module b5 - world health organization · module objective by the end of this module, you will be...

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Community Engagement

Module B5

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Module objective

By the end of this module, you will be able to:

● Describe why community engagement is essential for effective emergency risk communication

● Describe the links between health promotion, social mobilization and community engagement, and

● List actions for community engagement

Photo: WHO/A.Bhatiasevi

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Communities MUST BE at the heart of any public health intervention, especially in emergencies

Community engagement is central to any public health intervention.

Its importance is even more significant during public health emergencies.

Community engagement involves those affected in understanding the risks they face, and involves them in response actions that are acceptable.

Photo : WHO /A Bhatiasevi

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● Social Mobilization

● Communication for Development (C4D)

● Behaviour Change Communication

● Health Education

● Health Promotion

● Community Engagement

● Outbreak communication

● Crisis communication

● Risk Communication

● Communication for Behavioural Impact

Approaches and tactics linked to community engagement


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Health promotion – health education

A set of principles involving equity and empowerment, and practices encompassing of communication, capacity building and politically oriented activities, with the goal to enable others to gain more control over the influence of their lives and to improve their health.

● Health Education aims to provide information to influence their future decision-making on their health.

● Health Promotion aims at working on the needed social and political actions (e.g. legislation, movements, etc.)

- (Laverack, 2014)

Photo : WHO /A Bhatiasevi

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Social mobilization

Social mobilization is a process that engages and motivates a wide range of partners and allies at national and local levels to raise awareness of and demand for a particular development objective through dialogue

Members of institutions, community networks, civic and religious groups and others work in a coordinated way to reach specific groups of people for dialogue with planned messages. Social mobilization seeks to facilitate change through a range of players engaged in interrelated and complementary. - UNICEF

Photo: http://unicef.in/CkEditor/ck_Uploaded_Images/img_1174.jpg

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● Community engagement is the process by which community

benefit organizations and individuals build a long term relationship

with collective vision for the benefit of the community

● It is primarily about the practice of moving communities towards a

better change through empowerment

Community engagement

Photo : WHO /A.Bhatiasevi

This presentation will focus on community engagement for risk

communication

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What we usually do for health promotion, social mobilization include…

Messages

Leaflets

Posters

T-shirts

Radio spots

TV adverts

Town criers

BUT community engagement requires much more than these


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Why community engagement?

Graphic: http://www.dse.vic.gov.au/effective-engagement/introduction-to-

engagement/what-is-community-engagement

• Everyone has a right to know about risks to their health and well-being

• Culturally appropriate

information can help make informed decisions to reduce the health risks

• Action taken by individuals,

families and communities affected are key to controlling the public health threat/problem

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Actions for community engagement

Community engagement covers a broad range of activities. Some activities undertaken by government practitioners include:

● Reaching out to / informing the community of policy directions of the government

● Consulting the community as part of a process to develop government policy, or build community awareness and understanding

● Involving the community through a range of mechanisms to ensure that issues and concerns are understood and considered as part of the decision-making process

● Collaborating with the community by developing partnerships to formulate options and provide recommendations.

● Shared leadership / empowering the community to make decisions and to implement and manage change.

Source: Victoria Government, Australia

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Modified from US Department of Health and Human Services and Victoria Government, Australia

INFORM CONSULT INVOLVE COLLABORATE SHARED

LEADERSHIP

Some community

Involvement

More community

involvement

Better community

involvement

Community

involvement

Strong relationship

Provides

community with

information

Gets information or

feedback from the

community

Involves more

participation with

community on

issues

Forms partnerships

with community on

each aspect of the

project – from

development to

solution

Strong partnership

structure is formed

Optimally

established

communication

channels and

channels for

outreach

Develops

connections

Visibility of

partnership

established with

increased

cooperation

Partnership

building, trust

building

Broader health

outcomes affecting

broader

community. Strong

bidirectional trust

built

http://www.dse.vic.gov.au/effective-engagement/introduction-to-engagement/what-is-community-engagement

http://www.atsdr.cdc.gov/communityengagement/pdf/PCE_Report_508_FINAL.pdf



















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Principles of community engagement Planning phase

● Clarify purpose/goal

● Understand the community's culture, perception, economic condition, social networks, political and power structures, norms, values, demographic trends, history, past experience

● Establish relationships, build trust, work with formal and informal leaders, seek their commitment for mobilizing the community

● Map and leverage existing community engagement mechanisms, e.g. for polio, immunization campaigns, HIV work, red cross volunteers, etc.

