Social mobilization: communicating with affected communities

Transcription

1 Short Course on Infectious Diseases in Humanitarian Emergencies LSHTM-WHO 3 April 2009 Social mobilization: communicating with affected communities Norma Johnston

2 Session outline An overview of social mobilization and communities :15 Role play Feedback and discussion

3 Overview 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

4 1. What is social mobilization?

5 Social 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

6 Social mobilization evolved WHO's approach: Communication-for-Behavioural-Impact (COMBI) 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

7 Different levels of communications Intrapersonal Interpersonal Group Organizational Societal Global

8 2. What is the relevance of social mobilization in an outbreak response?

9 The 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

10 The context is critical 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

11 Where does social mobilization fit into rapid response? Exists as a distinct communications response strategy Supports and integrates all other aspects of rapid response Organizes and guides information dissemination Communications Logistics Security Case management Infection control Co-ordination ordination and CONTAINMENT Management COMMUNICATIONS Surveillance Laboratory investigation

12 Effective 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

13 Communications cannot Resolve existing political, technical, administrative and institutional problems

14 3. What are key principles and concepts that underpin effective social mobilization?

15 Role 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

16 Introducing Health worker: Parents: Religious leader: Village leader: Within your your group identify 1 rapporteur and and 1 observer to to feedback to to the the plenary

17 The disease Shonky viral haemorrhagic fever Incubation period 2-21 days Transmitted by direct contact with the blood, secretions, organs or other bodily fluids of infected persons Symptoms 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

18 The usual response Messages Leaflets Posters T-shirts Radio spots TV adverts Content? Do we need them? For what purpose? How are they going to be used? What will they contribute to control efforts? Communications Communications must must contribute contribute to to achieving achieving the the public public health health goal goal

19 Anthropological research

20 Perceptions Beliefs Behaviour Anthropological research Information Family and society Tools Ethnography Observation Segmentation Sources of information Socio-economic status Politics Culture Education Number-of-Steps-Away from Analysis Top-of-the-mind Analysis Day-In-the-Life-Of Analysis Behaviour and communication models

21 Communications theory Message Source Channel Receiver Effect Feedback Setting

22 3 Important communication factors Trust Credibility Empathy

23 The 3 pains of communication 1. Selective attention 2. Selective perception 3. Selective retention

24 The three pains 1. Selective attention attention wanders attention wanders

25 The three pains 2. Selective perception

26 The three pains 2. Selective perception

27 The three pains The three pains 2. Selective perception

28 The three pains 2. Selective perception

29 The three pains 3. Selective retention

30 The 3 COMBI principles 1. Identify key, specific behavioural objectives 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

31 There is no single magic bullet

32 The five integrated action areas 1. Administrative Mobilization/Public Relations/Advocacy 5. Point-of-Service Promotion 2. Community Mobilization 4. Advertising 3. Personal selling/ Interpersonal communication Multiple channels and multiple levels

33 Community perceptions Not convinced it was Ebola No cure no point in treatment Fear of isolation Inappropriate prevention measures Evil eye Blood samples sold

34 Promotional materials Banners Leaflets Social Mobilization Team T-shirts

35 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

36 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

37 Weaknesses Anticipation of traditional responses to crisis (eg witchcraft) 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

38 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

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