 Welcome everyone. Today we look at how COVID-19 affected the access to maternal health information in rural and urban communities in Ghana. With the help of our two guests, Sahar Kamis and Delay Takwada, both from the University of Maryland, we will be talking about the role of technology in determining the quality and quantity of information that expected mothers had access during the pandemic. We also dive into the motivations, the challenges of maternal health information access during this time. So let's jump in and let's talk about media and communication. Sahar and Delay, thank you so much for joining the conversation. Thank you so much. We appreciate the opportunity. Thank you so much. I would start, perhaps, Sahar with you by asking you, because your article focuses on access to maternal health information in Ghana. So why did you find this topic worthy of conducting research on? And why Ghana? Well, thanks so much again for having us on this podcast. It's a pleasure to talk about our co-authored article. I'm an associate professor of communication at University of Maryland. Delay is my brilliant and excellent PhD advisor, and she is actually from Ghana. So the selection of the topic was based on her own country of origin. The interest in the topic, however, is mutual between both of us, since I'm also a scholar of media and also gender and women's studies with a special focus on women's issues in the global south. So we feel this is a very important blind spot in the body of literature that deals with health in general. There is a little literature that deals with maternal health, and especially when it comes to maternal health among women from the global south. Therefore, we really felt it's very important to fill this very important gap in the existing body of literature in health communication in gender studies and women's studies by focusing on both an understudied topic, which is basically maternal health communication and an understudied population, in this case women in the global south, specifically in Ghana, which is the country of origin of my co-author as I previously mentioned. We felt this is very important also to pay attention to a topic that has been neglected even in the midst of the COVID-19 pandemic and in the midst of research and scholarship that tackles the COVID-19 pandemic, because a lot of these studies talked about things like, you know, vaccination and resistance to vaccines or social distancing and masking. But we did not really see a lot of attention paid to the idea of how women are being impacted in terms of their own motherhood, their own maternal health, maternal health communication, maternal health experiences. This has been also a blind spot and an understudied topic in the body of literature also that dealt with the COVID-19 pandemic. So for all of these reasons, we felt it's very important to pay attention to this understudied topic and to also give voice to the voiceless. Both of us are feminist scholars, both of us have an interest in gender and women's issues. And it's very important using qualitative methodology in this particular research to give voice to the voiceless. In other words, to listen to the voices and the experiences and perspectives of these women in their own words. And that's another value of this important study. Absolutely. Delight. Let's follow up on this giving voice to the voiceless and jump into the main findings of your article. Can you tell us more about that? Yes, Rodrigo. So one of the things that we set out to study as Dr. Kamis mentioned is the information sources that these women had during COVID. And we found out that when their reliance on their maternal health experts, their midwives, the healthcare providers was threatened by COVID-19 restrictions, they were able to use other sources to fill in the gap in their knowledge. So we found that they relied mostly on sources like their friends, their family members who have had the experience of pregnancy and childbirth, and also used other sources such as the internet. So the internet's use was heavy, particularly among the urban mothers who already had access to the resources to assess the internet. So we also found that although their relationship or their access to their providers was threatened, they still had the opportunity to speak to their providers when they wanted. So some of the women were given personal phone numbers of their midwives that they could call at any time to have a conversation with them in relation to what they were experiencing during pregnancy. And this was highly pronounced for women who lived in rural areas. So they kind of had this relationship with their healthcare providers that they were able to have access. And this was enabled by the mobile devices that they had and they could connect with their healthcare providers. So some of the other sources that they relied on were books and mainstream media. And although some of these women did not find much information in mainstream media, there were snippets of maternal health information here and there, but it wasn't enough. So all in all, the sources that they used were the healthcare providers, the internet, interpersonal networks, and the media. Very, very interesting. You've been there's been a focus here on the conversation. Sahar, I would like to follow up on this to look at the impact of the research in real case scenarios because it seems that it points out the importance and the light has said that as well. The importance of access to technology and investing in health literacy to expectant mothers. Can you elaborate on this Sahar, on the impact on social policies? Yeah, that's a very important point because as a scholar also of health communication I paid special attention to this particular aspect of public awareness campaigns and public health in general. And as the