By Racheal Ninsiima
Emergency situations are often fraught with uncertainty and increased stress and strain on local communities. Lessons from previous outbreaks such as Ebola show that people feared going to health facilities for treatment because of misinformation, mistrust and misunderstanding among affected communities. Moreover, initial response efforts tended to be top down and did not take into account community traditions and beliefs; for example, mandatory cremation policies countered deeply held religious beliefs. As a result, these efforts encountered resistance, disengagement and apathy.
Today, the COVID-19 pandemic is presenting a fast-changing situation and affected countries have adopted various restrictions to try and curb the spread and ‘flatten the curve’ of infections. However, as with Ebola, responses to the pandemic have largely involved governments telling communities what to do, seemingly with minimal community input. Yet communities can identify solutions because they know what knowledge and rumours are circulating; they can provide insight into stigma and structural barriers; and they are well placed to work with others from their communities to devise collective responses.
“COVID is new and community engagement has not been tested in a contextually relevant community engagement model to improve health and social wellbeing even such drastic measures like social distancing, lock down, self-isolation and other ‘new’ social norms,” says Prof. Nelson Sewankambo, a seasoned science researcher and director of THRiVE (Training Health Researchers into Vocational Excellence in East Africa).
Therefore, strengthening community capacity in public health and health research systems is an urgent and necessary requirement if this sort of epidemic is to be prevented and controlled in the future. In order to identify the best ways to effectively engage Ugandan communities, THRiVE is going to undertake a six months study titled: ‘Owning our future through community engagement: enhancing uptake of COVID-19 prevention and mitigation measures.’
Through a baseline survey, the research seeks to describe community perceptions among vulnerable urban and peri-urban populations in Nakawa and Kawempe divisions, their behaviors towards COVID-19, understand the social-economic effects of the pandemic and assess community coping mechanisms to the new social norms.
“In the second study phase we will plan for and implement a controlled community trial to assess the impact of a community engagement risk communication (CERC) intervention in promoting acceptance and uptake of prevention and mitigation measures for COVID-19 among vulnerable populations in urban and peri-urban communities of greater Kampala,” Prof. Sewankambo explains.
The uniqueness of this study is that THRiVE will promote community participation, ownership and sustainability of the efforts at the grassroots level. This approach will empower communities to take charge of their health and development by owning and committing to the mitigation measures. It is anticipated that the study will lead attitudinal change in relation to acceptance and implementation of globally proven and recommended measures to prevent COVID-19.
This study is being funded by Makerere University’s Research Innovation Fund.