Photo: http://www.unicef.org/cbsc/images/UNI102880-620x350.jpg

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Principles of community engagement Implementation phase

● Partner with community to create change and improve health.

● Recognize and respect diversity; and ensure that the most vulnerable are reached and engaged.

● Identify, mobilize assets and strengths in developing the community's capacity and resources to make decisions and take action.

● Be prepared to release control of actions and interventions to the community. Be flexible to meet the changing needs.


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Challenges

● Maintaining community involvement over time

● Overcoming differences between responders, community and different influencers

● Working with unique, especially vulnerable, or hard to reach communities

● Communities and responders may not perceive risk in the same ways

● Communities have complex social dynamics and changing power relationships which influence how we engage them

Community engagement is complex, hard work requiring

expertise and dedicated resources

Image: http://blogs-images.forbes.com/steveolenski/files/2014/09/bigstock-Challenges-Road-Sign-3530978.jpg

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Know the community

● Community structure – Formal and informal

– Opinion leaders and influencers

● Community dynamics

● Power relationships

● Sources of information

● Beliefs and practices

● Available resources

● Others Photo: WHO/A Bhatiasevi

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The perception trap - 2014 Ebola in West Africa

Trap 1- Fear: Ebola = death

● Everybody who has Ebola will die

● Ebola is a curse

Trap 3- Dismissal

● Don't want to know

● Don't want to believe

● Don't want to accept

Trap 2- Disbelief due to distrust

● The authorities can't handle the situation

● The foreigners are here to extract organs for scientific experiments


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Community engagement came late in Ebola outbreak in Liberia

Retrospective analysis of the Ebola response

Response Phase 1 Phase 2 Phase 3

Predominant risk communication strategy

Crisis communications Awareness-raising, social mobilization


Rationale Past experiences of Ebola outbreaks with 90% deaths, occurs in remote settings

Ebola spread in major cities. Increased survival rates, but unsafe burials and other dangerous practices continue

Community as part of the solution. Bring back trust

Key message Ebola kills. There is no cure. Bush meat consumption spreads the disease

Ebola is real. Signs & symptoms. Hotline

Avoid contact with dead bodies. Early treatment increases survival rates. De-stigmatize survivors

Intervention Mass media, posters, radio Campaign mode. Hotline. Mass media – print, broadcast, posters, radios, town criers, loud speakers on trucks & motorbikes, volunteers for social mobilization

Interpersonal communications. Community meetings, etc. Community awareness and training. Engage influencers including religious and tribal leaders

Outcomes Denial. Perception that Ebola spreads in remote areas, No bush meat = No Ebola risk. No cure = No treatment = stay at home, die at home

Demand exceeds response capacity. Lack of confidence in response, lack of trust in the existing structures

Community influencers are part of the response. More decentralized, localized communications. Mop-up campaigns in hotspots

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Applying sociological approaches in community engagement

● Lots of documented evidence from Ebola in West Africa (2014-2015), of where anthropology and other applied social sciences played a key role in understanding communities

● Insights on socio-cultural and political contexts of affected communities to build locally acceptable interventions. Some examples include:

– Understanding myths, beliefs

– Managing rumours, misinformation

– Decoding 'fear' 'resistance' 'risky health practices', etc.

– Working on community based interventions

– Adapted safe and dignified burial rites for Muslims and Christians


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Tools for creating community discussion*

Community map Discussion groups Individual Interviews

Household and

facility observations Seasonal

calendar/event

Timeline

Community walk and

observations

Storytelling Causes and effects Emergency scenario

Bean ranking Communication

circles

Visions for action

* Source: Bringing the community together to plan for Disease Outbreaks and other Emergencies. http://www.globalhealthcommunication.org

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Reminder

● Communities must be at the heart of any public health intervention, especially during an emergency

● It is critical to know and understand communities in order to effectively work with them in all phases – preparedness-response-recovery of a health emergency

● Multiple strategies and tactics should be used to engage communities

Photo: WHO/A. Zouiten

module b5 - world health organization · module objective by the end of this module, you will be...

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