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Mc Cartney AM, Scholz AH, Groussin M, Staunton C. Benefit-Sharing by Design: A Call to Action for Human Genomics Research. Annu Rev Genomics Hum Genet 2024; 25:369-395. [PMID: 38608642 DOI: 10.1146/annurev-genom-021623-104241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
The ethical standards for the responsible conduct of human research have come a long way; however, concerns surrounding equity remain in human genetics and genomics research. Addressing these concerns will help society realize the full potential of human genomics research. One outstanding concern is the fair and equitable sharing of benefits from research on human participants. Several international bodies have recognized that benefit-sharing can be an effective tool for ethical research conduct, but international laws, including the Convention on Biological Diversity and its Nagoya Protocol on Access and Benefit-Sharing, explicitly exclude human genetic and genomic resources. These agreements face significant challenges that must be considered and anticipated if similar principles are applied in human genomics research. We propose that benefit-sharing from human genomics research can be a bottom-up effort and embedded into the existing research process. We propose the development of a "benefit-sharing by design" framework to address concerns of fairness and equity in the use of human genomic resources and samples and to learn from the aspirations and decade of implementation of the Nagoya Protocol.
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Affiliation(s)
- Ann M Mc Cartney
- Genomics Institute, University of California, Santa Cruz, California, USA;
| | - Amber Hartman Scholz
- Department of Science Policy and Internationalisation, Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany;
| | - Mathieu Groussin
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany;
| | - Ciara Staunton
- School of Law, University of KwaZulu-Natal, Durban, South Africa
- Institute for Biomedicine, Eurac Research, Bolzano, Italy;
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Issahaku GR, Fischer HT, Appiah-Brempong E, Opoku D, Hanefeld J. Strategies to foster community engagement for epidemic and pandemic preparedness and response in sub-Saharan Africa: a scoping review protocol. BMJ Open 2024; 14:e082757. [PMID: 38839384 PMCID: PMC11163618 DOI: 10.1136/bmjopen-2023-082757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION The surge of public health emergencies over the past decade has disproportionately affected sub-Saharan Africa. These include outbreaks of infectious diseases such as Ebola, Monkeypox and COVID-19. Experience has shown that community participation is key to the successful implementation of infection control activities. Despite the pivotal role community engagement plays in epidemic and pandemic preparedness and response activities, strategies to engage communities have been underexplored to date, particularly in sub-Sahara Africa. Furthermore, reviews conducted have not included evidence from the latest pandemic, COVID-19. This scoping review aims to address these gaps by documenting through available literature, the strategies for community engagement for epidemic and pandemic preparedness and response in sub-Sahara Africa. METHODS AND ANALYSIS We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the methodological framework for scoping reviews from Arksey and O'Malley to guide the review. Two reviewers will develop a systematic search strategy to identify articles published from January 2014 to date. We will retrieve peer-reviewed research published in the English language from databases including Embase, EBSCO-host, PubMed, Global Health, CINAHL, Google Scholar and Web of Science. Additionally, we will search for relevant grey literature from the websites of specific international organisations, public health institutes and Government Ministries of Health in African countries. After the removal of duplicates, the two reviewers will independently screen all titles, abstracts and full articles to establish the relevance of each study for inclusion in the review. We will extract data from the included articles using a data extraction tool and present the findings in tabular form with an accompanying narrative to aid comprehension. ETHICS AND DISSEMINATION Ethical approval is not required for the conduct of scoping reviews. We plan to disseminate the findings from this review through publications in a peer-reviewed journal, presentations at conferences and meetings with policy-makers.
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Affiliation(s)
- Gyesi Razak Issahaku
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Tamale Teaching Hospital, Tamale, Ghana
| | - Hanna-Tina Fischer
- Institute for Virology, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Emmanuel Appiah-Brempong
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Opoku
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Health Care Management, Technische Universitat Berlin, Berlin, Germany
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Benson J, Lakeberg M, Brand T. Exploring the perspectives and practices of humanitarian actors towards the Participation Revolution in humanitarian digital health responses: a qualitative study. Global Health 2024; 20:36. [PMID: 38671505 PMCID: PMC11055264 DOI: 10.1186/s12992-024-01042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND As crises escalate worldwide, there is an increasing demand for innovative solutions to enhance humanitarian outcomes. Within this landscape, digital health tools have emerged as promising solutions to tackle certain health challenges. The integration of digital health tools within the international humanitarian system provides an opportunity to reflect upon the system's paternalistic tendencies, driven largely by Global North organisations, that perpetuate existing inequities in the Global South, where the majority of crises occur. The Participation Revolution, a fundamental pillar of the Localisation Agenda, seeks to address these inequities by advocating for greater participation from crisis-affected people in response efforts. Despite being widely accepted as a best practice; a gap remains between the rhetoric and practice of participation in humanitarian response efforts. This study explores the extent and nature of participatory action within contemporary humanitarian digital health projects, highlighting participatory barriers and tensions and offering potential solutions to bridge the participation gap to enhance transformative change in humanitarian response efforts. METHODS Sixteen qualitative interviews were conducted with humanitarian health practitioners and experts to retrospectively explored participatory practices within their digital health projects. The interviews were structured and analysed according to the Localisation Performance Measurement Framework's participation indicators and thematically, following the Framework Method. The study was guided by the COREQ checklist for quality reporting. RESULTS Varied participatory formats, including focus groups and interviews, demonstrated modest progress towards participation indicators. However, the extent of influence and power held by crisis-affected people during participation remained limited in terms of breadth and depth. Participatory barriers emerged under four key themes: project processes, health evidence, technology infrastructure and the crisis context. Lessons for leveraging participatory digital health humanitarian interventions were conducting thorough pre-project assessments and maintaining engagement with crisis-affected populations throughout and after humanitarian action. CONCLUSION The emerging barriers were instrumental in shaping the limited participatory reality and have implications: Failing to engage crisis-affected people risks perpetuating inequalities and causing harm. To advance the Participation Revolution for humanitarian digital health response efforts, the major participatory barriers should be addressed to improve humanitarian efficiency and digital health efficacy and uphold the rights of crisis-affected people.
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Affiliation(s)
- Jennifer Benson
- Health Sciences Bremen, University of Bremen, Bremen, Germany.
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
- Leibniz Science Campus Digital Public Health, Bremen, Germany.
| | - Meret Lakeberg
- Health Sciences Bremen, University of Bremen, Bremen, Germany
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tilman Brand
- Department Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
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Hotopf I, Majorin F, White S. What did we learn about changing behaviour during the COVID-19 pandemic? A systematic review of interventions to change hand hygiene and mask use behaviour. Int J Hyg Environ Health 2024; 257:114309. [PMID: 38325104 DOI: 10.1016/j.ijheh.2023.114309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/09/2023] [Accepted: 12/02/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND behaviour change interventions were central in the COVID-19 response and are vital for strengthening pandemic preparedness and resilience. To be effective, interventions must target specific behavioural determinants, but determinants are complex and multifaceted and there is a gap in robust, theory driven evidence on which behavioural determinants are most effective at changing mask usage and hand hygiene behaviour. PURPOSE to map available evidence on the types of hand hygiene and mask usage behaviour change interventions conducted during the COVID-19 pandemic and assess their effectiveness, feasibility and acceptability. METHODS we conducted a systematic review, searching four peer-reviewed databases for terms related to COVID-19, targeted behaviours (hand hygiene and mask usage) and interventions. Eligible studies were those which focused on adults or children in naturalistic, non-experimental settings; reported on an intervention designed to change hand hygiene and or mask usage to reduce COVID-19 transmission; provided clear outcome measures, including through self-report, proxy indicators or observation. Studies were excluded if they were purely qualitative, opinion pieces or based on secondary data alone; focused on health workers; measured intended rather than enacted behaviour; were conducted in laboratory or health care-based settings; involved infants; were published before the 11th of March 2020 (when COVID-19 was declared a pandemic) and published in a language other than English. There were no geographical limits set. Descriptive summaries were produced and the quality of evidence and reporting was evaluated. Studies were divided into three sub-groups according to the behaviour targeted and behaviour change techniques (BCTs) were mapped. Effect estimates were summarised and the relationship between BCTs and effect was explored. Feasibility and acceptability was summarised where reported. Due to the heterogeneity of studies included, meta-analysis could not be conducted. FINDINGS sixteen citations met the criteria, with sub-studies (two citations including multiple studies) totalling nineteen eligible studies. The majority were randomised controlled trials which targeted hand hygiene only and were conducted in high income nations, with none conducted in crisis settings. Due to the constraints of the pandemic, many interventions were delivered online. The quality of studies was low, with the majority demonstrating a medium risk of bias (Likert scale: low, medium, high). Whilst acceptability and feasibility was good, both were rarely evaluated. 'Natural consequences' was the most commonly used BCT group. Fourteen of the studies elicited positive or potentially positive effects in at least one intervention arm and/or targeted behaviour. Effective interventions typically targeted multiple individual BCTs, including 'Instruction on how to perform a behaviour', 'Information about health consequences', and group 'Reward and threat', through repeated engagement over a sustained period of time. CONCLUSION there is a substantial knowledge gap, particularly in low resource and crisis settings, and available evidence is of low quality. We must address these gaps to enable evidence-based practice and strengthen pandemic preparedness and resilience. Future research should include another systematic review which includes grey literature and different languages, as well as more robust evaluations which use implementation research to explore the impact of multiple BCTs in low resource and crisis settings. Evaluations should include assessments of acceptability, practicability, affordability and equity.
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Affiliation(s)
- India Hotopf
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Fiona Majorin
- London School of Hygiene and Tropical Medicine, London, UK
| | - Sian White
- UK Humanitarian Innovation Hub, London, UK
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Gabay G. Is it the "public" health system? The VOICE model for inclusiveness in universal (national) health systems - lessons from COVID-19. Front Public Health 2023; 11:1243943. [PMID: 38162599 PMCID: PMC10757723 DOI: 10.3389/fpubh.2023.1243943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
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Boland ST, Balabanova D, Mayhew S. Examining the militarised hierarchy of Sierra Leone's Ebola response and implications for decision making during public health emergencies. Global Health 2023; 19:89. [PMID: 37993942 PMCID: PMC10664671 DOI: 10.1186/s12992-023-00995-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND In September, 2014, Médecins Sans Frontières (MSF) called for militarised assistance in response to the rapidly escalating West Africa Ebola Epidemic. Soon after, the United Kingdom deployed its military to Sierra Leone, which (among other contributions) helped to support the establishment of novel and military-led Ebola Virus Disease (Ebola) response centres throughout the country. To examine these civil-military structures and their effects, 110 semi-structured interviews with civilian and military Ebola Response Workers (ERWs) were conducted and analysed using neo-Durkheimian theory. RESULTS The hierarchical Ebola response centres were found to be spaces of 'conflict attenuation' for their use of 'rule-bound niches', 'neutral zones', 'co-dependence', and 'hybridity', thereby not only easing civil-military relationships (CMRel), but also increasing the efficiency of their application to Ebola response interventions. Furthermore, the hierarchical response centres were also found to be inclusive spaces that further increased efficiency through the decentralisation and localisation of these interventions and daily decision making, albeit for mostly privileged groups and in limited ways. CONCLUSIONS This demonstrates how hierarchy and localisation can (and perhaps should) go hand-in-hand during future public health emergency responses as a strategy for more robustly including typically marginalised local actors, while also improving necessary efficiency-in other words, an 'inclusive hierarchical coordination' that is both operationally viable and an ethical imperative.
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Affiliation(s)
- Samuel T Boland
- Centre for Universal Health, Chatham House, 10 St James's Square, London, SW1Y 4LE, UK.
| | - Dina Balabanova
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Square, London, WC1H 9SH, UK
| | - Susannah Mayhew
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Square, London, WC1H 9SH, UK
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Silberberg B, Young C, Bag S, Moreira C, Norton S, Wells J, Shaban RZ. Socioeconomic disadvantage and engagement with digital contact tracing for COVID-19 in Western Sydney: A secondary analysis of surveillance data. Aust N Z J Public Health 2023; 47:100087. [PMID: 37738808 DOI: 10.1016/j.anzjph.2023.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/30/2023] [Accepted: 08/21/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE COVID-19 outcomes were highly inequitably distributed in Australia and worldwide. The digitalisation of public health interventions offers resource-efficiency and increased capacity for pandemic responses, but risks excluding the elderly and disadvantaged, reinforcing existing inequalities. Despite this, there has been little evaluation of the determinants of uptake of digital contact tracing. This paper describes the use of digital contact tracing for COVID-19 in a population in metropolitan Sydney and the determinants of engagement in this population. METHODS Routinely collected surveillance data for residents of Western Sydney Local Health District, returning a positive SARS-CoV-2 result between 1st August 2021 and 12th February 2022, were extracted including responses to a digital contact tracing questionnaire. Individual records were linked to area-level socioeconomic indices of disadvantage. Descriptive analyses explored characteristics of non-responders and geospatial variation. Logistic regression was undertaken to evaluate the effect of age, sex and socioeconomic disadvantage on the odds of response. RESULTS Of the 133 055 individuals included, 130 645 (98%) were issued a digital contact tracing questionnaire, and 106 432 (81%) responded. Odds of responding were lower in males (odds ratio: 0.79), individuals aged 80+ (odds ratio: 0.17) and the most disadvantaged communities (odds ratio: 0.32). CONCLUSIONS Digital data collection for contact tracing was a scalable and efficient tool in the context of the Western Sydney Local Health District COVID-19 response. However, older people and individuals in disadvantaged communities were less likely to engage. IMPLICATIONS FOR PUBLIC HEALTH Responses to future pandemics should leverage the resource-efficiency of digital interventions but should avoid compounding existing health inequalities.
