Findings and Implications From an Evaluation of the Gold Star Campaign in Post-Ebola Guinea: The Role of Gender and Education

In post-Ebola Guinea, the Health Communication Capacity Collaborative (HC3) project worked to rebuild trust in the health system and increase the utilization of reproductive, maternal, neonatal, and child health services. Core to HC3 Guinea was the promotion of quality local health centers through the Gold Star campaign (2016–2017). The current study aimed to determine the relationship between campaign exposure and attitudes/intentions regarding local health centers, to inform communication efforts in future epidemics. Between June–July 2017, HC3 Guinea conducted a telephone survey with men (n=1,000) and women (n=2,000) aged 18–49 years. Multivariate regression analyses estimated the association between campaign exposure and attitudinal/intention outcomes for the overall sample as well as for gender- and education-stratified samples. Survey results indicated that more than 30% of the sample recalled either the campaign (32.5%) or logo (37.6%). Statistically significant associations existed between exposure and various attitudinal outcomes. For example, regardless of gender/level of education, campaign recall was strongly associated with agreeing that the local health center improved in the last 6 months. Given that the campaign itself was short in duration, it is encouraging that attitudes changed with campaign exposure. Although a greater percentage of women than men held positive attitudes about health facilities, men seemed more influenced by campaign exposure. The current study provides evidence that mass media campaigns can help rebuild trust in health care facilities after an epidemic. Study findings also stress the value of conducting stratified analyses by important demographic characteristics (e.g., gender, education). Stratified analyses can help identify meaningful differences and better tailor health promotion activities and achieve greater success. The recent recurrence of Ebola in Guinea has resulted in renewed discussions about ways to incorporate these evaluation findings into current programming, including exploring ways to address gender considerations in message design and overall program strategy.