Using Multiple Risk Communication Interventions to increase risk perception and positive behavioral change towards Ebola Virus Disease: lessons from Western Region, Uganda.

Summary:

Uganda is still at high risk of Ebola Virus Disease (EVD) importation through seven boarderline Districts of; Kasese, Bunyangabu, Ntoroko, Kabarole, Bundibugyo, Kisoro and Kanungu compared to countries neigbouring DRCongo (DRC). Multitudes of Congolese still access Uganda through porous boarders which exposes Ugandan population to a great risk. EVD outbreak remains uncontained in DR Congo, where 3,274 EVD cases identified, of which 3,157 were confirmed and 2,185 deaths (2,068 confirmed and 114 probable). USAID/Communication for Health Communities (CHC) working adopted a multiple risk communication interventions to increase public alertness, vigilance enhance positive protective behavior in response to DRC situation. CHC together with District Risk Communication subcommittee, oriented over 5,390 people to establish risk communication structures at all district levels; 102 sub counties and 432 parishes to implement risk communication strategy, support surveillance and contact tracing, monitor community engagement and rumor management.

Background/Objectives

Uganda is still at high risk of Ebola Virus Disease (EVD) importation through seven boarderline Districts of; Kasese, Bunyangabu, Ntoroko, Kabarole, Bundibugyo, Kisoro and Kanungu compared to countries neigbouring DRCongo (DRC). Multitudes of Congolese still access Uganda through porous boarders which exposes Ugandan population to a great risk. EVD outbreak remains uncontained in DR Congo, where 3,274 EVD cases identified, of which 3,157 were confirmed and 2,185 deaths (2,068 confirmed and 114 probable). USAID/Communication for Health Communities (CHC) working adopted a multiple risk communication interventions to increase public alertness, vigilance enhance positive protective behavior in response to DRC situation.

Description Of Intervention And/or Methods/Design

Between November 2018 to August 2019, CHC twinned Risk communication agents with community champions who conducted EVD material dissemination, community dialogues, home visits, one-on-one and small group discussions. Community drives and film shows using Rigs trucks were done in 5 districts exposing people to EVD facts. Also drama groups were utilized during market days for edutainment highlighting how to detect, prevent and mitigate EVD. 28 RCAs and 1,000 Community champions, 437 teachers were equipped with Risk communication skills and EVD materials to help them generate discussions, demystify myths, address social and cultural norms and encourage referral of suspected cases to nearby health facilities.
 CHC together with District Risk Communication subcommittee, oriented over 5,390 people to establish risk communication structures at all district levels; 102 sub counties and 432 parishes to implement risk communication strategy, support surveillance and contact tracing, monitor community engagement and rumor management.

Results/Lessons Learned

Project data shows that, through multiple risk communication interventions of structure involvement, interpersonal engagements, home visits, community dialogues and opinion leadersду» meaningful participation. A total of 29,701 (14,535M, 15,166F) have been reached in 5 districts of Bundibugyo 8,704 (4,049M, 4,655F), Bunyangabu 5150 (2,706M, 2,444F), Kabarole 7,327 (3,322M, 4,005F), Kasese 23,631 (11,624M, 12,007F), Ntoroko 5,854 (3,145M, 2,709F) 
 During EVD Response interventions with multiple stakeholders involvement, Risk Communication Agents and Community structures reached 18,208 (8,720M, 9,488F) with EVD messages through community engagements (one on one (173M, 256F), small group discussions (830M, 956F), schools (7,243M, 7,783F), home visits (252M, 426F) community dialogue with uniformed men (222M, 67F), Disseminated 198 Ebola posters and community drives were conducted exposing over 65,000 people.
 Established risk communication structures streamlined the co-ordination and community led aspect leading to consistent feedback mechanisms, effective rumor tracking and timely response of challenges, meaningful community engagements and ownership at community levels.

Discussion/Implications For The Field

A frank discussion will bring key areas of clarification about these disciplines. Active debate and questions from the audience will uncover strengths and weaknesses of different methods, and insights around how disciplines can be integrated into SBCC programming. Our hope is that this will drive more thoughtful and pragmatic integration of such approaches in the coming years, with a greater body of evidence and learning for how new disciplines can bolster programming for greater impact.

Abstract submitted by:

Adanma Abalunam - The Busara Center for Behavioral Economics

Chaning Jang - The Busara Center for Behavioral Economics

Chris Larkin - IDEO

Jana Smith - Ideas42

Sema Sgaier - Surgo Foundation

Archna Vyas - Bill & Melinda Gates Foundation