Accelerating Health Outcomes through Health Care Call Centres- The SFH Initiative

By Jennifer Anyanti

A call centre is a means of obtaining enquiries and providing information from a large number of persons. They are critical in the provision of health information and guidance on health services and have become essential provision of information and services post Covid. It is estimated that 62% of health organisations have developed some form of call centre strategy.   

 SFH and Call centres- Start Up activities 

The Society for Family Health (SFH) commenced activities with scaling up call centres and Client Response Mechanisms (CRM) in 2009 The first approach was the development of a call centre in Gombe state in collaboration with the Gombe State Government. The commissioning of the call center was conducted on 11th November 2010.

Commissioning of the Call Centre

The Call Centre was funded by the Bill and Melinda Gates Foundation and situated within the Gombe state Specialist Hospital in the state capital. The centre was established to provide 24 hours a day and 7-days a week confidential platform providing phone advice and counselling related to maternal and neonatal health (MNH) to callers (i.e., pregnant women and mothers), and support to front line health workers (FLWs) e.g., Traditional Birth Attendants (TBAs) and Federation of Muslim Women Associations in Nigeria (FOMWAN).

The centre was staffed with 6 persons who were trained nurses and midwives. In addition to their primary training (nursing/midwifery), the call centre staff were trained on customer relations, counselling and communication strategies. To provide round-the-clock services, the call centre staffs operate in shifts: morning, afternoon, and nig

Traditional Birth Attendants calling call centre
A TBA calling the call centre

ht.  Specifically, the centre was established to: 1) be a link between pregnant women and mothers and front line health workers, Emergency Transport Scheme (ETS) drivers, and health facilities: pregnant women and mothers can call the centre for advice on the nearest health facility, or ETS drivers. FLWs could also call

the centre for additional health advice related to community members; 2) to advise and counsel pregnant women and mothers with concerns related to their pregnancies or newborns; 3) To increase utilisation of health services by encouraging pregnant women and mothers to make use of health facilities around them. The call centre staff logged in all calls received, why and from where the calls originated.  

 As part of the Gombe MNH project’s monitoring and evaluation (M&E) system, the project distributed data collection forms through project officers. Approximately 11% of the population used the call center for health information, and in total the call center reached over 241,000 callers. The highest number of calls recorded were from pregnant women and mothers of newborns. Approximately 81,000 pregnant women and 27,361 newborns were referred for health facility services and treatment, respectively. Contextual barriers to implementation were limited GSM coverage in rural areas and poor-quality network connectivity. The call centre was eventually handed over to the Gombe state Government in 2016 

 Scaling Up  

The National Agency for the Control of Aids (NACA) requested the British Department for International Development’s (DFID) support to provide interim start up support for the HIV&AIDS National Call Centre in 2012. DFID subsequently requested SFH to agree modalities for providing this support, commencing with engagement of staff, training, and payment of stipends for staff working in the call centre. Eventually this was scaled up under a USAID project called the SHiPS for MARPS project, providing CRM services to key populations (KPs) from a centre in Lagos state supporting several states.  To complement service delivery, following a competitive open-bidding process, the SHIPS for MARPs project outsourced the establishment of an HIV Call Centre. The HIV Advocacy Call Centre, located in Lagos State, completed start-up activities in the first quarter of 2017.

The Call Centre supported service delivery across all six project states and the FCT by providing HIV information and counselling, directing clients to all available service delivery points, and supporting treatment adherence and peer retention. It also generated data to monitor trends in service utilisation and provide client feedback to improve service quality. The Call Centre was beneficial for client follow up, thus decreasing the number of defaulters. Services provided included reminders for drug refills and clinic appointments, referrals for HIV and other sexual and reproductive services and adherence messages. Following a rigorous awareness campaign which included telephone calls, text messages, social media posts and End of Call Notifications (EoCN), the Call Centre recorded a significant increase in inbound calls. State teams also obtained consent to add client telephone numbers to the Call Centre database, which helped in awareness creation.    

The Call Centre was useful in discretely drawing out more Key Populations (KPs) to access the full HIV care cascade (90-90-90) and receive additional counselling and information. The project’s high level of performance on UNAIDS 90-90-90 targets is attributed to innovative strategies for improving linkage, retention, and treatment adherence. These include the deployment of Case Management Officers for sustained client follow up; use of the HIV Call Centre for service referrals, peer retention and client feedback and targeted testing based on project data. In the third year of implementation, in addition to providing prevention services, HTS and STI Syndromic Management services were included in the scope of the project. In the fourth year, Antiretroviral Therapy and ancillary services were introduced to address the care and treatment needs of HIV positive KPs.  

In 2019, SFH commenced activities on a call centre for its programmes, commencing with the Social Business Enterprise and the Health Family Network facilities, aimed at telemarketing, monitoring pharmacovigilance, as well as to serve as a contact point for network providers to obtain information including training and Provider BCC. This was very useful during the  Covid Pandemic Lockdown. Currently, the SFH Call Centre operates with 3 staff and a supervisor and has 675 calls weekly. The centre is scaling this up, and now includes a CRM mechanism to serve SFH’s Humanitarian and OVC Projects in Northern Nigeria and a standalone CRM in Kano for the ICHSSA 3 Project. SFH is also building capacity of the NACA call centre staff on HIV Self-Testing (ST) response in view of the scale up of the HIV ST in Nigeria. 

For additional information, contact SFH at info@sfhnigeria.org 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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