short course on infectious diseases in humanitarian ... · they inform social mobilization and...
TRANSCRIPT
Social Social mobilization:mobilization: communicating communicating
with affected communitieswith affected communities
Norma Johnston
Short Course on Infectious Diseases in Humanitarian Emergencies
LSHTM-WHO 3 April 2009
09.00 – 09.30 An overview of social mobilization and communities
09.30 – 10:15 Role play
10.15 – 10.45 Feedback and discussion
Session outlineSession outline
1. What is social mobilization?
2. What is the relevance of social
mobilization for outbreak control?
3. What are key principles and concepts
that underpin effective social
mobilization?
4. Introduction to case study/role play
OverviewOverview
1. What is social mobilization?1. What is social mobilization?1. What is social mobilization?
Social mobilizationSocial mobilization
Social mobilization is the task of mobilizing all societal and personal influences on an
individual and family to prompt individual and family action
with respect to specific healthy behaviours
COMBI differs from traditional social mobilization in two ways
– Concerned with reducing the burden of a disease
– Concerned with achieving behavioural impact through researching and communicating specific messages to specific target audiences
Social mobilization evolvedSocial mobilization evolved……WHO's approach: Communication-for-Behavioural-Impact (COMBI)
Different levels of communicationsDifferent levels of communications
Intrapersonal
Interpersonal
Group
Organizational
Societal
Global
2. What is the relevance of social mobilization in an outbreak response?
2. What is the relevance of social 2. What is the relevance of social
mobilization in an outbreak response?mobilization in an outbreak response?
The value of social mobilizationThe value of social mobilization
Organizes and promotes the behavioural responses of a broad range of individuals and institutions ranging from behaviours of individuals affected by or at risk of the outbreak to the behaviours of a host of others
– Supports ground personnel
– Provides information
– Raises a call to action
Outbreaks happen within existing social, cultural, political and economic settings
Success is dependent on the active participation of affected communities in control measures
More than just providing information and "sensitising" communities
The context is criticalThe context is critical
Where does social mobilization fit Where does social mobilization fit
into rapid response?into rapid response?
CONTAINMENT CONTAINMENT
COMMUNICATIONSCOMMUNICATIONS
CommunicationsCommunications
Logistics Logistics
SecuritySecurity
SurveillanceSurveillance
Laboratory investigationLaboratory investigation
Case managementCase management
Infection controlInfection control
CoCo--ordination ordination
and and
ManagementManagement
Exists as a distinct
communications
response strategy
Supports and
integrates all other
aspects of rapid
response
Organizes and
guides information
dissemination
Effective communications canEffective communications canEffective communications can
Help people overcome fear, anxiety and reduce feelings of vulnerability
Help people make informed decisions
Guide and inform outbreak control interventions
Save lives
Communications cannotCommunications cannot……
Resolve existing political,
technical, administrative and
institutional problems
3. What are key principles and concepts that underpin effective social mobilization?
3. What are key principles and concepts that underpin effective social mobilization?
Role PlayRole Play
Objective:– To highlight the importance of understanding the
socio-cultural context of disease outbreaks and how they inform social mobilization and communication activities
Fictitious scenario
4 groups interviewing selected members of a rural community
Explore – interpersonal communication
– key challenges for the adoption of control measures and how to overcome them
IntroducingIntroducing……
• Health worker:
• Parents:
• Religious leader:
• Village leader:
Within your group identify 1 rapporteur and 1 observer to feedback to the plenary
Within your group identify 1 rapporteur and 1 observer to feedback to the plenary
The diseaseThe diseaseShonky – viral haemorrhagic fever
Incubation period 2-21 days
Transmitted by direct contact with the blood, secretions, organs or other bodily fluids of infected personsSymptoms include sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is often followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding No specific treatment or vaccine is yet available for Shonky haemorrhagic fever
Suspected cases should be isolated from other patients and strict barrier nursing techniques implemented
Contact tracing and follow-up of people who may have been exposed to Shonky through close contact with other cases is essential
Messages…
Leaflets…
Posters…
T-shirts…
Radio spots…
TV adverts…
The usual responseThe usual response……
Content?