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Affiliation(s)
- Benjamin Silberberg
- Centre for Population Health, Western Sydney Local Health District, Australia.
| | - Christian Young
- NSW Biostatistics Training Program, NSW Ministry of Health, Australia
| | - Shopna Bag
- Centre for Population Health, Western Sydney Local Health District, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia
| | - Conrad Moreira
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Sophie Norton
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Jessica Wells
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Ramon Z Shaban
- Centre for Population Health, Western Sydney Local Health District, Australia; Sydney Institute for Infectious Diseases and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia
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Cheedella K, Conteh P, Zou G, Walley J, Kamara A, Wurie H, Witter S. Developing a social mobilisation intervention for salt reduction: participatory action research in Bombali district, Sierra Leone. BMC Public Health 2023; 23:1774. [PMID: 37700274 PMCID: PMC10496325 DOI: 10.1186/s12889-023-16693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 09/01/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND High salt intake is a major risk factor for hypertension, which in turn contributes to cardiovascular diseases, the major cause of death from non communicable diseases (NCDs). Research is limited on social mobilisation interventions to tackle NCDs, including in fragile health settings such as Sierra Leone. METHODS Participatory action research methods were used to develop a social mobilisation intervention for salt reduction in Bombali District, Sierra Leone. A team of 20 local stakeholders were recruited to develop and deliver the intervention. Stakeholder workshop reports and interviews were used to record outcomes, enablers, and barriers to the intervention. Focus group discussions were used to observe knowledge, attitudes, and behaviours of community members pre- and post- the intervention. RESULTS Stakeholders showed enthusiasm and were well engaged in the social mobilisation process around salt reduction. They developed radio jingles, radio show talks, organised community awareness raising meetings, school sensitisation outreaches, and door to door engagements. Stakeholders reported benefiting personally through developing their own skills and confidence in communication and felt positive about their role in educating their community. The interventions led to reported increased awareness of risks of high salt intake and NCDs, resulting in a reduction of salt use in the community, leading to perceived health gains. However, salt reduction was also met with some resistance due to social factors. Local community structures were also reactivated to work on the interventions and connect the community to the local health facility, which saw an increase in patients having their blood pressure checked. The comparison villages also experienced an increase in awareness and perceived reductions in salt intake behaviours. This was as messages had cascaded via the radio and initial focus group discussions. The social mobilisation stakeholders also agreed on future activities that could continue at no or low cost. CONCLUSION Social mobilisation interventions can provide low-cost strategies to tackle NCDs in fragile settings such as Sierra Leone through the utilisation of community structures. However, more research is required to ascertain the key enablers for replicability and if such successes can be sustained over a longer follow up period.
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Affiliation(s)
- Kiran Cheedella
- NIHR Research Unit On Health in Situations of Fragility, Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Peter Conteh
- NIHR Research Unit On Health in Situations of Fragility and College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Guanyang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - John Walley
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ajaratu Kamara
- NIHR Research Unit On Health in Situations of Fragility and College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Haja Wurie
- NIHR Research Unit On Health in Situations of Fragility and College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Sophie Witter
- NIHR Research Unit On Health in Situations of Fragility, Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
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Li L, Zhang S, Wang J, Yang X, Wang L. Governing public health emergencies during the coronavirus disease outbreak: Lessons from four Chinese cities in the first wave. URBAN STUDIES (EDINBURGH, SCOTLAND) 2023; 60:1750-1770. [PMID: 37416836 PMCID: PMC10311377 DOI: 10.1177/00420980211049350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
The ongoing coronavirus disease (COVID-19) pandemic has had a far-reaching impact on urban living, prompting emergency preparedness and response from public health governance at multiple levels. The Chinese government has adopted a series of policy measures to control infectious disease, for which cities are the key spatial units. This research traces and reports analyses of those policy measures and their evolution in four Chinese cities: Zhengzhou, Hangzhou, Shanghai and Chengdu. The theoretical framework stems from conceptualisations of urban governance and its role in public health emergencies, wherein crisis management and emergency response are highlighted. In all four cities, the trend curves of cumulative diagnosed cases, critical policies launched in key time nodes and local governance approaches in the first wave were identified and compared. The findings suggest that capable local leadership is indispensable for controlling the coronavirus epidemic, yet local governments' approaches are varied, contributing to dissimilar local epidemic control policy pathways and positive outcomes in the fight against COVID-19. The effectiveness of disease control is determined by how local governments' measures have adapted to geospatial and socioeconomic heterogeneity. The coordinated actions from central to local governments also reveal an efficient, top-down command transmission and execution system for coping with the pandemic. This article argues that effective control of pandemics requires both a holistic package of governance strategies and locally adaptive governance measures/processes, and concludes with proposals for both a more effective response at the local level and identification of barriers to achieving these responses within diverse subnational institutional contexts.
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Affiliation(s)
| | | | - Jinfeng Wang
- Institute of Geographic Sciences and Natural Resources Research, P.R. China
| | - Xiaoming Yang
- Shanghai Jing'an District Center for Disease Control and Prevention, P.R. China; Chinese Academy of Sciences
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Olaoye A, Onyenankeya K. A systematic review of health communication strategies in Sub-Saharan Africa-2015-2022. Health Promot Perspect 2023; 13:10-20. [PMID: 37309431 PMCID: PMC10257569 DOI: 10.34172/hpp.2023.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/08/2023] [Indexed: 06/14/2023] Open
Abstract
Background: Health communication strategies have become critical in managing public health issues across sub-Saharan Africa. In the literature, health communication strategies have been well documented. The studies are often narrow, focusing on individual countries or specific health issues. No research documented and consolidated the health communication strategies across sub-Saharan Africa. This review attempts to catalogue prevalent health communication strategies, how the various countries have implemented these strategies and the barriers to effective health communication practices in Africa. Methods: We systematically reviewed existing literature on health communication strategies in sub-Saharan Africa to answer formulated questions. A Google search was performed in October 2022 with the keywords 'health communication', 'strategies', 'promotion,' 'education,' and 'engagement,' The data reported in this article included evidence published between 2013 and 2023. Selected documents were content analyzed, and significant sections were mapped against specific strategies/themes. These subsets of data were used to present the results and analysis. Results:The review indicates that different health communication strategies have been deployed across Africa. In some countries, specific strategies are used to tackle specific health issues, while a combination of strategies is used in others. In some countries, the strategies are unclear, and implementation is improvised, sometimes misapplied, or truncated by bureaucratic red tape and incompetence. The prevalent strategies are mainly those prescribed from outside with little input from the beneficiaries. Conclusion: The review suggests that using a holistic or multi-pronged health communication approach that is context-specific and participatory could attract more uptakes of health messages.
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Affiliation(s)
- Adewale Olaoye
- University of Fort Hare, Alice, Eastern Cape, South Africa
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Wallace ACD, Ross RD, Tawse K, Nyain R, Gargu C, Wentworth DE, Bishop RJ, Eghrari AO. Demographic Factors Associated with Presenting for Eye Evaluation in the Partnership for Research on Vaccines and Infectious Diseases in Liberia III Natural History Study of Ebola Virus Disease. Middle East Afr J Ophthalmol 2023; 30:103-106. [PMID: 39006926 PMCID: PMC11238926 DOI: 10.4103/meajo.meajo_53_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 07/16/2024] Open
Abstract
PURPOSE Survivors of Ebola virus disease (EVD) are at risk for ocular complications after infection. We sought to identify demographic factors associated with the likelihood to present for eye examination among Ebola survivors enrolled in a longitudinal natural history study of EVD. METHODS The Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL) III Ebola natural history study is a 5-year study that seeks to identify long-term sequelae of EVD, including ocular sequelae. All survivors enrolled in the PREVAIL parent study from June 2015 to March 2016 were asked to return for comprehensive eye examination through June 2016. Logistic regression was conducted using self-reported survivor status, age, gender, and distance from the hospital as covariates. RESULTS A total of 1448 subjects enrolled in the parent PREVAIL III longitudinal cohort during the defined window, of which 1375 (95.0%) followed up for baseline eye examination. Ebola survivors (635/661, 96.1%) and adult close contacts (727/767, 94.8%) demonstrated a comparable likelihood for presenting for eye examination (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.36-1.28). In an adjusted model, age over 50 (OR 10.2, 95% CI 1.35-77.3) and living outside Montserrado County (OR 0.18, 95% CI 0.10-0.33) were associated with the likelihood of presenting for a baseline comprehensive eye examination. CONCLUSION Most EVD survivors and their close contacts who enrolled during the study window presented for eye examinations. Older participants and those who lived closer to clinical facilities were most likely to present. Focused strategies accounting for these factors may assist with organizations planning survivor care in the setting of EVD.
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Affiliation(s)
- Augustine C D Wallace
- Partnership for Research on Vaccines and Infectious Diseases in Liberia Eye Clinic, JFK Hospital, Monrovia, Liberia
| | - Robin D Ross
- University of Arizona College of Medicine, Phoenix, Arizona, USA
| | - Kirstin Tawse
- Colorado Permanente Medical Group, Denver, Colorado, USA
| | - Ruth Nyain
- Partnership for Research on Vaccines and Infectious Diseases in Liberia Eye Clinic, JFK Hospital, Monrovia, Liberia
| | - Catherine Gargu
- Partnership for Research on Vaccines and Infectious Diseases in Liberia Eye Clinic, JFK Hospital, Monrovia, Liberia
| | - Deborah E Wentworth
- Department of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Rachel J Bishop
- Wilmer Eye Institute, Johns Hopkins, Baltimore, Maryland, USA
| | - Allen O Eghrari
- Wilmer Eye Institute, Johns Hopkins, Baltimore, Maryland, USA
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Sory O, Kiendrébéogo JA, Kafando Y, Kaboré I, Tapsoba C, Kaboré S, Mbaye S, Touré C. The role and contribution of civil society and community actors in COVID-19 prevention and control: the case of the COMVID COVID-19 movement in Burkina Faso. BMJ Glob Health 2023; 8:bmjgh-2022-011508. [PMID: 37028812 PMCID: PMC10083517 DOI: 10.1136/bmjgh-2022-011508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/07/2023] [Indexed: 04/09/2023] Open
Abstract
Communities should play a crucial role in the fight against public health emergencies but ensuring their effective and sustained engagement remains a challenge in many countries. In this article, we describe the process of mobilising community actors to contribute to the fight against COVID-19 in Burkina Faso. During the early days of the pandemic, the national COVID-19 response plan called for the involvement of community actors, but no strategy had been defined for this purpose. The initiative to involve community actors in the fight against COVID-19 was taken, independently of the government, by 23 civil society organisations gathered through a platform called 'Health Democracy and Citizen Involvement (DES-ICI)'. In April 2020, this platform launched the movement 'Communities are committed to Eradicate COVID-19 (COMVID COVID-19)' which mobilised community-based associations organised into 54 citizen health watch units (CCVS) in Ouagadougou city. These CCVS worked as volunteers, performing door-to-door awareness campaigns. The psychosis created by the pandemic, the proximity of civil society organisations to the communities and the involvement of religious, customary and civil authorities facilitated the expansion of the movement. Given the innovative and promising nature of these initiatives, the movement gained recognition that earned them a seat on the national COVID-19 response plan. This gave them credibility in the eyes of the national and international donors, thus facilitating the mobilisation of resources for the continuity of their activities. However, the decrease in financial resources to offset the community mobilisers gradually reduced the enthusiasm for the movement. In a nutshell, the COMVID COVID-19 movement fostered dialogues and collaboration among civil society, community actors and the Ministry of Health, which plans to engage the CCVS beyond the COVID-19 response, for the implementation of other actions within the national community health policy.
