Social determinants of health: the role of effective communication in the COVID-19 pandemic in developing countries

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has affected many countries with increasing morbidity and mortality. Interestingly, many of the actions and policies adopted in countries are linked to the social determinants of health (SDH). The SDH are critical determinants of health and health inequalities that are not directly within the health sector. Policies such as social distancing, good hygiene, avoiding large gatherings, cancelling of social and sports events, using personal protective equipment, schools and restaurants closure, country lockdown, etc. are not necessarily within the health sector but have been promoted to prevent and attenuate COVID-19 infection rates significantly. The SDH that serve to reduce morbidity will forestall or substantially reduce the pressure on many weak health systems in developing countries that cannot cope with increased hospitalisation and intensive health care. This paper argues that one of the most critical social determinants of health (i.e. effective crisis and risk communication), is crucial in many developing countries, including those with fewer confirmed coronavirus cases. We note that the effectiveness of many of the other SDH in reducing the burden of the COVID-19 pandemic hinges on effective communication, especially crisis and risk communication. Although many countries are adopting different communication strategies during the COVID-19 crisis, effective crisis and risk communication will lead to building trust, credibility, honesty, transparency, and accountability. The peculiarity of many developing countries in terms of regional, cultural, linguistic and ethnic diversity is an essential consideration in ensuring effective crisis and risk communication. Developing countries facing significant poverty and disease burden cannot afford to handle the burgeoning of COVID-19 infections and must take preventive measures seriously. Thus, we submit that there is a need to intensify SDH actions and ensure that no one is left behind when communicating crisis and risk to the population to address the COVID-19 pandemic.

Pit latrines may be a potential risk in rural China and low-income countries when dealing with COVID-19

“…According to recent reports, the transmission routes of SARS-CoV-2 mainly include the respiratory tract by droplets or respiratory secretions, and contact with infected persons or contaminated surface with poor hygiene practice ( Arslan et al, 2020 ; Saeed et al, 2020 ). In order to prevent the spread of COVID-19 between people, several measures were widely accepted by many countries, such as social distancing, handwashing, mask-wearing, isolation, quarantine, and community containment ( Ataguba and Ataguba, 2020 ; Mahase, 2020 ; Teslya et al, 2020 ; Wilder-Smith and Freedman, 2020 ), and these measures were effective and have been confirmed by multiple reports ( Mwalili et al, 2020 ; Ngonghala et al, 2020 ; Teslya et al, 2020 ; Tian et al, 2020 ).…”

Public Health and Risk Communication During COVID-19—Enhancing Psychological Needs to Promote Sustainable Behavior Change

“…Two hundred six papers were excluded based on title and abstract screening, and 27 were excluded after reading the full paper. A total of 20 papers matched the inclusion criteria (36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56).…”

“…Out of the 20 papers included in this overview, 12 papers focused on issues relating to autonomy [i.e., cultural values, voluntary adoption of preventative measures, societal tightness vs. looseness; (36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)]; five papers related to issues of competence [i.e., adjusting messages to context, public involvement; (46,(49)(50)(51)(52)] and nine addressed relatedness (sense of community, trust) (36,38,42,46,51,(53)(54)(55)(56). Some of the papers addressed more than one issue.…”

“…The 12 papers (36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48) relating to autonomy that were identified in the systematic search, show an agreement that rapid, clear and decisive response, effective management, and public adherence to social norms were critical to slow the trajectory of the virus in the early stages.…”

“…Findings also show that to enhance effective management and adherence to social norms during this pandemic, interventions will need to be tailored to fit differences in countries' unique circumstances, while respecting their values, cultures, and belief systems (45)(46)(47)(48). However, there is agreement that authoritarian responses to COVID-19 may cause long-term damage to the autonomy and health of citizens, as they often reflect selfserving motives, lack of transparency, and limited information sharing (38).…”