light mentioned with one of our main findings was women needed more information through different channels, one of which was quote unquote mainstream media. However, there was a shortage in terms of supplying this kind of information through, for example, community radio or local television. That's a very important thing to be paid attention to in future research and other scholars want to also study this topic as well as government actually designing the kind of public awareness campaigns and public health literacy campaigns that these women need the most and providing this kind of important and valuable information through mainstream media such as radio and television and also designing it in a way that's most relevant and applicable and meaningful to this particular segment of the population. Because my previous research for example in rural Egypt showed that some of these governmental public awareness campaigns are completely out of touch with the targeted audience or targeted population. We do not really address women's needs or their own wants and demands, and therefore we don't really resonate with this particular segment of the population and are not effective. We are also doing audience research and making sure to tailor these messages and these public awareness campaigns to women using mainstream media is very important in addition to the importance also of positive peer group pressure. In our study we also notice the importance of interpersonal communication. That's a very important area as well that seems to be a blind spot sometimes in this type of research women sometimes rely on other women and on their own interpersonal networks to get information about maternal health. So this importance of interpersonal communication and face to face interaction also needs to be paid attention to and finally the light mentioned mobile devices that's also very important infrastructure and making sure women have access to these types of mobile devices is also very important because some of them relies on these devices to get access to the internet and to be able to do for example a Google search of the most important maternal health information. Perfect. We have touched upon the so what of your research very well explored. Let's look ahead now let's look at the future starting I would like to listen to both of you starting with the light. So for the researchers and planners that are listening to us. What should they focus next so tell us more about what happens from now on. Thank you Rodrigo so we have conducted the initial research into understanding the information access to mothers in rural and urban areas in Ghana. Moving forward, we were thinking that researchers should begin looking at how the information that these mothers assess from the various sources that we have found in our study impacts their behavior. When it comes to their maternal behavior, how does the information that they get influences how they relate or how they take care of themselves during pregnancy, how they take care of their child and how they interact with the healthcare systems during pregnancy. And also, we, we are thinking that researchers should also focus on the credibility of information that this massive mothers have access to on the internet. So one of the main findings of our study is that women who use multiple sources of information for their, during their pregnancy are able or a better positioned to understand their bodies their pregnancies and are very, very up to date when it comes to their healthcare with the healthcare system. And then so we are thinking that researchers should move forward to understand the credibility of information that these women have access to particularly on the internet, because there's a pool of information, tons of information on the internet. And a quick Google search can bring you millions of information, millions of data. So you are, we are thinking that researchers should start focusing on how the information that the women are retrieving are authentic, are credible and are not harming the women who are accessing this information because we, we want these women to have optimal pregnancy experiences other than negative effects out of these information that they access, access from the various sources. Right. Of course. Sahar, let's follow up on this. I would also like to listen to you on this. Let us know a little bit more about the research limitations because I think it's important to touch upon this as well. Before talking about the limitations, let me follow up on something very important that the life was talking about, which is basically the credibility of the information. Now we're living in an age where we have unfortunately sometimes an overflow of misinformation and disinformation. So I think future research also needs to look at this very important point. How can we verify the authenticity and the accuracy of this type of information is actually accurate factual it's not made up it's not you know this information and misinformation I believe that's a very important thing for researchers to look at and explore moving forward. In terms of the limitations of our study of course it's a qualitative research studies we had a small research sample like most qualitative research and that means we have limitations in terms of representativeness and generalizability. We cannot claim that this study is representative or generalizable to all urban and rural women in Ghana, let alone in Africa or in the global south more broadly. I believe that we need more studies and more research like I said at the beginning to fill this important gap in the existing body of literature, maybe explore this very important topic in different contexts in different settings in different countries, especially with paying attention to women in the global south, because we are the