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Affiliation(s)
- Orokia Sory
- Recherche pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
| | - Joël Arthur Kiendrébéogo
- Department of Public Health, Universite Joseph Ki-Zerbo Unite de Formation et de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Yamba Kafando
- Recherche pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
| | - Issa Kaboré
- Recherche pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
| | - Charlemagne Tapsoba
- Recherche pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
- Centre de Recherche en Santé de Nouna (CRSN), Ouagadougou, Burkina Faso
| | - Simon Kaboré
- Réseau Accès aux Médicaments Essentiels (RAME), Ouagadougou, Burkina Faso
| | - Seyni Mbaye
- Results for Development Institute, Dakar, Senegal
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Jackson SF, Morgan GT, Gloger A, Luca S, Cerda E, Poland B. Relationships are everything: The underpinnings of grassroots community action in the COVID-19 pandemic in Toronto. CITIES (LONDON, ENGLAND) 2023; 134:104163. [PMID: 36593904 PMCID: PMC9797416 DOI: 10.1016/j.cities.2022.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Most government emergency/pandemic response plans feature top-down decision making and communication strategies and a focus on 'hard' (physical) infrastructure. There is nothing about the importance of the ideas and communications originating from communities, the social infrastructure that supports their impact locally and their contribution to the central administration. In this study, we found that the 'soft' (social) infrastructure within communities and between communities and formal institutions is key to an inclusive and more equitable response to large-scale crises like the COVID-19 pandemic. Grassroots leaders in six Toronto neighbourhoods were interviewed between the first and second waves of the COVID-19 pandemic in Toronto about what helped or hindered community action. Three themes emerged: (1) Grassroots leaders and community organizations were able to act as key connection points in a two-way flow of information and resources with residents and service providers; (2) Grassroots leaders and groups were challenged to engage in this work in a sustained capacity without adequate resourcing; and (3) there was a disconnect between community-centred grassroots approaches and the City's emergency response. We conclude that there needs to be pre-disaster investment in community level planning and preparation that fosters two-way connections between all municipal emergency/disaster and pandemic preparedness plans and community-centred organizations and grassroots leaders working in marginalized communities.
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Affiliation(s)
- Suzanne F Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St. 5th Floor, Toronto, Ontario M5T 3M7, Canada
| | - Garrett T Morgan
- Department of Geography and Planning, University of Toronto, 100 St. George Street, Room 5047, Toronto, Ontario M5S 3G3, Canada
| | - Anne Gloger
- Centre for Connected Communities (C3), 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Sarah Luca
- Centre for Connected Communities, 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Ewa Cerda
- Centre for Connected Communities, 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St. 5th Floor, Toronto, Ontario M5T 3M7, Canada
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Seth A, Finlay B, Currie G, Roth C, Lach L, Hudon A, Lencucha R, Hunt M, Nicholas D, Shikako-Thomas K, Zwicker J. Impacts of the COVID-19 Pandemic: Pan-Canadian Perspectives From Parents and Caregivers of Youth With Neurodevelopmental Disabilities. J Pediatr Health Care 2023; 37:122-132. [PMID: 36639341 PMCID: PMC9832342 DOI: 10.1016/j.pedhc.2022.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The COVID-19 pandemic brought unprecedented challenges for youth with neurodevelopmental disabilities (NDD) and their families. Although health measures were implemented to contain the COVID-19 virus, they disrupted public service, profoundly impacting youth and their families' access to services. This study sought to better understand the perspectives and experiences of parents and caregivers of youth with NDD across Canada in accessing services and their mental health needs during the pandemic. METHOD The study used a qualitative research design in which we interviewed 40 parents and caregivers across Canada. RESULTS The results enabled us to understand the impact of service disruptions in significant areas of life, including health, education, employment, and risk mitigation. DISCUSSION Policymakers must consider a disability-inclusive lens during public health emergency planning and response to reduce the disproportionate impacts faced by youth with NDD and their families.
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Affiliation(s)
- Ash Seth
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada.
| | - Brittany Finlay
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Genevieve Currie
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Christiane Roth
- Research Associate, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | - Lucyna Lach
- Associate Professor, School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Anne Hudon
- Assissant Professor, Assistant professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Raphael Lencucha
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Matthew Hunt
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - David Nicholas
- Professor, Associate Dean of Research and Partnerships, Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Keiko Shikako-Thomas
- Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Jennifer Zwicker
- Associate Professor, School of Public Policy, University of Calgary, Calgary, Alberta, Canada
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Millimouno TM, Meessen B, Put WVD, Garcia M, Camara BS, Christou A, Delvaux T, Sidibé S, Beavogui AH, Delamou A. How has Guinea learnt from the response to outbreaks? A learning health system analysis. BMJ Glob Health 2023; 8:bmjgh-2022-010996. [PMID: 36854489 PMCID: PMC9980363 DOI: 10.1136/bmjgh-2022-010996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/23/2023] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION Learning is a key attribute of a resilient health system and, therefore, is central to health system strengthening. The main objective of this study was to analyse how Guinea's health system has learnt from the response to outbreaks between 2014 and 2021. METHODS We used a retrospective longitudinal single embedded case study design, applying the framework conceptualised by Sheikh and Abimbola for analysing learning health systems. Data were collected employing a mixed methods systematic review carried out in March 2022 and an online survey conducted in April 2022. RESULTS The 70 reports included in the evidence synthesis were about the 2014-2016 Ebola virus disease (EVD), Measles, Lassa Fever, COVID-19, 2021 EVD and Marburg virus disease. The main lessons were from 2014 to 2016 EVD and included: early community engagement in the response, social mobilisation, prioritising investment in health personnel, early involvement of anthropologists, developing health infrastructure and equipment and ensuring crisis communication. They were learnt through information (research and experts' opinions), action/practice and double-loop and were progressively incorporated in the response to future outbreaks through deliberation, single-loop, double-loop and triple-loop learning. However, advanced learning aspects (learning through action, double-loop and triple-loop) were limited within the health system. Nevertheless, the health system successfully controlled COVID-19, the 2021 EVD and Marburg virus disease. Survey respondents' commonly reported that enablers were the creation of the national agency for health security and support from development partners. Barriers included cultural and political issues and lack of funding. Common recommendations included establishing a knowledge management unit within the Ministry of Health with representatives at regional and district levels, investing in human capacities and improving the governance and management system. CONCLUSION Our study highlights the importance of learning. The health system performed well and achieved encouraging and better outbreak response outcomes over time with learning that occurred.
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Affiliation(s)
- Tamba Mina Millimouno
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea .,Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
| | - Bruno Meessen
- Health Systems Governance and Financing Department, World Health Organization, Geneva, Switzerland
| | - Willem Van De Put
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Marlon Garcia
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Bienvenu Salim Camara
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Aliki Christou
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Therese Delvaux
- Public Health Department, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Sidikiba Sidibé
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
| | - Abdoul Habib Beavogui
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Alexandre Delamou
- Research Section, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Centre d'Excellence d'Afrique pour la Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Conakry, Guinea
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Pare Toe L, Dicko B, Linga R, Barry N, Drabo M, Sykes N, Thizy D. Operationalizing stakeholder engagement for gene drive research in malaria elimination in Africa—translating guidance into practice. Malar J 2022; 21:225. [PMID: 35870909 PMCID: PMC9308116 DOI: 10.1186/s12936-022-04241-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractGene drive mosquitoes are increasingly considered a potential transformational tool for vector control of malaria mosquitoes. As part of efforts to promote responsible research in this field, a number of guidance documents have been published by the World Health Organization, National Academies and expert groups. While virtually all recent guidance documents on gene drive research stress the importance of stakeholder engagement activities, no specific guidelines on implementing them have been established. Target Malaria, a not-for-profit research consortium developing a vector-control gene drive approach to eliminate malaria, has reflected on how its stakeholder engagement strategy translates engagement guidance documents into practice. The project analysed and addressed the tension between the context specificities and the international recommendations. The engagement strategy combines published recommendations for responsible gene drive research, information collected from the local context where the project operates and a set of principles guiding the choices made. This strategy was first developed during the early phases of the project’s research, years ahead of any activities with gene drive mosquitoes in those countries of operations. These earlier activities, and their related engagement, allow the project to develop and adapt an engagement strategy appropriate for potential gene drive research in its field site countries. This paper offers a description of a stakeholder engagement strategy operationalization based on (1) adaptation to stakeholder preferences, (2) inclusiveness and (3) empowerment and accountability. The authors hope to offer concrete examples to support other projects with the development and implementation of their engagement strategies with particular attention to the co-development principle.
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Bain LE, Akondeng C, Njamnshi WY, Mandi HE, Amu H, Njamnshi AK. Community engagement in research in sub-Saharan Africa: current practices, barriers, facilitators, ethical considerations and the role of gender - a systematic review. Pan Afr Med J 2022; 43:152. [PMID: 36785694 PMCID: PMC9922083 DOI: 10.11604/pamj.2022.43.152.36861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/20/2022] [Indexed: 02/15/2023] Open
Abstract
Introduction meaningful community engagement is increasingly being considered the major determinant of successful research, innovation and intervention uptake. Even though there is available literature recommending community engagement in health research, there are still knowledge gaps in how communities might be best engaged in Sub-Saharan Africa. We, therefore, synthesized the existing literature on the current practices, barriers and facilitators, ethical considerations, and gender mainstreaming in the engagement of communities in research in sub-Saharan Africa. Methods this synthesis was developed following the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A combination of keywords and medical subject headings was used to search MEDLINE, EMBASE, Global Health Library through OVID SP, the Cochrane Library, PsychINFO, CINAHL, WHO Afro Library, WHO Global Index Medicus and the National Institute for Health Research, for all literature published between 1 January 2000 to 31 July 2021. Results thirty articles met our inclusion criteria. The key reported facilitators of effective community engagement in research included appropriate community entry and engagement of stakeholders. Barriers to effective community engagement in research included the availability of prohibitive cultural, historical and religious practices; geographical/spatial limitations, difficulties in planning and executing community engagement activities and communication barriers. Awareness creation and sensitization on the research through drama, social media, documentaries, and community durbars are some of the existing practices adopted in engaging communities in research. Gender mainstreaming was not considered appropriately in the engagement of communities in research, as only a few studies made provisions for gender considerations, and most of the time, interchanging gender for sex. Respect for autonomy, privacy and informed consent were the main ethical issues reported. Conclusion gender mainstreaming and ethical standards were reported as important, but not explored in depth. Gender as a social construct needs to be carefully integrated in the entire research cycle. Clear ethical concerns within a research project have to be co-discussed by the research team, community members and potential research participants.
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Affiliation(s)
- Luchuo Engelbert Bain
- Triangle Research Foundation (TRIFT), Limbe, Cameroon,,Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa,,Global South Health Services and Research (GSHS), Amsterdam, The Netherlands,,Corresponding author: Luchuo Engelbert Bain, Triangle Research Foundation (TRIFT), Limbe, Cameroon.
| | - Claudine Akondeng
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon,,Cameroon National Association of Family Welfare (CAMNAFAW), Yaoundé, Cameroun
| | - Wepnyu Yembe Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon,,Education and Learning for All (ELFA) Cameroon, Yaoundé, Cameroon,,Division of Operational Research in Health, DROS, Ministry of Public Health, Yaoundé, Cameroon
| | - Henshaw Eyambe Mandi
- Triangle Research Foundation (TRIFT), Limbe, Cameroon,,Coalition for Epidemic Preparedness Innovations, Oslo, Norway
| | - Hubert Amu
- Department of Population and Behavioral Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Alfred Kongnyu Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon,,Education and Learning for All (ELFA) Cameroon, Yaoundé, Cameroon,,Faculty of Medicine and Biomedical Sciences (FMBS), The University of Yaoundé I, Yaoundé, Cameroon
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Matos AR, Craveiro I. Participação pública em saúde e Covid-19 em Portugal. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
RESUMO Nas últimas décadas, o tema da participação pública em processos de decisão tem estado presente nas agendas políticas, com mais ou menos centralidade, em vários contextos democráticos do mundo. No campo da saúde, a participação pública apresenta-se como estratégia política com potencialidades para garantir maior corresponsabilização entre os atores envolvidos e para incrementar a transparência dos serviços, sendo enfatizada como boa prática que deve ser implementada em prol da qualidade das decisões, mas também de decisões que sejam orientadas para os reais problemas das populações. A pandemia da Covid-19 trouxe pressões adicionais aos sistemas de saúde, constituindo-se como contexto propício à análise da participação cidadã nos processos de decisão que enquadram problemas de saúde na sua relação com a pandemia. Este ensaio apresenta uma análise exploratória sobre a evolução das práticas de participação cidadã nas políticas de saúde em Portugal, destacando alguns dos seus desafios atuais e futuros. Procura-se, assim, compreender como a pandemia teve ressonância na forma como a participação em saúde vinha decorrendo no País, aferindo se, em um período global de crise com características singulares, a pandemia, enquanto problema coletivo, distendeu ou contraiu essas práticas participativas.
