Managing Ebola Virus Disease (EVD) Messaging and Misinformation During an EVD Outbreak in Uganda

Summary:

Trust, compliance, active involvement of affected populations are critical drivers for success in outbreaks like EVD. The EVD outbreak in DRC and the threat to Uganda of imported cases as reported in June and August 2019 in Kasese district raised concerns as fear escalated to panic and the rumours and misinformation which prevailed almost eroded the EVD awareness gains made during the preparedness phase. Averting misinformation and rumours on EVD requires special efforts to reach-out and communicate directly with the affected communities. This involves rapid message reframing and cascaded dissemination of key messages and dialogues, backed with fast and effective feedback loops horizontally and vertically, at all levels. Behavioural change and social action/reaction happen at the household and community level, among the affected populations. Therefore, it is important to continuously assess, establish and monitor what the affected populations, know, think, what they are concerned about, what they say and how they are responding to the various EVD responsive efforts put in place by government, partners and/or service providers. Any gap or failure to maintain the desired information flow, feedback mechanism and synergy between the different stakeholders especially at the community level, is bound to greatly contribute to misinformation which can vary by type, scale and effect. SBCC practitioners must put in place multiple measures for systematic tracking of the flow and effect of messages disseminated and should be cognizant of the reactions arising from the different contexts amongst the various audiences in the affected communities and beyond.

Background/Objectives:

The current Ebola outbreak in the DRC is the tenth and the largest in the country. Uganda has several districts bordering the DRC, putting it at high risk of EVD importation from the DRC. In June 2019, the first EVD outbreak was declared in Uganda, in Kasese District. After 42 days, a second imported case of a nine-year old girl was reported, again in Kasese. The re-occurrence of EVD raised concerns, misinformation and rumours become ripe.

Description of Intervention and/or Methods/Design:

After EVD outbreak declaration in Uganda (June 2019), UNICEF and partners supported MOH to adopt a district-led community engagement process which emphasised two-way communication through house to house visits and community dialogue meetings. The objective was to intensify direct engagement with communities and offer timely feedback and to achieve community-led action by leveraging on the existing decentralised local government structures and by utilising the trusted' community-based structures mainly the Village Health Teams (VHTs) and the local council leadership (LCs). This involved supporting the functionality of the local government structures to conduct on site visits and hold dialogue meetings with a range of influencers (school teachers, religious and cultural leaders, traditional healers, youths, transporters, security personnel and traders) and to provide support supervision through structured monthly review meetings with the VHTs and LCs. The cascaded approach resonated with the Social Ecological Model (SEM).

Results/Lessons Learned:

Between June 2019 and 31 October 2019, a cumulative total number of 706,516 (22%) people reached through interpersonal communication (that is, from house to house visits and through community meetings) out of the planned target of 3,258,484 by June 2020, in 24 districts. During execution, risk communication subcommittees were established at district level and were replicated at lower levels. EVD messages were translated in 14 local languages and relevant IEC materials distributed. Over 21 private radio stations covering the high-risk districts were engaged to air radio spots and talk shows, in respective local languages. U-report, mTRAC and social media platforms were utilised as tools for timely interaction, tracking and feedback.

Discussion/Implications for the Field:

Invest in research/evidence-based processes. Uganda utilised findings from EVD KAP and anthropological studies to design a responsive community engagement strategy. Incorporate risk communication into existing systems and strengthen capacities for routine monitoring and review of outcomes from the community engagement processes. Build skills in use of social media and SMS based technology for rumour tracking, feedback and management. The existence of well-documented, shared implementation framework is vital for consistency, coordination of stakeholders in EVD risk communication. Integration of risk communication in other EVD response activities is key in ensuring clear articulation of roles/responsibilities, avoiding duplication and ensuring coordination.

Abstract submitted by: 

Douglas Lubowa - UNICEF
Miriam Nagadya Lwanga - UNICEF
Mandi Chikombero - UNICEF