understudied minority in this particular type of research, we should give attention to this particular marginalized community, maybe use also a mixed methods approach, which complements or supplements both quantitative and qualitative research methodologies in order to give a more holistic and more comprehensive overview of this very important and timely topic by trying to give for example some kind of overview using some kind of quantitative survey and at the same time augment it and complement it using, for example, focus group discussions and in depth interviews, using a qualitative research methodology in our study we use in depth interviews and also use focus group discussions as one way to explore this particular topic in other research moving forward. And I want to add one last limitation which is basically that sometime has really, you know, has lapsed between the time these women experienced their own pregnancy during the pandemic and the time we actually asked them to recall these particular experiences and that some of them maybe had a difficult time recalling or remembering all the small, you know, nitty gritty my new details of their own pregnancy and their own maternal experience. That is another limitation in the study so maybe in the future. I don't want to say God forbid another pandemic, but whenever there is a health crisis it's best to actually do the study during the crisis itself as it's actually unfolding at the moment, rather than later in order to avoid the problem of women's ability or the participants ability to recall or to remember the accuracy and the details of the information. Absolutely the highlights for future research focused on, as you said, perhaps different methods, the timings of research which you just mentioned and of course, credibility of information which is what touches upon several other areas. So some highlights for future research delight. If our listeners wish to further explore this topic. What materials would you recommend the consult. Right, so we've put together some resources that artists of listeners could have access to and we did this specifically for people living in Ghana because this is specifically tailored to the cultural the social cultural environment that they're in their pool of resources when it comes to maternal health you can get some coming from the West and all that. But we decided to look for the ones that are within the community that participants to listeners might have interest in so we. There's this app called the talkative app, the talkative mom app, and it's the first parenting app by a Ghanaian woman, and she's had her experiences and everything, everything is built around Ghanaian women. And also we have drama baby, which is a Facebook page and a YouTube page that matters share their experiences we are hopeful that when women listen to this they are able to glean from the experiences of other women as well. So this is the mediums of pregnancy and childbirth, and we also have as the gynaecologist. This is a Facebook page that I believe that the administrators are Nigerians, but this is huge it has over a million participants in the group and there's a lot of pregnancy and childbirth information, and we believe that this, this sources are very credible as these administrators and managers of the pages have had fast experiences when it comes to mothering parenting pregnancy, and all that yes. We have also put together some academic resources for our listeners, if you want to read more on this topic there's some scholarly articles that we have put together, and I cannot mention all of them but these would be in the link that will be attached. Precisely to follow up on what the light has just provided us. If you are watching us on the let's talk about meeting communication websites, the recommended materials will be a little bit below from the page so you can have access to all these resources that both Sahar and the light have provided you. Sahar, let's close this episode with a punchline. If you could shorten this conversation we just had in a couple of sentences, what would it be. I would say the divide is real, and I want to talk about three different divides here. The first divide is the divide between the global north and the global south that is a very real and very much impactful divide that we have to be aware of when we talk about issues like health communication and maternal health communication. The third divide is the digital divide as much as we would like to hail the role of the internet and digital communication and digital media and say yes it's awesome that we have the internet. We have to remember that not every part of the world has 24 seven internet access a high speed internet on a 24 seven basis, not every person on this planet also has digital literacy skills so we have to also remember the impact of the digital divide and the third divide is the gender digital divide that all of these issues are multiplied many times over when it comes to women because a lot of women unfortunately are deprived from access to sources of information, including maternal health information because they don't have access to high speed internet and or digital literacy skills. So I want our listeners and viewers to remember the impact of the three very important divides and to also bear in mind that the COVID-19 pandemic had an amplifying and escalating impact when it came to all of these divides to increasing these gaps and increasing these divides even more. Amazing episode. Sahar Delight, it was a pleasure to have you here. Thank you so much. Thank you for having us. For our listeners, if you are watching us on YouTube, you can find all the resources and the materials at this conversation on the let's talk about website. You can also listen to this episode, whatever you get your podcast. Thank you very much.