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Matos AR, Craveiro I. Public participation in health and COVID-19 in Portugal. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-11042022e408i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
ABSTRACT In the last decades, public participation in decision-making processes has been an ongoing theme, assuming more or less centrality, within the political agendas in several democratic contexts around the world. In the health domain, public participation has been considered a political strategy with the potential of ensuring greater co-responsibility among the actors involved, as well as to increase health services’ transparency, thus being emphasized as one of the best practices that should be implemented towards the quality of decisions, especially those oriented to the real health problems of the populations. The COVID-19 pandemic brought additional pressures to health systems, constituting itself as a conducive context to the analysis of citizen participation in health decision-making processes. This essay presents an exploratory analysis on the evolution of citizen participation practices in health policies in Portugal, highlighting some of its current and future challenges. The present analysis aims to understand how the pandemic resonated in the way in which participation in the health domain had been carried out in the country, assessing whether, in a singular global period of crisis, the pandemic as a collective problem expanded or contracted these participatory practices.
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Boivin A, Dumez V, Castonguay G, Berkesse A. The Ecology of Engagement: Fostering cooperative efforts in health with patients and communities. Health Expect 2022; 25:2314-2327. [PMID: 35923116 PMCID: PMC9615077 DOI: 10.1111/hex.13571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/20/2022] [Accepted: 07/12/2022] [Indexed: 12/30/2022] Open
Abstract
CONTEXT Patients and community members are engaged in nearly every aspect of health systems. However, the engagement literature remains siloed and fragmented, which makes it difficult to connect engagement efforts with broader goals of health, equity and sustainability. Integrated and inclusive models of engagement are needed to support further transformative efforts. METHODS This article describes the Ecology of Engagement, an integrated model of engagement. The model posits that: (1) Health ecosystems include all members of society engaged in health; (2) Engagement is the 'together' piece of health and healthcare (e.g., caring for each other, preventing, researching, teaching and building policies together); (3) Health ecosystems and engagement are interdependent from each other, both influencing health, equity, resilience and sustainability. CONCLUSION The Ecology of Engagement offers a common sketch to foster dialogue on engagement across health ecosystems. The model can drive cooperative efforts with patients and communities on health, equity, resilience and sustainability. PATIENTS AND PUBLIC CONTRIBUTION Three of the authors have lived experiences as patients. One has a socially disclosed identity as a patient partner leader with extensive experience in engagement (individual care, education, research, management and policy). Two authors have significant experience as patients and informal caregivers, which were mobilized in descriptive illustrations. A fourth author has experience as an engaged citizen in health policy debates. All authors have professional lived experience in health (manager, researcher, health professional, consultant and educator). Six patient and caregiver partners with lived experience of engagement (other than the authors) contributed important revisions and intellectual content.
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Affiliation(s)
- Antoine Boivin
- Canada Research Chair in Partnership with Patients and CommunitiesMontrealQuebecCanada
- Center of Excellence for Partnership with Patients and the Public, Montreal University Hospital Research CenterUniversité de MontréalMontrealQuebecCanada
- Department of Family MedicineUniversité de MontréalMontrealQuebecCanada
| | - Vincent Dumez
- Center of Excellence for Partnership with Patients and the Public, Montreal University Hospital Research CenterUniversité de MontréalMontrealQuebecCanada
- Faculty of MedicineUniversité de MontréalMontrealQuebecCanada
| | - Geneviève Castonguay
- Canada Research Chair in Partnership with Patients and CommunitiesMontrealQuebecCanada
| | - Alexandre Berkesse
- Center of Excellence for Partnership with Patients and the Public, Montreal University Hospital Research CenterUniversité de MontréalMontrealQuebecCanada
- French School of Public Health (EHESP)RennesFrance
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21
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Frimpong LK, Okyere SA, Diko SK, Abunyewah M, Erdiaw-Kwasie MO, Commodore TS, Hernandez DO, Kita M. Actor-network analysis of community-based organisations in health pandemics: evidence from the COVID-19 response in Freetown, Sierra Leone. DISASTERS 2022; 46:903-927. [PMID: 34477244 PMCID: PMC8652973 DOI: 10.1111/disa.12508] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Freetown, Sierra Leone, is confronted with health risks that are compounded by rapid unplanned urbanisation and weak capacities of local government institutions. Addressing them implies a shared responsibility between government and non-state actors. In low-income areas, the role of community-based organisations (CBOs) in combating health disasters is well-recognised. Yet, empirical evidence on how they have utilised their networks and coordinated community-level strategies in responding to the COVID-19 pandemic is scant. This paper, based on a qualitative study in two informal settlements in Freetown, employs actor-network theory to understand how CBOs problematise COVID-19 as a health risk, interact with other entities, and the subsequent tensions that arise. The findings show that community vulnerabilities and past experiences of health disasters informed CBOs' perception of COVID-19 as a communal emergency. In response, they coordinated sensitisation and mobilisation programmes by relying on a network of actors to support COVID-19 risk reduction strategies. Nonetheless, misunderstandings among them caused friction.
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Affiliation(s)
- Louis Kusi Frimpong
- Lecturer at the Department of Geography and Earth Science, University of Environment and Sustainable Development, Ghana
| | - Seth Asare Okyere
- Assistant Professor at the Graduate School of Engineering, Osaka University, Japan
| | - Stephen Kofi Diko
- Assistant Professor at the Department of City and Regional Planning, University of Memphis, United States
| | - Matthew Abunyewah
- Adjunct Senior Lecturer at the School of Architecture and Built Environment, University of Newcastle, Australia
| | | | - Tracy Sidney Commodore
- PhD Candidate at the Institute of Statistical, Social and Economic Research, University of Ghana, Ghana
| | - Daniel Oviedo Hernandez
- Lecturer at the Bartlett Development Planning Unit, University College London, United Kingdom
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22
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Keita M, Polonsky J, Finci I, Mbala-Kingebeni P, Ilumbulumbu MK, Dakissaga A, Ngwama JK, Tosalisana MK, Ahuka-Mundeke S, Gueye AS, Dagron S, Keiser O, Fall IS. Investigation of and Strategies to Control the Final Cluster of the 2018-2020 Ebola Virus Disease Outbreak in the Eastern Democratic Republic of Congo. Open Forum Infect Dis 2022; 9:ofac329. [PMID: 36168547 PMCID: PMC9499850 DOI: 10.1093/ofid/ofac329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background On April 10, 2020, while the independent committee of the International Health Regulation was meeting to decide whether the 10th Ebola outbreak in the Demogratic Republic of Congo still constituted a Public Health Emergency of International Concern, a new confirmed case was reported in the city of Beni, the last epicenter of the epidemic. This study aimed to understand the source of this cluster and learn from the implemented control strategies for improved response in the future. Methods We conducted a combined epidemiological and genomic investigation to understand the origins and dynamics of transmission within this cluster and describe the strategy that successfully controlled the outbreak. Results Eight cases were identified as belonging to this final cluster. A total of 1028 contacts were identified. Whole-genome sequencing revealed that all cases belonged to the same cluster, the closest sequence to which was identified as a case from the Beni area with symptom onset in July 2019 and a difference of just 31 nucleotides. Outbreak control measures included community confinement of high-risk contacts. Conclusions This study illustrates the high risk of additional flare-ups in the period leading to the end-of-outbreak declaration and the importance of maintaining enhanced surveillance and confinement activities to rapidly control Ebola outbreaks.
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Affiliation(s)
- Mory Keita
- Regional Office for Africa, World Health Organization, Brazzaville, Congo.,Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Jonathan Polonsky
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland.,World Health Organization, Geneva, Switzerland
| | - Iris Finci
- European Program for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | | | - Michel Kalongo Ilumbulumbu
- Division Provinciale de la Santé du Nord-Kivu, Ministère de la Santé, Goma, Democratic Republic of Congo
| | - Adama Dakissaga
- Ministère de la Santé, Direction Régionale de la Santé du Plateau central, Ziniaré, Burkina Faso
| | - John Kombe Ngwama
- Direction Générale de la Lutte contre la Maladie, Ministère de la Santé, Kinshasa, Democratic Republic of Congo
| | - Michel Kasereka Tosalisana
- Division Provinciale de la Santé du Nord-Kivu, Ministère de la Santé, Goma, Democratic Republic of Congo
| | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of Congo
| | - Abdou Salam Gueye
- Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Stephanie Dagron
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
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Silva M, Tallman P, Stolow J, Yavinsky R, Fleckman J, Hoffmann K. Learning From the Past: The Role of Social and Behavior Change Programming in Public Health Emergencies. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-22-00026. [PMID: 36041834 PMCID: PMC9426983 DOI: 10.9745/ghsp-d-22-00026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022]
Abstract
The contributions of social and behavior change research/programming in 6 recent epidemics highlight the importance of further integrating such expertise into outbreak response.
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Affiliation(s)
- Martha Silva
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
| | - Paula Tallman
- Loyola University Department of Anthropology, Chicago, IL, USA
| | - Jeni Stolow
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - Julia Fleckman
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Kamden Hoffmann
- MOMENTUM Integrated Health Resilience, IMA World Health, Washington, DC, USA
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Zachariah D, Mouwad D, Muscat DM, Ayre J, Nutbeam D, McCaffery KJ. Addressing the Health Literacy Needs and Experiences of Culturally and Linguistically Diverse Populations in Australia during COVID-19: A Research Embedded Participatory Approach. JOURNAL OF HEALTH COMMUNICATION 2022; 27:439-449. [PMID: 36120983 DOI: 10.1080/10810730.2022.2118910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Communicating health information quickly and effectively with diverse populations has been essential during the COVID-19 pandemic. However, health communication practices are often top down and poorly designed to rapidly meet diverse health literacy, cultural and contextual needs of the population. This paper describes a research and practice partnership focused on health literacy, multicultural health, and community engagement to address COVID-19 in Australia. The partnership became influential in the local and state-based response to the COVID-19 Delta outbreak in Western and South Western Sydney, an area of high cultural and socioeconomic diversity. Our approach, bringing together academic researchers and frontline health staff working with multicultural populations using a model of co-design and community engagement and action via the "4 M model," has been successful. It supported the Western Sydney community to achieve some of the highest vaccination rates in the world (>90%). There is an ongoing need to engage respectfully and responsively with communities to address specific challenges that they face and tailor communications and supports accordingly for successful pandemic management. Combining co-designed empirical research with community engagement and action ensures needs are robustly identified and can be appropriately addressed to support an effective public health response.
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Affiliation(s)
- Dipti Zachariah
- Multicultural Health, Integrated and Community Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Dana Mouwad
- Health Literacy Hub, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Danielle Marie Muscat
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Health Literacy Hub, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Julie Ayre
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Health Literacy Hub, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Don Nutbeam
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Health Literacy Hub, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Kirsten Jo McCaffery
- Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Health Literacy Hub, Western Sydney Local Health District, Sydney, NSW, Australia
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Cuen AJ, Kante A, Tsemo S, Djoudalbaye B. Fighting COVID-19 and HIV through community mobilisation: lessons from an integrated approach to the Africa CDC Partnership to Accelerate COVID-19 Testing (PACT) initiative in seven countries. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2022; 21:132-142. [PMID: 35901297 DOI: 10.2989/16085906.2022.2103005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Recent literature has shown how the HIV architecture, including community systems, has been critical for fighting COVID-19 in many countries, while sustaining the HIV response. Innovative initiatives suggest that fostering the integration of health services would help address the colliding pandemics. However, there are few documented real-life examples of community mobilisation strategies responding to COVID-19 and HIV. The African Union and Africa Centres for Disease Control and Prevention (Africa CDC) launched the Partnership to Accelerate COVID-19 Testing (PACT) in June 2020 with the goal of training and deploying one million community health workers across the continent. UNAIDS partnered with Africa CDC to implement the PACT initiative in seven countries, i.e. Algeria, Côte d'Ivoire, Gabon, Ghana, Madagascar, Malawi and Namibia. The initiative engaged networks of people living with HIV and community-led organisations to support two of its pillars, test and trace, and the sensitisation to protective measures against COVID-19 for the most vulnerable populations. It later expanded to improve access to COVID-19 vaccines. Based on the assessment of country projects, this article explains how PACT activities implemented by communities contributed to mitigating COVID-19 and HIV among vulnerable and marginalised groups. This article contributes to a better understanding of the impact of a community-based approach in responding effectively to emerging health threats and provides lessons from integrated COVID-19 and HIV community-led responses.
