Three Acts of Resistance during the 2014–16 West Africa Ebola Epidemic

Marcis, Fréderic Le; Enria, Luisa; Abramowitz, Sharon; Mari-Sáez, Almudena; Faye, Sylvain Landry

doi:10.7227/jha.014

Cited by 27 publications

(37 citation statements)

References 30 publications

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“…Also, and despite the respite offered by the gradual advance of the pandemic, we have found that countries have taken a number of relatively similar -if not identical -health measures, which more fundamentally raises the question of the appropriateness of these measures to their national contexts and reawakens the myth of a "turnkey" response applicable to all and at all times. Yet all the scienti c literature on public health interventions, including in Africa [33,34] and on COVID-19 [13] a rms the importance of taking contexts into account in order for measures to be effective [35]. This need to contextualize the health response also requires taking into account the speci cities of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…For example, regarding containment measures, a scoping review synthesising relevant knowledge published in 2018 highlights the importance of community involvement for their effectiveness [36]. A study on Ebola in 2014-2016 in the region similarly showed the need for community involvement in disease control interventions that take into account local dynamics [34]. The analysis of the situation in ve African countries at the beginning of the pandemic also showed the importance of community involvement [10].…”

Section: Discussionmentioning

confidence: 99%

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The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

Bonnet¹,

Bodson

Marcis³

et al. 2020

Preprint

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Background: In early March 2020, the COVID-19 pandemic hit West Africa. Countries in the region quickly set up crisis management committees and organised drastic measures to stem the spread of the coronavirus. The objective of this article is to analyse the epidemiological evolution of COVID-19 in seven Francophone West African countries (Benin, Burkina Faso, Côte d'Ivoire, Guinea, Mali, Niger, Senegal) as well as the public health measures decided upon during the first four months of the pandemic. Methods: Our method is based on quantitative and qualitative data from the pooling of information from a COVID-19 data platform and collected by a network of interdisciplinary collaborators present in the seven countries. Descriptive and spatial analyses of quantitative epidemiological data and content analyses of qualitative data on public measures and management committees were performed. Results: Attack rates for COVID-19 range from less than 10 per 100,000 inhabitants (Benin) to more than 45 per 100,000 inhabitants (Guinea). The spatio-temporal analysis shows three phases of incidence clusters. By the end of June 2020, case numbers had plateaued in some countries (Burkina Faso, Niger, Mali) while others continued to see the number of infections increasing (Benin, Côte d'Ivoire, Guinea, Senegal). The countries all reacted quickly to the crisis, in some cases before the first reported infection, and implemented public measures in a relatively homogeneous manner. None of the countries implemented country-wide lockdowns, but in some cases implemented partial or local containment measures. At the end of June 2020, countries began to lift certain restrictive measures, sometimes under pressure from the general population or from certain economic sectors. All the countries have adopted response plans and organized multiple crisis management committees, although their content and functioning have not always been transparent or easy to understand. Conclusion: Much research remains to be done in West Africa. It will be necessary to better understand the dynamics of the pandemic, which appears to be largely under control, as well as the effectiveness and implementation of the state responses, which have been rapidly formulated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

Bonnet¹,

Bodson

Marcis³

et al. 2020

Preprint

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“…All articles were in English except for one, which was in French. 38 Thirty-two articles were included, but two articles report three 39 and four 40 distinct community engagement initiatives. As such, the remainder of the review will focus on 37 initiatives.…”

Section: Article Characteristicsmentioning

confidence: 99%

“…Specific make-up of community engagement approaches was often not detailed or did not include diversity and representation, though several reported community engagement structures, including representation from Ebola survivors, 56 women within reproductive age and students, 46 women representatives 39 and youth. 38 54 56 Health system linkages and support Of those that provided details on linkages, very few were explicitly linked to other health system components (with the exception of tracing).…”

Section: Target Groups and Equity Considerationsmentioning

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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“…This was a transformative policy approach, and because it correlated with the epidemic's decline, has been perceived to have facilitated the reduction in acts of direct violence and overt avoidance towards the public health response. 5 Decisions on whether or not to act on messages of public health campaigns are influenced by the level of auto nomous motivation to undertake behaviour change. [6][7][8] According to self-determination theory, 9 engagement in extrinsically motivated behaviours, such as participation in outbreak response efforts that are counter to personally or culturally satisfying practices, or both (eg, bushmeat consumption, traditional burials), would be increasingly enhanced and maintained as people identify with their value.…”

Section: Introductionmentioning

confidence: 99%

Unmet needs and behaviour during the Ebola response in Sierra Leone: a retrospective, mixed-methods analysis of community feedback from the Social Mobilization Action Consortium

Skrip

Bedson

Abramowitz

et al. 2020

The Lancet Planetary Health

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Background The west African Ebola epidemic (2014-15) necessitated behaviour change in settings with prevalent and pre-existing unmet needs as well as extensive mechanisms for local community action. We aimed to assess spatial and temporal trends in community-reported needs and associations with behaviour change, community engagement, and the overall outbreak situation in Sierra Leone. MethodsWe did a retrospective, mixed-methods study. Post-hoc analyses of data from 12 096 mobiliser visits as part of the Social Mobilization Action Consortium were used to describe the evolution of satisfied and unsatisfied needs (basic, security, autonomy, respect, and social support) between Nov 12, 2014, and Dec 18, 2015, and across 14 districts. Via Bayesian hierarchical regression modelling, we investigated associations between needs categories and behaviours (numbers of individuals referred to treatment within 24 h of symptom onset or deaths responded to with safe and dignified burials) and the role of community engagement programme status (initial vs follow-up visit) in the association between satisfied versus unsatisfied needs and behaviours.Findings In general, significant associations were observed between unsatisfied needs categories and both prompt referrals to treatment and safe burials. Most notably, communities expressing unsatisfied capacity needs reported fewer safe burials (relative risk [RR] 0·86, 95% credible interval [CrI] 0·82-0·91) and fewer prompt referrals to treatment (RR 0·76, 0·70-0·83) than did those without unsatisfied capacity needs. The exception was expression of unsatisfied basic needs, which was associated with significantly fewer prompt referrals only (RR 0·86, 95% CrI 0·79-0·93). Compared with triggering visits by community mobilisers, follow-up visits were associated with higher numbers of prompt referrals (RR 1·40, 95% CrI 1·30-1·50) and safe burials (RR 1·08, 1·02-1·14).Interpretation Community-based development of locally feasible, locally owned action plans, with the support of community mobilisers, has potential to address unmet needs for more sustained behaviour change in outbreak settings.

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Three Acts of Resistance during the 2014–16 West Africa Ebola Epidemic

Cited by 27 publications

References 30 publications

The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

The COVID-19 Pandemic in Francophone West Africa: From the First Cases to Responses in Seven Countries

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

Unmet needs and behaviour during the Ebola response in Sierra Leone: a retrospective, mixed-methods analysis of community feedback from the Social Mobilization Action Consortium

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