Governments across the African continent have been urged to make Risk Communication and Community Engagement (RCCE) as well as Social Behavioural Change (SBC) a focal point in the management of public health emergencies and preparations for future pandemics by mobilising adequate financial and technical resources.
These are some of the recommendations at a side event tagged ‘Strengthening the Continental Risk Communication and Community Engagement (RCCE) and Social Behaviour Change (SBC) Architecture: Preparing Communities for the Next Pandemic’ at the 3rd International Conference on Public Health in Africa (CPHIA 2023) in Lusaka, Zambia.
Organised by the Africa Centres for Disease Control and Prevention (Africa-CDC), CPHIA is one of the biggest public health event in the world that brings together political leaders from across the continent and global leaders, with this year’s edition being attended by 5,000 participants in-person and about 20,000 virtually between November 27 and 30, 2023.
The side event which was held on Monday had health and communication experts, researchers and African Union media fellows across the continent in attendance.
In his remarks, the Chair of Public Health Risk Communication and Community Engagement Community of Practice for Africa (PH-RCCE-CoPA), Dr Da Costa Aboagye, noted that in the recent past, most countries had been focusing on strengthening surveillance, laboratory systems, logistics and case management during public health emergencies with minimal focus on tackling issues that touch the hearts of the people in communities.
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He lamented that the current realities in various African countries showed that risk communication had not been given full attention. He, however, believed that “it is never too late to do the right thing, especially as we want to build the Africa we want.”
“The Ebola outbreak in West Africa, which took nearly two years and other outbreaks that came after especially Covid-19, taught us a great lesson about the importance of risk communication, particularly engaging and listening to the affected communities. However, priority and financial commitments are not matched to the community engagement interventions that touch and transform the behaviours of communities and individuals.
“This side event presents a paradigm shift to chat a new path by giving priorities and financial resource allocations to the risk communication and community engagement pillar in public health emergencies while continuing to strengthen the risk communication and SBC architecture under health system strengthening to aid preparations towards the next pandemic,” Aboagye said.
He warned that it would be a huge mistake if by the next pandemic, risk communication pillars in various countries had not been strengthened, adding that most countries in Africa did not have risk communication national budget allocations and instead depend solely on development partners’ support.
Aboagye recalled that in June 2023, PH-RCCE-CoPA members met in Kampala, Uganda, and collectively agreed that countries must prioritise RCCE as a key pillar of public health emergency response.
He said, “The health promotion and risk communication experts representing 48 African Union (AU) member states emphasised that early community engagement is critical to ensure community ownership of public health interventions during disease outbreaks; therefore, strategies, as well as financial resources for emergency response must be decentralised and extended to cover RCCE activities.
“Furthermore, during the Kampala gathering, countries presented their unique RCCE experience while responding to multiple outbreaks; and key among the challenges highlighted were low adherence to preventive measures, vaccine hesitancy, inadequate human and financial capacity to execute RCCE activities and lack of RCCE legal framework for the sustainability of the RCCE pillar.
“Currently, with more than 200 members across the continent, the PH-RCCE-CoPA has been holding monthly knowledge and experience sharing webinars which have been instrumental in bringing RCCE experts together for peer-to-peer knowledge and experience exchange on the COVID-19 pandemic, Monkey Pox , Marburg, Ebola and other public health emergencies.”
The side event featured panel discussions focused on four key areas: strengthening RCCE and SBC Leadership; advancing synergy and coordination at national and continental levels; developing RCCE workforce for efficient pandemic preparedness and response; experience sharing with a focus on research to highlight the gains made and identify gaps in RCCE/SBC during outbreak response and integration of digital technology (AI) into RCCE/SBC interventions for public health emergency/disease outbreak response and visibility for RCCE/SBC as a key pillar for emergency response.
Giving insights from his team’s research, one of the panelists, Rogers Ayebare, Senior Programme Officer at Makere University Infectious Diseases Institute, disclosed that there were concerns by vulnerable populations including mothers on whether a healthcare intervention such as vaccination would affect their pregnancy or breast feeding of their babies.
Ayebare advised that there should be a change in research strategies to ensure participation of key priority groups – women, mothers and children – to make risk communication easier in African communities.
“We are doing community engagement to enable people to make informed decisions on whether they should go to hospital, take vaccines and drugs. We have some successes because we do this at public health institutes as well as local academic institutes. One of the challenges we have encountered is the fact that research regulation in countries is moving at a slower pace than the outbreak.
“Also, after collecting the data, we have the challenge of communicating science to the people. It is one thing to say my drug treated 95 out of 100 people; it is another thing to say five children in a trial have died,” he said.
The researcher cautioned that as technologies were being deployed to scale up risk communication research, “we need to consider the fact that 36% of the population have access to the internet.”
“So as we are using technology to make this big leap, we risk leaving two-third of the continent behind. We need to invest in digitising healthcare and digitising communities,” he added.
Mavuto Thomas, a member of PH-RCCE-CoPA, advised stakeholders to prepare ahead of future pandemics by building capacity at community, district national and regional levels through effective RCCE and SBC mechanisms.
“At Africa CDC, we have divided the African continent into five zones where we have RCCE practitioners working together to fight pandemics and sharing their experiences on RCCE. People are at the centre of what we are doing, we are trying to engage people when there is no outbreak because whenever there is an outbreak, people are afraid and their concentration level is very limited.
“We need to use different channels and means to get to the people. We have trained volunteers and community health workers who are going door-to-door to engage the people, using interpersonal communication to correct misinformation and allay people’s fears,” Thomas stated.
Earlier, at a press briefing on the CPHIA 2023 themed, ‘Breaking the Barriers and Repositioning Africa in the Global Health Architecture,’ the Director General, Africa Centres for Disease Control and Prevention (Africa-CDC), Dr Jean Kaseya, said it is time to discuss with African leaders, researchers and advocates on how to break the barriers.
“Africa is contributing to global health security. We cannot ignore that, we have to acknowledge what Africa is bringing to the world and what it is giving to the world.
“With the theme, we believe we have the ambition to position not only Africa but also Africans because this is the time for the world to hear from Africans and acknowledge the presence of African leaders and ensure Africans play key roles in all of these organisations,” he said.
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