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Affiliation(s)
| | - Agnes Kante
- UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Sihaka Tsemo
- UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa, Addis Ababa, Ethiopia
| | - Benjamin Djoudalbaye
- Health Diplomacy and Communication, Africa Centres for Disease Control, Addis Ababa, Ethiopia
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Musaazi J, Namageyo-Funa A, Carter VM, Carter RJ, Lamorde M, Apondi R, Bakyaita T, Boore AL, Brown VR, Homsy J, Kigozi J, Koyuncu A, Nabaggala MS, Nakate V, Nkurunziza E, Stowell DF, Walwema R, Olowo A, Jalloh MF. Evaluation of Community Perceptions and Prevention Practices Related to Ebola Virus as Part of Outbreak Preparedness in Uganda, 2020. GLOBAL HEALTH: SCIENCE AND PRACTICE 2022; 10:GHSP-D-21-00661. [PMCID: PMC9242603 DOI: 10.9745/ghsp-d-21-00661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 03/29/2022] [Indexed: 11/15/2022]
Abstract
Targeted risk communication and community engagement strategies to raise Ebola virus disease awareness and knowledge, particularly in setting where risk of infection is perceived to be low, may not be sufficient to motivate people to adopt protective behaviors and prevention practices. Introduction: During the 2018–2020 Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo, risk communication and community engagement (RCCE) were prioritized in geographic areas in Uganda considered at high risk of introduction of EVD. To inform EVD preparedness in Uganda, we evaluated community perceptions and prevention practices related to EVD in 6 districts in Uganda. Methods: In March 2020, we conducted a population-based survey in 6 purposively selected districts in Uganda using multistage cluster sampling. We examined differences between districts classified as high- versus low risk for EVD in terms of their message exposure from RCCE; risk perception; and EVD knowledge, attitudes, and prevention practices. Results: A total of 3,485 respondents were interviewed (91% response rate). EVD message exposure was more common in the high- versus low-risk districts. EVD risk perceptions were low overall but greater in the high- versus low-risk districts. Comprehensive knowledge was significantly greater in the high- versus low-risk districts (adjusted prevalence ratio [aPR] 1.61, 95% confidence interval [CI]=1.35, 1.93). Respondents' engagement in all 3 EVD prevention practices (frequent handwashing with soap, avoiding physical contact with suspected Ebola patients, and avoiding burials involving contact with a corpse) was very low (4%). However, respondents with comprehensive knowledge were more likely to engage in all 3 EVD prevention practices compared to respondents without comprehensive knowledge (aPR 1.87, 95% CI=1.08, 3.25). Conclusion: Our findings suggest that while RCCE efforts as part of EVD outbreak preparedness may have contributed to higher EVD knowledge in the targeted high-risk districts, uptake of prevention behaviors was similarly low across districts. In a non-outbreak setting, implementing targeted RCCE strategies may not be sufficient to motivate people to adopt protective behaviors in the absence of a high threshold of perceived threat such as in an active outbreak.
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Affiliation(s)
- Joseph Musaazi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- Correspondence to Joseph Musaazi ()
| | - Apophia Namageyo-Funa
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Victoria M. Carter
- National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rosalind J. Carter
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mohammed Lamorde
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rose Apondi
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Amy L. Boore
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Vance R. Brown
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jaco Homsy
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Institute for Global Health Sciences, University of California San Francisco, California, USA
| | - Joanita Kigozi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Aybüke Koyuncu
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria Sarah Nabaggala
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Vivian Nakate
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Emmanuel Nkurunziza
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Daniel F. Stowell
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Walwema
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Apollo Olowo
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mohamed F. Jalloh
- Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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Bayugo YV, Labarda M, Cruz JRB, Mier-Alpaño JD, Tiangco PMP, Oyene UE, Omoleke SA, Ulitin A, Ong A, Fajardo MS, Echavarria MI, Alger J, Mathanga D, Msiska BK, Ekwunife OI, Nwaorgu O, Abella Lizcano L, Gomez Quenguan N, Nieto Anderson CI, Beltran BY, Carcamo Rodriguez ED, Núñez ES, Nkosi-Kholimeliwa V, Mwafulirwa-Kabaghe G, Juban N. Description of global innovative methods in developing the WHO Community Engagement Package. BMJ Open 2022; 12:e063144. [PMID: 35672075 PMCID: PMC9174797 DOI: 10.1136/bmjopen-2022-063144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Development of a Community Engagement Package composed of (1) database of community engagement (CE) experiences from different contexts, (2) CE learning package of lessons and tools presented as online modules, and (3) CE workshop package for identifying CE experiences to enrich the CE database and ensure regular update of learning resources. The package aims to guide practitioners to promote local action and enhance skills for CE. SETTING AND PARTICIPANTS The packages were co-created with diverse teams from WHO, Social Innovation in Health Initiative, UNICEF, community practitioners, and other partners providing synergistic contributions and bridging existing silos. METHODS The design process of the package was anchored on CE principles. Literature search was performed using standardised search terms through global and regional databases. Interviews with CE practitioners were also conducted. RESULTS A total of 356 cases were found to fit the inclusion criteria and proceeded to data extraction and thematic analysis. Themes were organised according to rationale, key points and insights, facilitators of CE and barriers to CE. Principles and standards of CE in various contexts served as a foundation for the CE learning package. The package comprises four modules organised by major themes such as mobilising communities, strengthening health systems, CE in health emergencies and CE as a driver for health equity. CONCLUSION After pilot implementation, tools and resources were made available for training and continuous collection of novel CE lessons and experiences from diverse socio-geographical contexts.
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Affiliation(s)
| | - Meredith Labarda
- School of Health Sciences, University of the Philippines Manila, Manila, Philippines
| | | | | | | | | | | | - Allan Ulitin
- Institute of Health Policy and Development Studies - National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Alberto Ong
- Alliance for Improving Health Outcomes, Quezon City, Philippines
| | | | - Maria Isabel Echavarria
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Jackeline Alger
- Hospital Escuela, Tegucigalpa, Honduras
- Instituto de Enfermedades Infecciosas y Parasitologia Antonio Vidal, Tegucigalpa, Honduras
| | - Don Mathanga
- College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Obinna Ikechukwu Ekwunife
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
- Social Innovation in Health Initiative (SIHI), Nnamdi Azikiwe University, Awka, Nigeria
| | - Obioma Nwaorgu
- Social Innovation in Health Initiative (SIHI), Nnamdi Azikiwe University, Awka, Nigeria
- Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Lorena Abella Lizcano
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Natalia Gomez Quenguan
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | | | | | | | - Eduardo Salomón Núñez
- Facultad de Ciencias Médicas, Universidad Católica de Honduras Nuestra Señora Reina de la Paz Facultad de Ciencias de la Salud, Tegucigalpa, Honduras
- Cirugía General, Hospital General Santa Teresa, Comayagua, Honduras
| | | | | | - Noel Juban
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
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Sunder M V, Prashar A. State and citizen responsiveness in fighting a pandemic crisis: A systems thinking perspective. SYSTEMS RESEARCH AND BEHAVIORAL SCIENCE 2022; 40:SRES2849. [PMID: 35941990 PMCID: PMC9348510 DOI: 10.1002/sres.2849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Management scholars have recognized organizational responsiveness among the essential capabilities of social organizations. It becomes essential for a social change to occur during a crisis, where the uncertainty or environmental dynamism is high. However, a social change cannot be successful unless constituent subsystems of a social organization exhibit responsiveness. Using systems theory, we conceptualize 'nation' as a social system and examine its responsiveness towards environmental uncertainly, taking an example of the COVID-19 pandemic. How can state and citizen community responsiveness help fight a pandemic crisis? We test these direct and moderating effects on data representing 14 countries. We perform a hierarchical regression analysis on the restructured, balanced country-wise panel data. Our findings highlight the importance of state and community interaction effects in controlling pandemic growth. Accordingly, we claim that only a collaborative approach by citizen communities with the respective governments will enable handling an uncertain situation.
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Akbar MA, Juniarti N, Yamin A. The Roles of Community Health Nurses' in Covid-19 Management in Indonesia: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:96-109. [PMID: 35372635 PMCID: PMC8957658 DOI: 10.30476/ijcbnm.2021.90884.1739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022]
Abstract
Background The majority of Covid-19 cases occur at the community level requiring health services to be available at the primary health care level, which also includes Community Health Nursing (CHN) services. It is important to understand various perspectives of the parties involved, effective solutions, and strategies used by nurses in managing Covid-19 in order to be able to provide these services. The purpose of this study was to explore the community health nurses' (CHNs) roles in the Covid-19 management in Indonesia. Methods A qualitative method was used to explore the perspective from nurses and health cadres as participants. Data were collected through in-depth phone interviews with 11 participants from December 2020 to February 2021 in Bandung. Data were analyzed manually using thematic analysis. Results Five themes were extracted in this study, namely providing comprehensive services by CHNs; utilizing technology to bridge the information needs; implementing family nursing care; spreading the wings of health cadres by CHNs; and collaborating as the heart of Covid-19 prevention and management. Conclusion CHNs should employ health education, empowerment strategies, group processes, and advocacy in adapting to the Covid-19 pandemic situation. The five themes identified in this study can be used by policy makers to develop strategies in optimizing the CHN in Covid-19 pandemic management and the possible challenges of future global pandemics.
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Affiliation(s)
- M Agung Akbar
- Department of Community Health Nursing, Academy of Nursing Al-Maarif, Baturaja, Indonesia
| | - Neti Juniarti
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Ahmad Yamin
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
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Dick L, Moodie J, Greiner AL. Are we ready? Operationalising risk communication and community engagement programming for public health emergencies. BMJ Glob Health 2022; 7:bmjgh-2022-008486. [PMID: 35318265 PMCID: PMC8943758 DOI: 10.1136/bmjgh-2022-008486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/23/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Leah Dick
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janae Moodie
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ashley L Greiner
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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McKay G, Baggio O, Camara CA, Erlach E, Robles Dios L, Checchi F, Rohan H. The response is like a big ship': community feedback as a case study of evidence uptake and use in the 2018-2020 Ebola epidemic in the Democratic Republic of the Congo. BMJ Glob Health 2022; 7:bmjgh-2021-005971. [PMID: 35197250 PMCID: PMC8867249 DOI: 10.1136/bmjgh-2021-005971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 11/19/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction The 2018–2020 Ebola outbreak in the Democratic Republic of the Congo (DRC) took place in the highly complex protracted crisis regions of North Kivu and Ituri. The Red Cross developed a community feedback (CF) data collection process through the work of hundreds of Red Cross personnel, who gathered unprompted feedback in order to inform the response coordination mechanism and decision-making. Aim To understand how a new CF system was used to make operational and strategic decisions by Ebola response leadership. Methods Qualitative data collection in November 2019 in Goma and Beni (DRC), including document review, observation of meetings and CF activities, key informant interviews and focus group discussions. Findings The credibility and use of different evidence types was affected by the experiential and academic backgrounds of the consumers of that evidence. Ebola response decision-makers were often medics or epidemiologists who tended to view quantitative evidence as having more rigour than qualitative evidence. The process of taking in and using evidence in the Ebola response was affected by decision-makers’ bandwidth to parse large volumes of data coming from a range of different sources. The operationalisation of those data into decisions was hampered by the size of the response and an associated reduction in agility to new evidence. Conclusion CF data collection has both instrumental and intrinsic value for outbreak response and should be normalised as a critical data stream; however, a failure to act on those data can further frustrate communities.
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Affiliation(s)
- Gillian McKay
- Department of Global Health and Development, The London School of Hygiene and Tropical Medicine, London, UK
| | - Ombretta Baggio
- The International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | | | - Eva Erlach
- The International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | - Lucia Robles Dios
- The International Federation of the Red Cross and Red Crescent Societies, Goma, Democratic Republic of the Congo
| | - Francesco Checchi
- Department of Infectious Disease Epidemiology, The London School of Hygiene and Tropical Medicine, London, UK
| | - Hana Rohan
- UK Public Health Rapid Support Team, The London School of Hygiene and Tropical Medicine, London, UK
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Mahmood SS, Hasan MZ, Hasan AMR, Rabbani MG, Begum F, Yousuf TB, Hanifi SMA, Reidpath DD, Rasheed S. Health system impact of COVID-19 on urban slum population of Bangladesh: a mixed-method rapid assessment study. BMJ Open 2022; 12:e057402. [PMID: 35197355 PMCID: PMC8882639 DOI: 10.1136/bmjopen-2021-057402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE We aimed to rapidly assess the health system impact of COVID-19 in the urban slums of Bangladesh. DESIGN Setting and participantsA cross-sectional survey among 476 households was conducted during October-December 2020 in five selected urban slums of Dhaka North, Dhaka South and Gazipur City Corporation. In-depth interviews with purposively selected 22 slum dwellers and key informant interviews with 16 local healthcare providers and four policymakers and technical experts were also conducted. OUTCOME MEASURES Percentage of people suffering from general illness, percentage of people suffering from chronic illness, percentage of people seeking healthcare, percentage of people seeking maternal care, health system challenges resulting from COVID-19. RESULTS About 12% of members suffered from general illness and 25% reported chronic illness. Over 80% sought healthcare and the majority sought care from informal healthcare providers. 39% of the recently delivered women sought healthcare in 3 months preceding the survey. An overall reduction in healthcare use was reported during the lockdown period compared with prepandemic time. Mismanagement and inefficient use of resources were reported as challenges of health financing during the pandemic. Health information sharing was inadequate at the urban slums, resulting from the lack of community and stakeholder engagement (51% received COVID-19-related information, 49% of respondents knew about the national hotline number for COVID-19 treatment). Shortage of human resources for health was reported to be acute during the pandemic, resulting from the shortage of specialist doctors and uneven distribution of health workforce. COVID-19 test was inadequate due to the lack of adequate test facilities and stigma associated with COVID-19. Lack of strong leadership and stakeholder engagement was seen as the barriers to effective pandemic management. CONCLUSION The findings of the current study are expected to support the government in tailoring interventions and allocating resources more efficiently and timely during a pandemic.
