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. 2018 Aug 5;8(8):e017573. doi: 10.1136/bmjopen-2017-017573

Table 1.

Details of intervention activities and during visits to the intervention villages

Event Activity Where Time Purpose
Day 1 Meeting the Alkalo (village head)

  • TCs play a song in praise of the Alkalo.

  • The team greet the Alkalo.

  • Explain purpose/project.

  • Meet VHW and TBA and MaaSupervisor.

 Alkalo’s residence 20 min

  • Alkalo is the entry point to the village; must receive a visit before start of work.

  • Alkalo and wife have social status & their support motivates mothers.
Announce to the villagers

  • TCs invite villagers to afternoon meeting by drumming and campaign song with the use of a loud speaker.

 Within whole village 2 hours

  • Create alert.

  • Mobilise the community.

  • Assist memorisation by repetition of song and behaviours.
House-to-house visit with MaaSupervisors

  • House-to-house visit (invite household members to afternoon meeting) with TBA and VHW.

 Residence of every household especially with young children 3 hours

  • Social mobilisation to involve the whole community.
Record a short video

  • Video the Alkalo and wife handwashing and reheating weaning food to show at the village meeting later.

 Alkalo’s residence 15 min

  • Alkalo and wife have social status and their support motivates mothers engender a social norm.
Afternoon village meeting

  • TC’s drum/sing the six behaviours and pledging song while villagers arrive at meeting site.

  • Opening prayers by the Imam (religious leader) lead prayers for the gathering (Gambian cultural norm).

  • Opening remark by the Alkalo.

  • Introduction of project by PHO.

  • Two dramas (MaaChampion and Funtu) by TCs.

  • Summary of six behaviours from the drama by PHO.

  • Question and answer from village audience led by PHO.

  • Pledge song by TCs.

  • Play ‘Choose soap’ silent animation video.19

  • Show video of Alkalo (washing hands with soap) and his wife (reheated weaning food) translated live in local language.

  • Announce MaaChampion competition by PHO.

  • Invite mothers of children aged 6–24 months to pledge to practise behaviours.

  • Give pledged mother’s plastic sheets for covering surfaces to enable hygienic drying of utensils/pots on a clean surface.

  • Take a group photo of pledged mothers for the honour board.

  • Closing remark by PHO.

  • More drumming and songs (motivational).

  • Print and display pledged mothers and Alkalo’s photos on honour board at the Bantaba.

 Village ‘Bantaba’ (a central place where villagers meets – usually under a large tree) 4 hours

  • Inform the community/provide instructions.

  • Model or demonstrate behaviour.

  • Engender all motivational drivers, particularly nurture and affiliation.

  • Prompt identification with a role model.

  • Prompt action through pledging.

  • Set graded tasks through competitions.

  • Target mothers for their pledge.

  • Prompt intention formation.

  • Assist memorisation by repetition of song and messages.

  • Display of photos of pledged mothers for contingent reward.
Community volunteers training

  • Train new assistant MaaSupervisors by village volunteers/trained MaaSupervisors, supervised by PHO.

 Village Bantaba 2 hours

  • Enable encouragement of mothers and competition success.

  • Involve more community members to engender development of social norms.
Day 2 Meeting the Alkalo

  • Greet the Alkalo

 Alkalo’s residence 10 min As day 1
Announce to the villagers As day 1 As day 1 2 hours As day 1
House-to-house visit with MaaSupervisors

  • Engage MaaSupervisors with household visits and boost their confidence.

  • Assess/encourage pledged mothers for progress to next stage.

 Residence of each pledged mother 3 hours

  • Prompt practice of key behaviours.

  • Provide feedback.

  • Prompt self-monitoring/review/community participation.
Ad hoc women or men meetings held separately in neighbourhoods

  • Glo Germ demonstration.

  • Explain two stories (MaaChampion and Funtu) on flip chart.

  • Play silent animation video ‘Choose soap’ on iPad/laptop.

 Neighbourhoods 30 min

  • Engender disgust through Glo Germ: dirt on hands.

  • Engender all motivational drivers, particularly nurture and affiliation through stories.

  • Engage men and women to support mothers of young children.

  • Prompt specific goal setting.
Day 3 Meeting Alkalo As day 2 As day 2 20 min As day 2
Announce to the villagers As day 1 As day 1 2 hours As day 1
House-to-house visit with MaaSupervisors As day 2. Additionally:

  • During household visits, video mothers who succeeded to became a MaaChampion to show at the afternoon.

 As day 2 3 hours As day 2—additionally videoing to provide contingent reward.
Afternoon village meeting As day 1 and including the following:

  • Show animation video from India handwashing ‘SuperAmma’ project with spontaneous translation.19

  • Show videos from mothers who succeeded to become MaaChampions.

  • Take photo of new pledged mothers with their plastic sheets and of MaaChampion’s with medals and displayed on honour boards (pledging and certification ceremonies).

 As day 1 4 hours As day 1
Day 4 Meeting Alkalo As day 2 As day 2 20 min As day 2
Announce to village As day 1 As day 1 2 hours As day 1
House-to-house visit with MaaSupervisors As day 3 As day 3 3 hours As day 3
Afternoon village meeting As Day 1 including the following:

  • Certification ceremony: present medals for MaaChampions/MaaSupervisors with drumming.

  • Group picture with all MaaChampions, MaaSawarr and MaaFamboos for the honour board.

  • During village wide ceremony, erect a weaning food hygiene board at the village entrance establishing the village as a ‘weaning-food hygiene’ village with drumming/campaign songs and present village certificate to the Alkalo (certification ceremony).

  • Give motivational advice on sustainability by Alkalo, MaaSupervisors and PHOs.

  • Closing remark (emphasis on sustainability).

 As day 1 4 hours As day 1 including below:

  • Create ownership of the project and self-monitoring to enable sustainability.

  • A community sense of achievement and pride commitment by MaaChampions.

  • Inculcated motivational drivers.

  • Encourage achievement of goals through the board as a reminder.
Day 5 Meeting Alkalo As day 2 As day 2 20 min As day 2
Announce to the villagers As day 1 As day 1 2 hours As day 1
House-to-house visit with MaaSupervisors As day 3 As day 3 3 hours As day 3
Afternoon village meeting As day 4 but not including erection of the village board or certification As day 4 4 hours As day 4

The idea of a 4-day programme was adapted from the India SuperAmma study.13 However, the details of the activities during each day of the Team’s visit to the villages were adapted from Gautam et al’s Nepal study.13 Itself drawing on aspects from the SuperAmma India study (see footnote to table 3 for source of adapted tools).

PHO, public health officer; TBA, traditional birth attendant; TC, traditional communicator; VHW, village health worker.