Do we need them?
For what purpose?
How are they going to be
used?
What will they contribute
to control efforts?
Communications must contribute to achieving the public health goalCommunications must contribute to achieving the public health goal
Anthropological researchAnthropological research
Perceptions
Beliefs
Sources of information
Behaviour
Education
Socio-economic status
Culture
Politics
Family and society
Observation
Ethnography
Behaviour and communication models
Day-In-the-Life-Of Analysis
Top-of-the-mind Analysis
Segmentation
Number-of-Steps-Away
from Analysis
Information Tools
Anthropological researchAnthropological research
Communications theoryCommunications theory
Message
Source
Channel
Receiver
Effect
Feedback
Setting
3 Important communication factors3 Important communication factors
Trust
Credibility
Empathy
The 3 pains of communicationThe 3 pains of communication
1. Selective attention
2. Selective perception
3. Selective retention
The three painsThe three pains
1. Selective attention
attention wanders attention wanders
The three painsThe three pains
2. Selective perception
The three painsThe three pains
2. Selective perception
The three painsThe three pains
2. Selective perception
The three painsThe three pains
2. Selective perception
The three painsThe three pains
3. Selective retention
The 3 COMBI principlesThe 3 COMBI principles
1. Identify key, specific behaviouralobjectives linked to prevention and control objectives
2. Conduct a market situational analysis to define the behavioural and communication objectives
3. Apply a strategic mix of communication interventions
There is no single magic bulletThere is no single magic bulletThere is no single magic bullet
The five integrated action areas
1. Administrative Mobilization/Public Relations/Advocacy
2. Community Mobilization
4. Advertising 3. Personal selling/ Interpersonal communication
5. Point-of-Service Promotion
Multiple channels and multiple levels
Community perceptions
• Not convinced it was Ebola
• No cure – no point in treatment
• Fear of isolation
• Inappropriate prevention measures
• Evil eye
• Blood samples sold
Promotional materials
Leaflets
Banners
T-shirts
Social Mobilization Team
Strategy: COMBI
� Blend of communication interventions� 1.Administrative mobilization/public advocacy• Commissioner, chiefs and church leaders made emotional appeal to reduce
personal and collective risk and addressed rumours
• 2.Community mobilization• Official meetings with chiefs, traditional healers and local communities in
areas with high number of cases
• House-to-house where possible
• Target market places and churches
• 3. Interpersonal communication/counselling• Intensify counselling/training in basic communication techniques
• Provide distinct uniforms for credibility
• Produce and distribute leaflets for compliance and credibility
• 4.Advertising
• Banners, placed in market places, schools and churches (triggers to remind people)
• Evening announcements (when people are home)
• Easily recognisable branding
Successes
• Behavioural Impact? • Were people reporting sick cases more frequently?
• Were sick people staying at home and avoiding gatherings?
• Were those looking after sick people taking precautions?
• Were those attending burials avoiding touching dead bodies?
• Programme experiences
• Having ex-Ebola patients on the team was extremely helpful in allaying
fears of the isolation ward personalising risk
• Specific and more appropriate information was being circulated
amongst communities
Weaknesses
• Anticipation of traditional responses to crisis (egwitchcraft)
• Planning of teacher’s training – missed opportunity to distribute simple leaflet encouraging active participation of school children within their families
• The influence of local hierarchies and relationships on decision-making and implementation
Future recommendations
• Credibility with communities should be
established very early. Simple signs of status
(such as badges/T-shirts/armbands) should be a
standard part of an outbreak response enabling
a visible distinction of Ebola Control Teams
• Resource list of local and available
communication expertise should be compiled eg
artists, printing companies, translators, radio
producers…