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Affiliation(s)
| | - Md Zahid Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - A M Rumayan Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Md Golam Rabbani
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Farzana Begum
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Tariq Bin Yousuf
- Urban Resilience Project, Dhaka North City Corporation, Dhaka, Bangladesh
| | | | - Daniel D Reidpath
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Sabrina Rasheed
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
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Kaza S, Gupta P, Vaidya R, Nooyi S, Chaudhury N. Effect of COVID-19 lockdown on lifestyle habits and self-care practices of diabetic and hypertensive patients in rural Shimla and Udaipur – Findings from the HealthRise India program. Indian J Public Health 2022; 66:466-472. [PMID: 37039175 DOI: 10.4103/ijph.ijph_1908_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background COVID-19 pandemic has increased the risk of mortality among patients with noncommunicable diseases. Maintaining a good metabolic control, lifestyle modification along with improved self-care practices are not only associated with less severe COVID-19 infections but also with a high recovery rate. Objectives This research article explores the changes in lifestyle habits, self-care practices, and metabolic control among patients enrolled in the HealthRise program. The study compares behavioral changes, before COVID-19 pandemic and during COVID-19 pandemic, between intervention and control arms in Shimla and Udaipur. Methods A quasi-experimental study design was employed for program implementation in select villages of Shimla district, and Udaipur district. A total of 459 patients from Shimla and 309 patients from Udaipur with diabetes mellitus or hypertension or with both were enrolled and followed for 1 year. Results Metabolic control in Shimla intervention arm was 2.6 times higher than in control arm (P = 0.001) before COVID-19 pandemic. During COVID-19 pandemic, Odds of metabolic control in Shimla intervention was 1.5 times higher when compared with control arm (P = 0.03). In Udaipur, metabolic control before COVID-19 pandemic was comparable between control and intervention arms. During the pandemic, metabolic control in intervention arm of Udaipur was 5 times higher when compared to the control arm ((P = 0.001). Conclusion Participants exposed to support, appreciate, learn, and transfer-community life competence process (SALT-CLCP) intervention maintained metabolic control during the COVID-19 pandemic with improved behavioral and self-care practices. Community-based interventions such as SALT-CLCP method bring ownership and empower community in achieving the better health outcomes.
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Ayala G, Sprague L, van der Merwe LLA, Thomas RM, Chang J, Arreola S, Davis SLM, Taslim A, Mienies K, Nilo A, Mworeko L, Hikuam F, de Leon Moreno CG, Izazola-Licea JA. Peer- and community-led responses to HIV: A scoping review. PLoS One 2021; 16:e0260555. [PMID: 34852001 PMCID: PMC8635382 DOI: 10.1371/journal.pone.0260555] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/18/2021] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In June 2021, United Nations (UN) Member States committed to ambitious targets for scaling up community-led responses by 2025 toward meeting the goals of ending the AIDS epidemic by 2030. These targets build on UN Member States 2016 commitments to ensure that 30% of HIV testing and treatment programmes are community-led by 2030. At its current pace, the world is not likely to meet these nor other global HIV targets, as evidenced by current epidemiologic trends. The COVID-19 pandemic threatens to further slow momentum made to date. The purpose of this paper is to review available evidence on the comparative advantages of community-led HIV responses that can better inform policy making towards getting the world back on track. METHODS We conducted a scoping review to gather available evidence on peer- and community-led HIV responses. Using UNAIDS' definition of 'community-led' and following PRISMA guidelines, we searched peer-reviewed literature published from January 1982 through September 2020. We limited our search to articles reporting findings from randomized controlled trials as well as from quasi-experimental, prospective, pre/post-test evaluation, and cross-sectional study designs. The overall goals of this scoping review were to gather available evidence on community-led responses and their impact on HIV outcomes, and to identify key concepts that can be used to quickly inform policy, practice, and research. FINDINGS Our initial search yielded 279 records. After screening for relevance and conducting cross-validation, 48 articles were selected. Most studies took place in the global south (n = 27) and a third (n = 17) involved youth. Sixty-five percent of articles (n = 31) described the comparative advantage of peer- and community-led direct services, e.g., prevention and education (n = 23) testing, care, and treatment programs (n = 8). We identified more than 40 beneficial outcomes linked to a range of peer- and community-led HIV activities. They include improved HIV-related knowledge, attitudes, intentions, self-efficacy, risk behaviours, risk appraisals, health literacy, adherence, and viral suppression. Ten studies reported improvements in HIV service access, quality, linkage, utilization, and retention resulting from peer- or community-led programs or initiatives. Three studies reported structural level changes, including positive influences on clinic wait times, treatment stockouts, service coverage, and exclusionary practices. CONCLUSIONS AND RECOMMENDATIONS Findings from our scoping review underscore the comparative advantage of peer- and community-led HIV responses. Specifically, the evidence from the published literature leads us to recommend, where possible, that prevention programs, especially those intended for people living with and disproportionately affected by HIV, be peer- and community-led. In addition, treatment services should strive to integrate specific peer- and community-led components informed by differentiated care models. Future research is needed and should focus on generating additional quantitative evidence on cost effectiveness and on the synergistic effects of bundling two or more peer- and community-led interventions.
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Affiliation(s)
- George Ayala
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
- Alameda County Department of Public Health, Oakland, CA, United States of America
- * E-mail:
| | - Laurel Sprague
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | - L. Leigh-Ann van der Merwe
- Social, Health and Empowerment Feminist Collective of Transgender Women in Africa, East London, South Africa
- Innovative Response Globally to Transgender Women and HIV (IRGT), Oakland, CA, United States of America
| | | | - Judy Chang
- International Network of People Who Use Drugs, London, United Kingdom
| | - Sonya Arreola
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
- Arreola Research, San Francisco, CA, United States of America
| | | | | | - Keith Mienies
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | | | - Lillian Mworeko
- International Community of Women Living with HIV Eastern Africa, Kampala, Uganda
| | - Felicita Hikuam
- AIDS and Rights Alliance for Southern Africa, Windhoek, Namibia
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El-Majzoub S, Narasiah L, Adrien A, Kaiser D, Rousseau C. Negotiating Safety and Wellbeing: The Collaboration Between Faith-Based Communities and Public Health During the COVID-19 Pandemic. JOURNAL OF RELIGION AND HEALTH 2021; 60:4564-4578. [PMID: 34559364 PMCID: PMC8475844 DOI: 10.1007/s10943-021-01434-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 05/27/2023]
Abstract
The COVID-19 pandemic led to lockdown measures where congregational faith-based activities were prohibited. With time, the collateral impacts of confinement emerged as priorities, and impositions had to be balanced with the collaboration of the population. In this process, faith-based organizations played a key role in encouraging their congregations to adhere to lockdown measures while fostering their mental wellbeing and resilience. This paper describes the process of establishing a collaborative negotiation among the Montreal Regional Public Health Unit, the police, and the Muslim and Jewish communities, examining the role of mediation in this context. Despite some obstacles, such as communication difficulties and decision-making limitations, the collaborative approach seems to buffer the escalation of intercommunity tension and to promote communities' commitment to physical distancing measures and should be considered in times of pandemic for a more inclusive public health approach.
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Affiliation(s)
- Salam El-Majzoub
- Department of Psychiatry, McGill University, Montreal, QC Canada
| | | | - Alix Adrien
- Department of Epidemiology, Biostatics and Occupational Health, McGill University, Montreal, QC Canada
| | - David Kaiser
- Public Health School- Department of Social and Preventative Medicine, Université de Montréal, Montreal, QC Canada
| | - Cécile Rousseau
- Division of Social and Cultural Psychiatry, McGill University, Montreal, QC Canada
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Wu S, Neill R, De Foo C, Chua AQ, Jung AS, Haldane V, Abdalla SM, Guan WJ, Singh S, Nordström A, Legido-Quigley H. Aggressive containment, suppression, and mitigation of covid-19: lessons learnt from eight countries. BMJ 2021; 375:e067508. [PMID: 34840136 PMCID: PMC8624062 DOI: 10.1136/bmj-2021-067508] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Shishi Wu
- Dalla Lana School of Public Health, University of Toronto, Canada
| | - Rachel Neill
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Chuan De Foo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Alvin Qijia Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Anne-Sophie Jung
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Victoria Haldane
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Canada
| | - Salma M Abdalla
- Independent Panel for Pandemic Preparedness and Response Secretariat
- School of Public Health, Boston University, USA
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, China
- Department of Thoracic Surgery, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, China
| | - Sudhvir Singh
- Independent Panel for Pandemic Preparedness and Response Secretariat
- Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Anders Nordström
- Independent Panel for Pandemic Preparedness and Response Secretariat
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Independent Panel for Pandemic Preparedness and Response Secretariat
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Kemper S, Bongers M, Slok E, Schoonmade LJ, Kupper J, Timen A. Patient and public engagement in decision-making regarding infectious disease outbreak management: an integrative review. BMJ Glob Health 2021; 6:bmjgh-2021-007340. [PMID: 34824137 PMCID: PMC8627369 DOI: 10.1136/bmjgh-2021-007340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Worldwide, people experience the effects of infectious disease outbreaks on a regular basis. These effects vary from direct impact of the virus on health, to indirect impact of control measures on day-to-day life. Yet, incorporating the experiences, views and ideas of patients and the public in decision-making in managing outbreaks does not take place on a structural basis. However, this might be beneficial. We examined the current incorporation of patient and public engagement (PPE) in decision-making regarding outbreak management (OM). Methods A systematic search was executed in PubMed, Embase, APA PsycInfo, Web of Science, Scopus and other literature sources. Papers describing PPE in decision-making regarding OM on a collective level (group-level) were included. Relevant information about study characteristics, methods, impact and embedment of PPE in decision-making in OM was collected. Results The search yielded 4186 papers of which 13 were included. The papers varied in study context and design. Remarkably, no substantial patient engagement was identified. Overall, public engagement (PE) in decision-making regarding OM was mostly executed by a mix of methods, for example, workshops, interviews and surveys. Knowledge and idea sharing between the public and experts was deemed beneficial for establishing well-informed discussions. The efforts resulted in either direct implications for practice or recommendations in policy papers. Most papers described their efforts as a first step. No structural embedment of collective PE in decision-making regarding OM was identified. Furthermore, the quality of most papers was low to moderate due to insufficient description. Conclusion Overall, various practices for PE can be potentially valuable, but structural embedment in OM decision-making on a collective level was low. Before PPE can be permanently embedded in OM, more evidence on its impact needs to be collected. Furthermore, reporting on the engagement process and used terminology needs to be harmonised to ensure reproducibility and transparency.
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Affiliation(s)
- Sophie Kemper
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands .,Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Mej Bongers
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ene Slok
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - L J Schoonmade
- Medical Library, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jfh Kupper
- Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - A Timen
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
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Varkey RS, Joy J, Sarmah G, Panda PK. Socioeconomic determinants of COVID-19 in Asian countries: An empirical analysis. JOURNAL OF PUBLIC AFFAIRS 2021; 21:e2532. [PMID: 33173444 PMCID: PMC7645920 DOI: 10.1002/pa.2532] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 10/07/2020] [Indexed: 05/07/2023]
Abstract
The spread of coronavirus disease, 2019, has affected several countries in the world including Asian countries. The occurrences of COVID infections are uneven across countries and the same is determined by socioeconomic situations prevailing in the countries besides the preparedness and management. The paper is an attempt to empirically examine the socioeconomic determinants of the occurrence of COVID in Asian countries considering the data as of June 18, 2020, for 42 Asian countries. A multiple regression analysis in a cross-sectional framework is specified and ordinary least square (OLS) technique with heteroscedasticity corrected robust standard error is employed to obtain regression coefficients. Explanatory variables that are highly collinear have been dropped from the analysis. The findings of the study show a positive significant association of per capita gross national income and net migration with the incidence of total COVID-19 cases and daily new cases. The size of net migration emerged to be a potential factor and positive in determining the total and new cases of COVID. Social capital as measured by voters' turnout ratio (VTR) in order to indicate the people's participation is found to be significant and negative for daily new cases per million population. People's participation has played a very important role in checking the incidence of COVID cases and its spread. In alternate models, countries having high incidence of poverty are also having higher cases of COVID. Though the countries having higher percentage of aged populations are more prone to be affected by the spread of virus, but the sign of the coefficient of this variable for Asian country is not in the expected line. Previous year health expenditure and diabetic prevalence rate are not significant in the analysis. Therefore, people-centric plan and making people more participatory and responsive in adhering to the social distancing norms in public and workplace and adopting preventive measures need to be focused on COVID management strategies. The countries having larger net migration and poverty ratio need to evolve comprehensive and inclusive strategies for testing, tracing, and massive awareness for sanitary practices, social distancing, and following government regulation for management of COVID-19, besides appropriate food security measures and free provision of sanitary kits for vulnerable section.
