Safaa Moussa, Rokayya Konswa, and Dalia Samhouri, from WHO Regional Office for the Eastern Mediterranean, explain the importance of investing in risk communication and community engagement
Health emergencies such as the 2014-2016 Ebola outbreak in West Africa and the COVID-19 pandemic reinforced discussions around the global interconnectedness of health. The complex and multidimensional nature of these recent health emergencies highlighted the importance of designing a set of multifaceted, multi-sectoral and evidence-based interventions that draw upon and are accountable to the needs of the communities they intend to serve. Amid the extensive efforts to strengthen capacities to reduce risks and safeguard communities, risk communication and community engagement emerged as a key discipline with the promise to create a two-way channel between recommendations and innovations at the governance and finance levels to people’s needs on the ground.
Risk communication and community engagement is the umbrella term for people-centred approaches and strategies that apply social and behavioural insights and interventions to encourage public trust and participation to support the full spectrum of the health emergency management cycle – prevention, preparedness, response and recovery. In other words, risk communication and community engagement are inspired by communities and their varying contexts – psycho-social, economic, political, and environmental – to design solutions that offer protection and resilience outcomes.
The COVID-19 pandemic and the need for risk management
The novel COVID-19 pandemic exposed limitations in health emergency and disaster risk management when confronted with a pandemic of unprecedented health and socioeconomic impacts. These limitations loomed darkest at the community level where waning trust in health policies due to persistent neglect in engagement and empowerment, particularly among vulnerable communities, made way for the infodemic, which multiplied the magnitude of the pandemic as communities were confounded by a barrage of conflicting information, misinformation, and disinformation. Consequently, risk communication to encourage public health and social measures, including vaccination, was interrupted in various settings. Similarly, the already complex and enormous needs in fragile settings rendered health interventions minute when compared to the preexisting needs on the ground.
Building health system preparedness & resilience
Implementing the International Health Regulations (2005) towards building health system preparedness and resilience will continue to remain at the top of the global health agenda as a visceral undertaking necessitating all government and international coordination. However, we must not neglect possible immediate gains and tools at hand. Risk communication and community engagement is an indispensable tool offering immediate solutions as a multi-sectoral and multi-hazard core capacity for prevention, preparedness and response to health emergencies grounded by social and behavioural change.
Accordingly, while governing bodies are revisiting policies for pandemic prevention, preparedness and response and introducing amendments to the International Health Regulations (2005) to ensure better health outcomes, we must, in the interim, continue to build on existing capacities that invest in community listening, strengthening, and engagement.
Unfortunately, chronic underinvestment and funding in local capacities which can actively inform policies and ensure they are in line with needs on the ground has continued to plague our efforts to attain better health outcomes. We must refrain from grappling over the contention between investing in preparedness versus response and the appositeness of development in humanitarian contexts. It is high time we invest in risk communication and community engagement as the bedrock for decision-making and policy design to inform evidence and science-based on-ground interventions through expanding partnerships and strengthening the integration of a whole-of-society approach to surveillance, investigation, access to healthcare and referral and communicating risks to societies.
Risk communication & community engagement
Risk communication and community engagement’s main pillars identified by experts within the field are the systematic research and collection of social and behavioural insights, risk communication and infodemic management, community engagement, and multi-sectoral coordination that brings all elements and stakeholders together. The International Community has already moved towards institutionalizing risk communication and community engagement as a technical pillar for social and behavioural change, offering cross-cutting support to both emergency and non-emergency health interventions. The reality at national levels is unfortunately quite different.
Currently, most national discussions around RCCE have been cosmetic at best. Ministries of health have been observably slow at building on the momentum of the COVID-19 response and embarking on the necessary restructuring of their RCCE systems, which are currently composed of oftentimes skilled but scattered staff. Despite existing capacities for health education and promotion, media and communication, and some elements of risk communication, the work has not been done to effectively create a unified and integrated structure for risk communication and community engagement guided by social and behavioural insights.
Accordingly, governments should take the potentially stirring yet necessary step to re-envision national structures through landscaping existing capacities, investing in workforce capacities and clarifying functions, and implementing an integrated approach for risk communication and community engagement. That will enhance public trust, empower communities and influence the desired social and behaviour change leading to more resilient communities.
