Strengthening risk communication and community engagement in disease outbreak response: a systems perspective

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Strengthening risk communication and community engagement in disease outbreak response: a systems perspective Workshop on Building Communication Capacity to Counter Infectious Disease Threats Erma Manoncourt, PhD M&D Consulting Inc. Wednesday, 14 December 2016

Lessons Learned from Ebola and Vaccine-derived Polio Virus Outbreaks ØCoordination mechanisms for risk communication ØPreparedness to detect and respond to outbreaks ØBuilding communication capacity in a limited resource environment ØBottlenecks 2

Strengthening Risk Communication Strengthening Leadership and Coordination Enhancing Technical Capacity Systematizing Technical Guidance Improving Data & Strategic Information Systems Increasing Institutional Resources

The UN Mission for Emergency Ebola Overview of the Presentation Response (UNMEER) Mission Critical Activities UN Agency Lead UNMEER Case finding & contact tracing WHO Case isolation & management Community engagement & behaviour change WHO, WFP & UNICEF UNICEF Coordination & Crisis Management Safe Burials ICRC

Strengthening Risk Communication Strengthening Leadership and Coordination Ebola - Social Mobilization & Community Engagement Pillar Global Polio Eradication Initiative (GPEI) Partnership

EBOLA SOCIAL MOBILIZATION /COMMUNITY ENGAGEMENT Pillar Chair: MOH Co-chair: UNICEF Partners UN Agencies NGOs/Civil Society Government Ministries DISTRICT Superintendent (Chair) CBOs, NGOs, UN, Community Radio Religious Leaders Neighborhood Watch Traditional/ Local Leaders Health Workers Teachers Family

GPEI Partnership National Government + WHO Rotary International Centers for Disease Control UNICEF Bill & Melinda Gates Foundation UN & other private Foundations Development banks EU & donor government Humanitarian & NGOs (i.e. Red Cross/Crescent) Corporate partners In-country volunteers

Strengthening Risk Communication Enhancing Technical Capacity Surge Capacity Mechanisms Academic Corporate Partnerships Systematizing Technical Guidance National Comprehensive Capacity Development Plan Frontline workers Supervisors & Managers Policy/Decision-Makers

Train, Motivate and Empower Frontline Workers

Strengthening Risk Communication Clarifying the Who Ebola Response Communication/Journalist/ FLWs (Social Mobilizers) Polio Outbreak Communications /Social Mobilizers Safe Burial Teams Case Managers Immunization/Polio/ Health Officers/Managers FLWs/Vaccinators Contact Tracers

Strengthening Risk Communication Enhancing Technical Capacity Standard Operating Procedures (SOPs) & Preparedness Training Online Support Systematizing Technical Guidance Technical Advisory Group (TAG) Joint planning / programming frameworks

SOP Risk Communication Polio Outbreak Response 24 h MEDIA 72 h <14 days > 14 days MEDIA C4D C4D MEDIA C4D MEDIA Outbreak SOP briefing, Outbreak

Strengthening Risk Communication Independent Monitoring Improving Data & Strategic Information Systems Outbreak Assessment (OBRA) National Social Science/ Anthropology Researchers/ Networks Community Monitoring

2.A Chiefdom -Did you see any Miking activities today?

5. Have you heard of any secret burials today? 0 0 1.27 2.17 2.33 2.63 2.86 3.03 3.45 4.26 4.88 5.26 6.06 6.25 Kono Western Rural Western Urban (Freetown) Bombali Kambia Kailahun Bo Pujehun Koinadugu Kenema Tonkolili Port Loko Moyamba Bonthe Kambia 1/43 Bombali 1/46 Koinadugu 1/29 Port Loko 3/57 Tonkolili 2/41 Kono 0/42 Western Urban (Freetown) 1/79 Western Rural 0/33 Moyamba 2/33 Bo 1/35 Kenema 2/47 Kailahun 1/38 Bonthe 2/32 Pujehun 1/33

Strengthening Risk Communication Increasing Institutional Resources Private sector Convergence with other health-related programs/ Ministries initiatives Prepositioning w/n ongoing programmes Community in-kind/ volunteers

Strengthening Risk Communication CATCH 22 Bottlenecks Lack of consistent policy direction / guidance Topping off salaries Staff Turnover/ Demotivation Health Promotion Dept in MOH Relative power & influence w/n Government hierarchy Community volunteers

Monitoring Key Determinants of Child Deprivations MAF Determinants Definitions Policy and Planning Budget /Financing Cross cutting Enabling Environment Social Norms Widely followed social rules of behaviour Legislation/Policy Adequacy of laws and policies Budget/Expenditure Allocation & disbursement of required resources Management /Coordination Roles and Accountability/ Coordination/ Partnership Availability of Essential Commodities/Inputs Essential commodities/ inputs required to deliver a service or adopt a practice Service delivery Supply Access to Adequately Staffed Services, Facilities and Information Physical access (services, facilities, information) Service utilization Demand Financial Access Social and Cultural Practices and Beliefs Direct and indirect costs for services/practices Individual/ community beliefs, awareness, behaviors, practices, attitudes Timing & Continuity of Use Completion/continuity in service, practice Qty Quality of care Adherence to required quality standards (national or international norms)

What went well Overall Visibility, information and outreach Communication skills training of frontline staff Mobilization of change agents FBO, leaders, youth Engagement of communities Guinea 1. Mobilization of local leaders 2. Training program 3. Religious leaders highly involved 4. Media involvement Liberia 1. Partner mobilization 2. Media coverage & involvement 3. District level coordination 4. Hot spot approach Sierra Leone 1. Hot line 2. Radio 3. Outreach 4. Media 5. Evidence 6. Hot spot approach