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Affiliation(s)
- Rittu S. Varkey
- Department of EconomicsCHRIST (Deemed to be University)BengaluruIndia
| | - Justin Joy
- Department of EconomicsCHRIST (Deemed to be University)BengaluruIndia
| | - Gargee Sarmah
- Department of EconomicsCentral University of Tamil NaduThiruvarurIndia
| | - Prasant K. Panda
- Department of EconomicsCentral University of Tamil NaduThiruvarurIndia
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Lauwerier E, Willems S, Verloigne M. Health Equity in Times of a Pandemic: A Plea for a Participatory Systems Approach in Public Health. Front Public Health 2021; 9:689237. [PMID: 34778163 PMCID: PMC8586000 DOI: 10.3389/fpubh.2021.689237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Emelien Lauwerier
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sara Willems
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maïté Verloigne
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Caperon L, Arakelyan S, Innocenti C, Ager A. Identifying opportunities to engage communities with social mobilisation activities to tackle NCDs in El Salvador in the context of the global COVID-19 pandemic. Int J Equity Health 2021; 20:222. [PMID: 34627271 PMCID: PMC8501926 DOI: 10.1186/s12939-021-01559-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social mobilisation is potentially a key tool in the prevention of non-communicable diseases (NCDs) in fragile settings. This formative study addressed existing and potential social mobilisation mechanisms seeking behaviour to tackle NCDs in El Salvador, with an emphasis on the implications in the context of the current COVID-19 pandemic. METHODS We conducted 19 semi-structured interviews with health workers, government officials, NGO leaders, and community members. Interviews addressed mechanisms for social mobilisation which existed prior to COVID-19, the ways in which these mechanisms tackled NCDs, the impact of COVID-19 on social mobilisation activities and new, emerging mechanisms for social mobilisation in the wake of the COVID-19 pandemic. RESULTS Findings indicate a growing awareness of NCDs within communities, with social mobilisation activities seen as valuable in tackling NCDs. However, major barriers to NCD prevention and treatment provision remain, with COVID-19 constraining many possible social mobilisation activities, leaving NCD patients with less support. Factors linked with effective social mobilisation of communities for NCD prevention included strong engagement of community health teams within community structures and the delivery of NCD prevention and management messages through community meetings with trusted health professionals or community members. There are gender differences in the experience of NCDs and women were generally more engaged with social mobilisation activities than men. In the context of COVID-19, traditional forms of social mobilisation were challenged, and new, virtual forms emerged. However, these new forms of engagement did not benefit all, especially those in hard-to-reach rural areas. In these contexts, specific traditional forms of mobilisation such as through radio (where possible) and trusted community leaders - became increasingly important. CONCLUSIONS New mechanisms of fostering social mobilisation include virtual connectors such as mobile phones, which enable mobilisation through platforms such as WhatsApp, Facebook and Twitter. However, traditional forms of social mobilisation hold value for those without access to such technology. Therefore, a combination of new and traditional mechanisms for social mobilisation hold potential for the future development of social mobilisation strategies in El Salvador and, as appropriate, in other fragile health contexts.
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Affiliation(s)
- Lizzie Caperon
- Research Unit on Health in Situations of Fragility, Institute for Global Health & Development, Queen Margaret University, Edinburgh, UK.
| | - Stella Arakelyan
- Research Unit on Health in Situations of Fragility, Institute for Global Health & Development, Queen Margaret University, Edinburgh, UK
| | | | - Alastair Ager
- Research Unit on Health in Situations of Fragility, Institute for Global Health & Development, Queen Margaret University, Edinburgh, UK
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Brandt AJ, Katalenich B, Seal DW. Qualitative Review of Organizational Responses to Rumors in the 2014-2016 Ebola Virus Disease Outbreak in Liberia and Sierra Leone. GLOBAL HEALTH: SCIENCE AND PRACTICE 2021; 9:654-667. [PMID: 34593588 PMCID: PMC8514024 DOI: 10.9745/ghsp-d-21-00203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022]
Abstract
Rumors and misinformation were a challenge in the 2014–2016 Ebola Virus Disease response and continue to be so in the current COVID-19 pandemic. It is important to understand previous organizational approaches to identifying and addressing rumors to refine and improve these approaches. Introduction: Rumors and misperceptions were a persistent challenge in the response to the 2014–2016 Ebola Virus Disease (EVD) outbreak in West Africa. This study aimed to document organizational approaches to identifying and addressing rumors and provide practical recommendations for future outbreaks. Methods: We conducted semistructured interviews with 34 individuals who participated in the EVD response in Liberia and/or Sierra Leone. Interviews focused on the general organizational approach and organizational response to specific rumors. Interviews were recorded and transcribed verbatim. Results: Most respondents reported that rumors were considered an organizational priority and their importance increased over time. Formal rumor identification systems using community-level reporters were described in Liberia and Sierra Leone as well as varied informal systems. A wide range of approaches was used to address rumors including Community Led Ebola Action, Community Led Total Sanitation, drama performances, Ebola Treatment Center/Unit-based approaches, radio, leveraging community leaders as an information source, and organization change. Interpersonal and community-led approaches were described most often. Staff whose professional roles did not involve rumor management reported informally addressing rumors with colleagues and beneficiaries. Rumors reflecting valid concerns with the EVD response, such as potential infection in health care facilities, were addressed through organizational change and improvement. Discussion: Interpersonal and community-led approaches were considered effective by participants and hold promise for future outbreaks. Informal systems developed at Ebola Treatment Centers/Units highlighted how these facilities may be utilized as an information hub. Professionals who interact with beneficiaries, especially local staff, are likely to address rumors informally and organizations may benefit from considering local staff an asset in rumor management. Rumors alerted responders to issues in the EVD response, but this may not be the most efficient mechanism to receive and address concerns.
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Affiliation(s)
- Amelia J Brandt
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.,Center for Salud/Health & Opportunities for Latinos, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bonnie Katalenich
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - David W Seal
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
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Wang X, Yang Z, Xin Z, Wu Y, Qi S. Community identity profiles and COVID-19-related community participation. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2021; 32:398-410. [PMID: 34898963 PMCID: PMC8653172 DOI: 10.1002/casp.2568] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/11/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023]
Abstract
Prior studies have revealed that community identity promotes participation. However, it remains unclear whether heterogenous community identity profiles emerged and how they differed in coronavirus disease 2019 (COVID‐19)‐related community participation. Thus, the current study used a person‐oriented approach to address these issues. A total of 1,083 Chinese residents participated in a national online survey in mid‐March 2020. A latent profile analysis found that residents belonged in one of four community identity profiles: Strong identifiers (43.7%), function‐dominant identifiers (25.0%), emotion‐dominant identifiers (19.8%) and weak identifiers (11.5%). The strong identifiers profile showed the most positive COVID‐19‐related community management attitude and the highest participation intention and participation behaviour among the four profiles. Compared with strong identifiers, other profiles displayed less positive management attitude and lower participation intention and, in turn, exhibited less participation behaviour. The findings can help community organizers and administrators design intervention programs targeting specific subgroups amid the COVID‐19 pandemic. Please refer to the Supplementary Materials section to find this article's Community and Social Impact Statement.
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Affiliation(s)
- Xiangkun Wang
- School of Psychology, Inner Mongolia Normal UniversityHohhotChina
| | - Zhixu Yang
- School of Economics, Central University of Finance and EconomicsBeijingChina
| | - Ziqiang Xin
- Department of Psychology, Renmin University of ChinaBeijingChina
| | - Yuntena Wu
- School of Psychology, Inner Mongolia Normal UniversityHohhotChina
| | - Shisan Qi
- School of Psychology, Inner Mongolia Normal UniversityHohhotChina
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Siregar KN, Kurniawan R, BaharuddinNur RJ, Nuridzin DZ, Handayani Y, Retnowati, Rohjayanti, Halim L. Potentials of community-based early detection of cardiovascular disease risk during the COVID-19 pandemic. BMC Public Health 2021; 21:1308. [PMID: 34217235 PMCID: PMC8254668 DOI: 10.1186/s12889-021-11384-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/24/2021] [Indexed: 12/01/2022] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) pandemic has led to a significant decline in Non Communicable Diseases (NCD) screening and early detection activities, especially Cardiovascular Disease (CVD). This study aims to assess the potential of community-based self-screening of CVD risk through the mhealth application. Methods This is operational research by actively involving the community to carry out self-screening through the mHealth application. Community health workers were recruited as facilitators who encourage the community to carry out self-screening. To evaluate the potential of community-based self-screening of CVD risk, we use several indicators: responses rate, level of CVD risk, and community acceptance. Results Of the 846 individuals reached by the cadres, 53% or 442 individuals carried out self-screening. Based on the results of self-screening of CVD risk, it is known that around 21.3% are at high risk of developing CVD in the next 10 years. The results of the evaluation of semi-structured questions showed that about 48% of the people had positive impressions, 22% assessed that this self-screening could increase awareness and was informative, 3% suggested improvements to self-screening tools. Conclusion Cadres play an important role in reaching and facilitating the community in their environment to remain aware of their health conditions by conducting self-screening of CVD risk. The availability of the mHealth application that the public can easily access can simplify CVD risk prediction and expand screening coverage, especially during the COVID-19 pandemic, where there are social restrictions policies and community activities.
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Affiliation(s)
- Kemal Nazarudin Siregar
- Department of Biostatistics and Population Studies, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia. .,Health Informatics Research Cluster, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia.
| | - Rico Kurniawan
- Department of Biostatistics and Population Studies, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Ryza Jazid BaharuddinNur
- Research Center of Biostatistics and Health Informatics, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Dion Zein Nuridzin
- Research Center of Biostatistics and Health Informatics, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Yolanda Handayani
- Health Informatics Research Cluster, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Retnowati
- Research Center of Biostatistics and Health Informatics, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Rohjayanti
- Head of Section of NCD Control Program, District Health Office, Bogor District, Indonesia
| | - Lindawati Halim
- Coordinator of Health Centers, Babakan Madang Sub-district, Bogor District, Indonesia
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44
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Murta FLG, Marques LLG, Santos APC, Batista TSB, Mendes MO, Silva ED, Neto AVS, Fabiano M, Rodovalho SR, Monteiro WM, Lacerda MVG. Perceptions about malaria among Brazilian gold miners in an Amazonian border area: perspectives for malaria elimination strategies. Malar J 2021; 20:286. [PMID: 34174880 PMCID: PMC8236171 DOI: 10.1186/s12936-021-03820-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/15/2021] [Indexed: 12/03/2022] Open
Abstract
Background Mining in the Amazon exposes gold miners to various diseases, including malaria, whose control is still a major challenge. The environment of the mines contributes to the proliferation of vector mosquitoes and the precarious housing conditions facilitate transmission of the disease. Understanding gold miners’ perceptions is essential for the formulation of strategies to fight malaria. A qualitative study was carried out in the municipality of Calçoene, state of Amapá, Brazilian Amazon adjointining the municipality of Oiapoque, that is in the border area with French Guiana and Suriname. Methods A semi-structured interview was applied to an intentional sample of 29 miners, a number determined by the theoretical saturation criterion. Thematic analysis was adopted to obtain the results and the Cohen's Kappa index was calculated to verify the agreement between observers during coding. Results The agreement between observers was verified by a Cohen's Kappa index of 0.82. Analysis of the interviews showed that gold miners were subjected to prejudice from the community due to forest diseases that they can transmit, and their activities are often associated with crime. When the miners return to their hometown after a period of mining, the urban population blames them for the onset of diseases such as malaria. Most participants in the survey did not know how malaria transmission occurs, and associated its occurrence with contaminated water and food. Participants reported not being afraid of the disease, trusting the diagnosis and available treatment, though this depends on where they are treated. The use of therapeutic resources, such as medicinal plants and medicines acquired in the illegal market, is very common in this population. Despite the challenges identified by the research subjects, they believe that the disease can be controlled, or the cases reduced, but there was low acceptability for a possible mass drug administration (MDA) intervention. Conclusion Despite a recent reduction in malaria prevalence in Brazil, there are still vulnerable populations, such as gold miners, who help to perpetuate the existence of the disease in the Amazon. The lack of knowledge regarding how the transmission of malaria occurs, associated with myths regarding this and the use of traditional health practices and illegal drugs for the treatment of the disease without a specific diagnosis, jeopardizes the country’s efforts to eliminate malaria. It is necessary to implement control programmes in these populations, especially those who frequently travel around the border region and to remote locations, which are difficult regions for health teams to access, thus hindering diagnostic and treatment actions. For this reason, understanding the perceptions of these individuals as well as their customs, beliefs and lifestyle, can assist in the production of targeted educational material and adoption of strategies in the elimination of malaria in the country. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03820-0.
