Background: The current Ebola epidemic in West Africa has presented a major public health challenge to both the affected countries and the international health community at large. Unfortunately, the bulk of previous research has centered on clinical care, transmission risks, and epidemiological tracing due to the immediacy of addressing patient needs. Minimal efforts have focused on evaluating community-based social mobilization strategies in real-time, which present a crucial aspect of breaking transmission chains and increasing awareness. This study aimed to characterize and assess the methods utilized in the current Ebola response operation by depicting the experiences and perspectives of local Guinean Red Cross (CRG) volunteers and primary response staff working on the frontline of the outbreak. Methods: The authors performed a qualitative study in Guinea, consisting of interviews and focus groups in Conakry and Guéckédou, the original outbreak epicentre and location of the primary Ebola treatment center. Additional recruitment was conducted at the International Federation of the Red Cross (IFRC) Africa Zone office in Nairobi. Study participants were identified through expert purposive and convenience sampling methods, and included: IFRC staff in Guinea, Nairobi, and Geneva; localCRGstaff and volunteers; Ministry of Health personnel; staff from other major international humanitarian partner organizations working in Guinea; and community members. Due to the immediate nature of the outbreak and time-sensitivity of response activities, only verbal informed consent was obtained. Findings: Data from 63 unique study participants, including 27 individual interviews and five separate focus groups, were analyzed. Major themes supported the effectiveness of community-based prevention strategies in community uptake of key messages. Successful approaches for targeting reticent subpopulations included enlisting support from religious leaders and village elders to secure trust from community members. Bidirectional, dynamic methods of communication were also identified as essential characteristics of behaviour change, rather than relying on static materials such as informational posters and pre-taped PSAs. Messages focusing on the lethality of disease were found to reduce essential care-seeking behaviours. Interpretation: Local Red Cross volunteers and staff are ideally placed for social mobilization efforts to prevent transmission, combat misinformation in the event of an Ebola outbreak. They often have an established relationship with community members and understand the anthropological background, which can be a challenge for incoming foreign aid workers. The community-based work of this cadre is an essential component of the response effort complementary to the clinical work. Findings and lessons learned from this research provide the groundwork for continuing response efforts, as well as for future Ebola and infectious disease outbreaks in similar international settings.
Fu, C., Roberton, T., & Burnham, G. (2015). Community-based social mobilization and communications strategies utilized in the 2014 West Africa Ebola outbreak. Annals of Global Health, 81(1), 126. https://doi.org/10.1016/j.aogh.2015.02.791