes, there are also several pitfalls that lie in the path of using these platforms in the diverse context where MSF works. People’s access to and perception and usage of social media are highly context-specific. Our teams need to understand how information is produced, transferred, and consumed as well as what factors influence the flow of information on a community level to implement context-specific and culturally appropriate digital health promotion interventions.
To strengthen our knowledge about how MSF teams can interact effectively with communities through social media and other digital tools, MSF launched the Patient Multimedia Engagement (PME) project in early 2019, funded by MSF Transformational Investment Capacity (TIC). The two-year project included two one-year pilots in Mexico and Colombia, during which Facebook and WhatsApp campaigns were used to promote MSF’s mental health services for survivors of sexual violence and other situations of violence in the countries. Lessons learned from these two pilots were used to create the PME toolkit, a step-by-step guide for developing digital engagement campaigns in MSF operations.
Building on the PME toolkit, the innovation team in the MSF Manson Unit launched an information ecosystem mapping initiative in the fall of 2021 in Bangladesh, to assess how health information spreads within the community.
Working with the Rohingya population in the Balukhali refugee camp in Cox’s Bazar, and in the local community in villages surrounding the camp, the team quickly realised that the two communities access information very differently:
“While we saw large gender disparities in how information is accessed by members of the Rohingya population, we did not register any significant differences between how men and women in the Bangladesh host community access information,” says Francesc Galban Horcajo, Medical Innovation Lead with the Manson Unit.
“In some locations, we have found that online information is not trusted unless coming from a known local source. In these contexts, we have explored community-based chat channels and online groups containing influential community members, that have allowed us to share and distribute health information.”
“When we communicate with vulnerable populations about sensitive topics, we often need to take a more targeted approach, and ensure the content and communication approach is adapted to their sociocultural environment.”
“One important goal of the information ecosystem mapping work is to showcase the need for context-specific approaches as opposed to a one-size-fits-all approach when implementing any type of health promotion intervention—online or offline.”
The information ecosystem mapping was expanded late last year to also include Kamrangirchar in Dhaka, Bangladesh, Taiz city in Yemen, Penang in Malaysia, and Dushanbe in Tajikistan. Through this work, the team seeks to understand not just what information and communication tools are being used in these communities, but also if there is a discrepancy between how these tools are used for case identification, health information, and patient support purposes in different settings.
Information ecosystem mapping is a multi-faceted process that, just as digital health promotion activities informed by this work, needs to be adapted to each context. In all locations, data from interviews, surveys, existing research literature, and Geographical Information Systems (GIS) data are synthesised and analysed to produce a map of the local information flows. The Manson Unit’s information ecosystem mapping work is currently in its final stages and will be completed this spring, followed by the launch of several digital health promotion campaigns.
“One other important goal of this work is to showcase the need for context-specific approaches as opposed to a one-size-fits-all approach when implementing any type of health promotion intervention—online or offline. Through this work, we also aim to improve our understanding of how the PME toolkit can be tailored for different environments and health thematic areas,” says Dasha Reddy, who leads the Manson Unit’s information ecosystem mapping work.
Digital health promotion requires a blend of expertise, including medical, technical, legal, and social research. To reap the benefits of innovative information and communication technologies and implement evidence-based interventions, the lessons learned from MSF’s digital health promotion activities need to be documented, disseminated, validated and revisited frequently by multidisciplinary teams within our organization. The information ecosystem mapping work is a critical component in this process.