ABSTRACT:
Digital health technologies can bridge inequities in access to health information where literacy, affordability, and stigma serve as barriers to communication. In Nigeria, misinformation and limited access to trusted sources have hindered prevention and timely care for diseases such as Lassa fever, mpox, and COVID-19. To address these gaps, the Breakthrough ACTION project deployed a digital intervention, Adventures of Wazobia (AoW), that combined gamified learning, interactive storytelling, and multilingual delivery via a toll-free interactive voice response (IVR) system to improve epidemic preparedness and promote preventive behaviors among low-literacy, youth, and women populations. Between 2023 and 2024, AoW was deployed nationwide as a multilingual (English, Hausa, Yoruba, Pidgin, and Igbo) IVR and audio drama. Users accessed a scenario-based game, replayed for mastery, and earned “game hero” status, while the episodic audio drama, adapted from Médecins Sans Frontières’ Road to Care, featured culturally resonant storylines and broader themes. Both promoted practice to improve prevention of Lassa fever and mpox, early fever reporting, vaccination, handwashing, and safe environmental practices. Over 1.16 million calls were recorded from 700,000 unique users, with 7.9 million minutes of engagement. Players initiated 5.1 million games and completed 2.2 million narratives, reinforcing messages through repetition. The drama reached 35,000 listeners with 67,000 minutes of interaction. Among users, participation was highest among youth aged 18–34 years, and Hausa speakers accounted for more than half of all interactions, confirming the value of multilingual, youth-centered design. These results highlight the effectiveness of toll-free gamification and multilingual drama in reinforcing learning and sustaining youth engagement. AoW shows how accessible, multilingual digital platforms can transform health communication by promoting inclusion and placing lifesaving knowledge in people’s hands. Through toll-free access, relatable storytelling, and gamified learning, digital tools can empower the underserved to make informed health decisions, strengthen preparedness, and advance equity in public health.