Building Trust in the Guinean Public Health System: A Story of Intentional Partnership

Written by: Antonia Morzenti, Program Officer, and Meei Child, Communications Officer, Breakthrough ACTION

Trust is a crucial element of public health programs. In 2018, when Breakthrough ACTION began working with the Service National de Promotion de la Santé (SNPS) in Guinea, their top priority was to get people to trust that their public health system had the capacity and integrity to deliver high-quality healthcare. Working together, Breakthrough ACTION and the SNPS embarked on a journey to overcome three barriers that affected the quality of healthcare and Guinean’s trust in those services: (1) insufficient coordination of public health social and behavior change (SBC) interventions; (2) lack of harmonized communication messages; and (3) the need to strengthen SBC capacity.

Coordinating public health SBC interventions

Implementing public health programs requires the participation of multiple stakeholders. Although there may be overlapping objectives and goals among the stakeholders, their collective activities are not always coordinated. Though charged with the crucial mission to oversee health promotion activities, the SNPS was barely known by Guineans, even within the Ministry of Health (MOH).

To build credibility, Breakthrough ACTION worked with the SNPS to develop an overarching vision and strategic plan. “With Breakthrough ACTION’s assistance, we were able to develop documents such as the SNPS National Policy and the SNPS Five-Year Strategic Operational Work Plan, which allowed relevant projects to align themselves with SNPS,” shared Dr. Ibramina Fania Camara, SNPS Department Manager.

Breakthrough ACTION also reinstated the Social and Behavior Change Technical Working Group to bring all SBC and public health actors in Guinea together regularly. “Establishing this group allowed the SNPS to know who was doing what and how we could work together. In this way, we were able to pool our efforts to deliver more impact with fewer resources,” explained Fania.

Harmonizing communication messages

Providing accurate, credible, and consistent messages is essential to instilling trust in the public health system. Prior to Breakthrough ACTION’s partnership with the SNPS, there was no unified framework or tool to develop consistent health messages. This led to duplication of efforts and, sometimes, contradictory health messages. Fania remarked, “it was necessary to coordinate everyone working in health communication. We needed to speak with one voice so that people were not overwhelmed by contradictory messages.”

Breakthrough ACTION and the SNPS organized a five-day workshop for the MOH and local and international NGOs to develop the Harmonized Message Guide. This resource is a compendium of practical information—including SBC messages and channels of interventions—on priority health behaviors around issues like malaria; maternal, newborn, and child health; and family planning.

Today, all levels of the public health system use the guide to create and disseminate essential health messages across the country.

Strengthening SBC capacity

SBC interventions are only as good as the teams that design and implement them. To determine the skills Guinea’s SBC community needed, Breakthrough ACTION polled members of the SBC Technical Working Group on their needs. As a result, Breakthrough ACTION and SNPS delivered three virtual seminars to hone skills in three areas: (1) using key findings to plan SBC programs; (2) understanding the context for problem identification; and (3) building a dynamic and well-coordinated SBC team.

While Breakthrough ACTION continues to serve as an SBC expert among its partners, the SNPS now leads the meetings and coordinates all health activities among partners. Attesting to the progress made through the partnership, Fania said, “We didn’t know what SBC was. We also didn’t know about SBC approaches such as human-centered design, the Community Action Cycle, and community engagement.”

The work continues

Only three short years have passed since Breakthrough ACTION and SNPS started on their shared journey. Today, the SNPS leads all communication and public health activities in Guinea and functions as Guinea’s SBC and communication experts for public health activities. “Breakthrough ACTION helped SNPS get to where we are today,” remarked Fania, who also noted that such achievements were made possible by a partnership characterized by respect, humility, and sensitivity to the ever-changing local context.

By encouraging other partners in the field to look to the SNPS for leadership, Breakthrough ACTION helped unify all relevant health actors under the SNPS banner. Fania is optimistic for the future. “Since the time Breakthrough ACTION and the SNPS started working together, there has been change at all levels.” Fania believes this is just the beginning. “We have an obligation to pass on this information to the larger community so that we can all enjoy the benefits of SBC,” says Fania. With a continued focus on improving the quality health communications and healthcare services through SBC, Guinea’s health system is on a steady path towards earning the public’s trust.