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Affiliation(s)
- Felipe L G Murta
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil. .,Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil.
| | - Leonardo L G Marques
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Alicia P C Santos
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Talita S B Batista
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Maxwell O Mendes
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Elair D Silva
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Alexandre V S Neto
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil
| | - Marcio Fabiano
- Fundação Para o Desenvolvimento Científico e Tecnológico em Saúde, Rio de Janeiro, Brazil
| | - Sheila R Rodovalho
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil.,Pan American Health Organization - PAHO, World Health Organization, Brasilia, Brazil
| | - Wuelton M Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil
| | - Marcus V G Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Brazil.,Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil.,Fundação Oswaldo Cruz, Instituto Leônidas e Maria Deane (FIOCRUZ-Amazonas), Manaus, Brazil
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45
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Walker BF, Adukwu EC. The 2013-2016 Ebola epidemic: evaluating communication strategies between two affected countries in West Africa. Eur J Public Health 2021; 30:118-124. [PMID: 31177274 DOI: 10.1093/eurpub/ckz104] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ebola is a haemorrhagic disease with high fatality rates between 25 and 90%. The 2013-16 Ebola outbreak in West Africa was the largest to date with >28 000 cases and >11 000 fatalities. This outbreak exposed inadequacies in public health agencies and has spurred health officials to re-evaluate the way Ebola virus disease (EVD) epidemics are co-ordinated and communicated. METHODS This project compares, using the systematic review method, differences in the communication of EVD in Nigeria and Liberia with data from selected articles analyzed using thematic analysis. RESULTS The most successful communication strategies were community engagement and targeted health-communication to the most at-risk groups. We also highlight the importance of a multi-modal strategy to effectively communicate prevention and management of EVD to affected communities. Secondary to these findings included the relevance of the media, particularly social media tools in managing such serious outbreak situations. CONCLUSION This study provides the basis for the development of a theory-based framework to effectively communicate EVD and reduce the negative outcomes observed during the 2013-16 EVD outbreak.
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Affiliation(s)
- Brodie F Walker
- Department of Applied Science and Centre for Research in Biosciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Emmanuel C Adukwu
- Department of Applied Science and Centre for Research in Biosciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Bedson J, Jalloh MF, Pedi D, Bah S, Owen K, Oniba A, Sangarie M, Fofanah JS, Jalloh MB, Sengeh P, Skrip L, Althouse BM, Hébert-Dufresne L. Community engagement in outbreak response: lessons from the 2014-2016 Ebola outbreak in Sierra Leone. BMJ Glob Health 2021; 5:bmjgh-2019-002145. [PMID: 32830128 PMCID: PMC7445350 DOI: 10.1136/bmjgh-2019-002145] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 12/05/2022] Open
Abstract
Documentation of structured community engagement initiatives and real-time monitoring of community engagement activities during large-scale epidemics is limited. To inform such initiatives, this paper analyses the Community Led Ebola Action (CLEA) approach implemented through the Social Mobilization Action Consortium (SMAC) during the 2014–2016 Ebola epidemic in Sierra Leone. The SMAC initiative consisted of a network of 2466 community mobilisers, >6000 religious leaders and 42 local radio stations across all 14 districts of Sierra Leone. Community mobilisers were active in nearly 70% of all communities across the country using the CLEA approach to facilitate community analysis, trigger collective action planning and maintain community action plans over time. CLEA was complemented by interactive radio programming and intensified religious leader engagement. Community mobilisers trained in the CLEA approach used participatory methods, comprised of an initial community ‘triggering’ event, action plan development and weekly follow-ups to monitor progress on identified action items. Mobilisers collected operational and behavioural data on a weekly basis as part of CLEA. We conducted a retrospective analysis of >50 000 weekly reports from approximately 12 000 communities from December 2014 to September 2015. The data showed that 100% of the communities that were engaged had one or more action plans in place. Out of the 63 110 cumulative action points monitored by community mobilisers, 92% were marked as ‘in-progress’ (85%) or ‘achieved’ (7%) within 9 months. A qualitative examination of action points revealed that the in-progress status was indicative of the long-term sustainability of most action points (eg, continuous monitoring of visitors into the community) versus one-off action items that were marked as achieved (eg, initial installation of handwashing station). Analysis of behavioural outcomes of the intervention indicate an increase over time in the fraction of reported safe burials and fraction of reported cases referred for medical care within 24 hours of symptom onset in the communities that were engaged. Through CLEA, we have demonstrated how large-scale, coordinated community engagement interventions can be achieved and monitored in real-time during future Ebola epidemics and other similar epidemics. The SMAC initiative provides a practical model for the design, implementation and monitoring of community engagement, integration and coordination of community engagement interventions with other health emergency response pillars, and adaptive strategies for large-scale community-based operational data collection.
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Affiliation(s)
- Jamie Bedson
- Restless Development Sierra Leone, Freetown, Sierra Leone.,Consultant to the Bill and Melinda Gates Foundation, Seattle, Washington, USA
| | | | - Danielle Pedi
- Bill and Melinda Gates Foundation, Seattle, Washington, USA
| | - Saiku Bah
- Restless Development Sierra Leone, Freetown, Sierra Leone
| | | | | | | | | | | | | | - Laura Skrip
- Epidemiology, Institute for Disease Modeling, Bellevue, Washington, USA
| | - Benjamin M Althouse
- Epidemiology, Institute for Disease Modeling, Bellevue, Washington, USA .,Information School, University of Washington, Seattle, Washington, USA.,Biology, New Mexico State University, Las Cruces, NM, United States
| | - Laurent Hébert-Dufresne
- Vermont Complex Systems Center, University of Vermont, Burlington, Vermont, USA.,Computer Science, University of Vermont, Burlington, Vermont, USA
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47
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Jalloh MF, Sengeh P, James N, Bah S, Jalloh MB, Owen K, Pratt SA, Oniba A, Sangarie M, Sesay S, Bedson J. Integrated digital system for community engagement and community-based surveillance during the 2014-2016 Ebola outbreak in Sierra Leone: lessons for future health emergencies. BMJ Glob Health 2021; 5:bmjgh-2020-003936. [PMID: 33355270 PMCID: PMC7757454 DOI: 10.1136/bmjgh-2020-003936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 11/04/2022] Open
Abstract
Community engagement and community-based surveillance are essential components of responding to infectious disease outbreaks, but real-time data reporting remains a challenge. In the 2014-2016 Ebola outbreak in Sierra Leone, the Social Mobilisation Action Consortium was formed to scale-up structured, data-driven community engagement. The consortium became operational across all 14 districts and supported an expansive network of 2500 community mobilisers, 6000 faith leaders and 42 partner radio stations. The benefit of a more agile digital reporting system became apparent within few months of implementing paper-based reporting given the need to rapidly use the data to inform the fast-evolving epidemic. In this paper, we aim to document the design, deployment and implementation of a digital reporting system used in six high transmission districts. We highlight lessons learnt from our experience in scaling up the digital reporting system during an unprecedented public health crisis. The lessons learnt from our experience in Sierra Leone have important implications for designing and implementing similar digital reporting systems for community engagement and community-based surveillance during public health emergencies.
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Affiliation(s)
- Mohamed F Jalloh
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden .,Focus 1000, Freetown, Sierra Leone
| | | | | | - Saiku Bah
- Restless Development Sierra Leone, Freetown, Sierra Leone
| | | | | | | | | | | | - Samuel Sesay
- Health Education Division, Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
| | - Jamie Bedson
- Restless Development Sierra Leone, Freetown, Sierra Leone
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48
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How To Prepare for the Unexpected: a Public Health Laboratory Response. Clin Microbiol Rev 2021; 34:34/3/e00183-20. [PMID: 33980686 PMCID: PMC8142518 DOI: 10.1128/cmr.00183-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Public health laboratories (PHLs) continue to face internal and external challenges to their abilities to provide successful, timely responses to public health crises and emerging threats. These laboratories are mandated to maintain the health of their communities by identifying, diagnosing, and warning constituents of potential and real health emergencies. Public health laboratories (PHLs) continue to face internal and external challenges to their abilities to provide successful, timely responses to public health crises and emerging threats. These laboratories are mandated to maintain the health of their communities by identifying, diagnosing, and warning constituents of potential and real health emergencies. Due to the changing characteristics of public health threats and their cross-jurisdictional nature, laboratories are facing increased pressure to ensure that they respond in a consistent and coordinated manner. Here, the Association of Public Health Laboratories (APHL) Emerging Leader Program Cohort 11 members have compiled stories from subject matter experts (SMEs) at PHLs with direct involvement in crises to determine the characteristics of a successful response. Experts examined a diverse selection of emerging threats from across PHLs, including infectious diseases, opioids, natural disasters, and government shutdowns. While no public health crisis will be identical to another, overarching themes were consistent across subjects. Experiences from SMEs that could improve future responses to emerging threats are highlighted.
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49
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Chiam AL, Cheng NWI, Larson H. Community engagement for outbreak preparedness and response in high-income settings: A systematic review. Glob Public Health 2021; 17:1113-1135. [PMID: 33938368 DOI: 10.1080/17441692.2021.1919734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND This review aims to (i) identify and critique existing methods of community engagement for outbreak preparedness and response in high-income settings, and (ii) understand community members' experiences of community engagement, and their views and concerns towards pandemic planning/response. METHODS Following the PRISMA guidelines, a systematic review was conducted by searching Medline, Embase, PubMed, Global Health, CINAHL Plus and Scopus for publications from 2004 to June 2019. Potential literature was screened using explicit inclusion and exclusion criteria. Included studies were appraised using the Critical Appraisal Skills Programme Qualitative Research checklist. Those using deliberative approaches were appraised using additional criteria for judging deliberation quality. Thematic synthesis was then conducted. RESULTS Primary studies employed participatory research approaches, deliberative forums, interviews/focus groups to engage community members on pandemic planning/response with varying degrees of involvement and methodological rigour. This review indicates such endeavours must take into account instrumental and relational considerations: socioeconomic pressures; agency and capacity; diversity and divergent views; educate, communicate and engage; trust and transparency. CONCLUSION Community engagement for pandemic planning/response requires clear methods, processes and who 'community' constitutes. Instrumental and relational considerations must be addressed concurrently in pandemic planning/response to enhance preparedness for public health emergencies.
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Affiliation(s)
| | | | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK
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50
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Cordie A, AbdAllah M, Vergori A, Kharono B, Karkouri M, Esmat G. Human immunodeficiency virus (HIV) and coronavirus disease 2019; impact on vulnerable populations and harnessing lessons learnt from HIV programmes. New Microbes New Infect 2021; 41:100857. [PMID: 33680476 PMCID: PMC7912358 DOI: 10.1016/j.nmni.2021.100857] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 02/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) can act as a dual prong attack against management of people living with human immunodeficiency virus (HIV); it induces harm on both individual and national levels. People living with HIV may show rapid deterioration in severe acute respiratory syndrome coronavirus 2 infection as a result of physiological or psychological vulnerability. Additionally, the spread of COVID-19-especially in low- and middle-income countries-may limit HIV control measures, delivery and linkage to HIV care and prevention. Attention should be given to pregnant women and the LGBTQI+ community for their higher susceptibility to poor outcomes. Engagement of both governmental and non-governmental organizations is encouraged for better results.
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Affiliation(s)
- A. Cordie
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - M. AbdAllah
- Medical Research Division, National Research Centre, Giza, Egypt
| | - A. Vergori
- HIV/AIDS Unit, National Institute for Infectious Diseases L.Spallanzani, IRCCS, Rome, Italy
| | - B. Kharono
- University of Washington, Seattle, WA, USA
| | - M. Karkouri
- Association de Lutte Contre le Sida/Coalition Plus, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Morocco
| | - G. Esmat
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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