Evaluating implementation of the Ebola response in Margibi County, Liberia

Sepers, Charles E.; Fawcett, Stephen B.; Hassaballa, Ithar; Reed, Florence D. DiGennaro; Schultz, Jerry A.; Munodawafa, Davison; Phori, Peter Malekele; Chiriseri, Ephraim

doi:10.1093/heapro/day010

Cited by 11 publications

(11 citation statements)

References 4 publications

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“…Broad contextual concerns preceding the outbreak refer to poverty, unemployment or economic crisis, 38 49 health system failure, lack of development infrastructure, 49 50 colonial/postcolonial factors, ethnic and political conflicts, 38 39 lack of trust in government and international agencies, 42 traditional practices and rituals that are resistant to change, 15 51 geographical challenges 52 and mobile populations. 53…”

Section: Resultsmentioning

confidence: 99%

Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

et al. 2020

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IntroductionCommunity engagement has been considered a fundamental component of past outbreaks, such as Ebola. However, there is concern over the lack of involvement of communities and ‘bottom-up’ approaches used within COVID-19 responses thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation within the COVID-19 response.MethodologyA rapid evidence review was conducted to identify how community engagement is used for infectious disease prevention and control during epidemics. Three databases were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, Middle East respiratory syndromeand H1N1 since 2000. No restrictions were applied to study design or language.ResultsFrom 1112 references identified, 32 articles met our inclusion criteria, which detail 37 initiatives. Six main community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility committees, individuals and key stakeholders. These worked on different functions: designing and planning, community entry and trust building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration.ConclusionCOVID-19’s global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and to support equity-informed responses. Aligning previous community engagement experience with current COVID-19 community-based strategy recommendations highlights how communities can play important and active roles in prevention and control. Countries worldwide are encouraged to assess existing community engagement structures and use community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.

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Section: Resultsmentioning

confidence: 99%

Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

et al. 2020

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“…Results showed an association between implementation of the Ebola response effort and bending the curve to fewer new Ebola cases in Lofa County, similar to findings from the evaluation of the response effort in Margibi County, Liberia. 19,20 In this case study design, the concordance of fuller implementation of the Ebola road map and reduction in EVD is suggestive; however, other correlated events may have helped produce the observed outcomes. Yet, before the M&E system, there was little documentation of the intervention-activities implemented, their timing, and pattern of implementation.…”

Section: Discussionmentioning

confidence: 68%

Participatory Monitoring and Evaluation of Ebola Response Activities in Lofa County, Liberia: Some Lessons Learned

Hassaballa

Fawcett

Sepers

et al. 2019

Int Q Community Health Educ

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To address the Ebola outbreak in West Africa, the World Health Organization and the United Nations Children’s Fund led a multilevel and multisectoral intervention known as the Ebola response effort. Although surveillance systems were able to detect reduction in Ebola incidence, there was little understanding of the implemented activities within affected areas. To address this gap, this empirical case study examined (a) implementation of Ebola response activities and associated bending the curve of incidence of Ebola virus disease and (b) candidate factors associated with fuller implementation of the Ebola response effort. A mix of qualitative and quantitative methods were used to address these questions. A participatory monitoring and evaluation system was used to capture, code, characterize, and communicate nearly a hundred Ebola response activities implemented in Lofa County, a highly affected area in Liberia. The Ebola response effort was enabled by community engagement and collaboration across different sectors. Results showed fuller implementation corresponded with a marked reduction in Ebola virus disease. This report concludes with a discussion of how monitoring and evaluation can strengthen implementation of activities needed to address disease outbreaks.

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“…Broad contextual concerns preceding the outbreak refer to poverty, unemployment or economic crisis [34, 45], health system failure, lack of development infrastructure [45, 46], colonial/post-colonial factors and ethnic and political conflicts [34, 35].…”

Section: Resultsmentioning

confidence: 99%

Community engagement for COVID-19 prevention and control: A Rapid Evidence Synthesis

Gilmore

Ndejjo

Tchetchia

et al. 2020

Preprint

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Introduction Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. The COVID-19 pandemic and its control efforts require social actions and behaviours, all of which place a large reliance on individual and community compliance, highlighting the need for appropriate community engagement to support such work. However, there is concern over the lack of involvement of communities within COVID-19 thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation of community engagement within COVID-19 response. Methodology A rapid evidence review was conducted to identity how community engagement is used for infectious disease prevention and control during epidemics. Three databases (PubMed, CINHAL and Scopus) were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, MERS and H1N1 since 2000. No restrictions were applied to study design or language, though articles must have detailed a minimum of one community engagement for infection prevention and control initiative. All authors participated in searching, screening, and data extraction, with a minimum of two authors at each stage. Results From 1,112 references identified in our search, 32 articles met our inclusion criteria. All but 3 articles were published on or after 2015 which details 37 community engagement initiatives for Ebola (n=28), Zika (n=5) and H1N1 (n=4). Twenty-seven of these initiatives were implemented in low-income countries and 10 from high-income countries. Six broad community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility or community health committees, individuals and key stakeholders. These actors worked across six different functions: designing and planning, community entry and trust-building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. Leaders were the most prevalent actor being engaged, and behaviour change communication, risk communication, and surveillance and tracing were the most common function of community engagement. Implementation considerations community engagement in prevention and control of COVID-19 are reported within. Conclusion COVID-19 global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and support equity-informed responses. Previous experience from outbreaks shows that community engagement can take many forms and include different actors and approaches who support various prevention and control activities. Countries worldwide are encouraged to assess existing community engagement structures, and utilise community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.

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Evaluating implementation of the Ebola response in Margibi County, Liberia

Cited by 11 publications

References 4 publications

Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

Community engagement for COVID-19 prevention and control: a rapid evidence synthesis

Participatory Monitoring and Evaluation of Ebola Response Activities in Lofa County, Liberia: Some Lessons Learned

Community engagement for COVID-19 prevention and control: A Rapid Evidence Synthesis

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