- Sean Wilson, Chief of Party/Guyana Country Representative, Johns Hopkins Center for Communication Programs
- Lyndsey Mitchum, Program Specialist, Johns Hopkins Center for Communication Programs
- Jarret Cassaniti, Senior Program Officer, Johns Hopkins Center for Communication Programs
Theme: Pause and Reflect
The Breakthrough ACTION Guyana was tasked with developing the national malaria social and behavior change (SBC) strategy and campaign. They used an after-action review (AAR) with the Ministry of Health to review previous efforts, and in doing so co-developed an optimized strategy for 2021’s efforts.
Breakthrough ACTION is USAID’s flagship social and behavior change (SBC) project led by Johns Hopkins Center for Communication Programs. Staff focus on using a variety of approaches – from mass media to community outreach to user-driven social media campaigns—to inspire long-lasting change. The Guyana team’s work has focused on improving malaria outcomes among mining communities through developing SBC approaches to address key behaviours related to malaria testing and treatment.
In 2021, Breakthrough ACTION Guyana was tasked with developing the national malaria SBC strategy and campaign to support the distribution of long-lasting insecticide treated nets (LLIN). The team quickly identified two immediate barriers to project implementation:
- They were unfamiliar with the wider distribution plans for the LLINs, run by the Ministry of Health
- As part of their work with the Ministry of Health on previous projects, they were aware of the complexities in the supply-side elements of the LLIN project, which communication was not fully equipped to tackle.
The value of an after-action review
Given these challenges, Breakthrough ACTION Guyana identified the need for a clear, honest and open dialogue with the Ministry of Health in order to overcome these barriers.
An after-action review (AAR) was used to focus on learnings from previous efforts as a way to inform the approach moving forward. The Breakthrough ACTION team invited the MOH staff to participate in a review of the LLIN distribution efforts that was conducted in 2018.
This invitation was welcomed, as the Ministry of Health was already familiar with the process, having participated in previous AARs focused on other parts of the Breakthrough ACTION work. This led to a strong, trusting relationship between the two organizations and had effectively sensitized the MOH to the benefits of the after-action review process.
Prior to organizing the activity, the Breakthrough ACTION team conducted an internal meeting to draw on the experiences of each team member and then decide on the strategy that would be utilized, including agreeing on who would facilitate the discussion. Team members also knew beforehand, that any member of the team could “jump in” to support the lead facilitator and ask probing questions to enhance the discussion.
The Breakthrough ACTION team created an informal atmosphere for the AAR using a combination of approaches:
- The AAR questions were shared before the AAR was conducted. This helped to reduce the “element of surprise” and provide the MOH team with the opportunity to clearly think through their responses prior to the discussion.
- Verbal/written assurance was provided that the key purpose was to learn from the activity and ensure that similar activities could benefit from the views expressed.
- Though virtual, the atmosphere was deliberately “friendly.” This was accomplished as a result of mutual respect and our joint work.
What was the outcome?
The discussion helped both the MOH and Breakthrough ACTION Guyana identify strengths and challenges from the 2018 LLIN distribution. It was also an opportunity to document these learnings and co-develop a roadmap to improve the new strategy.
One clear optimization was planning for greater and earlier engagement with private sector stakeholders, who they realized were key to allowing nets to be distributed to hard-to-reach areas and audiences.
Taking time to reflect on past experiences helped uncover considerations for the next LLIN distribution, such as developing SBC materials and campaign messages within the context of the existing campaign, Lil Mosquito, Big Problem. Both organizations were also able to work on a joint strategy well in advance of the distribution itself. This allowed the team to be more intentional and organized to distribute the nets to different populations in Guyana’s hinterlands. For example, implementing a pre-registration process was discussed and planned for the next LLIN distribution.
Lessons for others
- Start small and build: The initial few AARs focused on small activities conducted with government partners. Reviewing a relatively inconsequential activity allowed the partners to safely and easily participate in the AAR process and gain a firsthand understanding of the purpose, process, and ultimate value. Subsequent AARs focused on bigger activities with more partners, culminating in an AAR that covered the entire 2018 mosquito net distribution campaign. AARs don’t always pay dividends immediately.
- Informality: while the AARs have a structure and process, they don’t have to be entirely formal. Guyana’s AAR experiences show that the partners get the most out of the activity when the facilitation is conducted with flexibility and fluidity. AARs that are fun and enjoyable are more productive.
- Virtual tools enhance AARs: Conducting AARs over web conferencing software allows more people to join. Transparency and comfort improve when notes are taken collaboratively in real-time and made visible through a screen share.
To find out more:
Contact Sean Wilson at [email protected]