Community Engagement

Module B5

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 Module objective
By the end of this module, you will be able to:

● Describe why community engagement is essential for

effective emergency risk communication

● Describe the links between health promotion, social

mobilization and community engagement, and

● List actions for community engagement

Photo: WHO/A.Bhatiasevi

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Communities MUST BE at the heart of any public
health intervention, especially in emergencies
Community engagement is
central to any public health
intervention.
Its importance is even more
significant during public
health emergencies.
Community engagement
involves those affected in
understanding the risks
they face, and involves
them in response actions
that are acceptable.
Photo : WHO /A Bhatiasevi

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Approaches and tactics linked to community
engagement
● Social Mobilization ● Community Engagement

● Communication for ● Outbreak

Development (C4D) communication

● Behaviour Change ● Crisis communication

Communication
● Risk Communication
● Health Education
● Communication for
● Health Promotion Behavioural Impact

Photo: WHO/A.Bhatiasevi

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 Health promotion – health education
A set of principles involving equity and empowerment, and practices
encompassing of communication, capacity building and politically oriented
activities, with the goal to enable others to gain more control over the
influence of their lives and to improve their health.
● Health Education aims to provide information to influence their future
decision-making on their health.
● Health Promotion aims at working on the needed social and political
actions (e.g. legislation, movements, etc.)
- (Laverack, 2014)

Photo : WHO /A Bhatiasevi

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 Social mobilization
Social mobilization is a process that
engages and motivates a wide range of
partners and allies at national and local
levels to raise awareness of and demand for
a particular development objective through
dialogue

Photo: http://unicef.in/CkEditor/ck_Uploaded_Images/img_1174.jpg

Members of institutions, community networks, civic and religious groups

and others work in a coordinated way to reach specific groups of people for
dialogue with planned messages. Social mobilization seeks to facilitate
change through a range of players engaged in interrelated and
complementary.
- UNICEF

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 Community engagement
● Community engagement is the process by which community
benefit organizations and individuals build a long term relationship
with collective vision for the benefit of the community
● It is primarily about the practice of moving communities towards a
better change through empowerment

This presentation will focus on

community engagement for risk
communication

Photo : WHO /A.Bhatiasevi

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 What we usually do for health promotion,
social mobilization include…
Messages
Leaflets
Posters
T-shirts
Radio spots
TV adverts
Town criers

Photo : WHO /A.Bhatiasevi

BUT community engagement requires
much more than these

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 Why community engagement?
• Everyone has a right to
know about risks to their
health and well-being

• Culturally appropriate
information can help make
informed decisions to
reduce the health risks

• Action taken by individuals,

families and communities
affected are key to
controlling the public health Graphic: http://www.dse.vic.gov.au/effective-engagement/introduction-to-
threat/problem engagement/what-is-community-engagement

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 Actions for community engagement
Community engagement covers a broad range of activities. Some activities undertaken by
government practitioners include:
● Reaching out to / informing the community of policy directions of the government
● Consulting the community as part of a process to develop government policy, or build
community awareness and understanding
● Involving the community through a range of mechanisms to ensure that issues and
concerns are understood and considered as part of the decision-making process
● Collaborating with the community by developing partnerships to formulate options and
provide recommendations.
● Shared leadership / empowering the community to make decisions and to implement
and manage change.
Source: Victoria Government, Australia

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 Community engagement
Modified from US Department of Health and Human Services and Victoria Government, Australia

INFORM CONSULT INVOLVE COLLABORATE SHARED

LEADERSHIP
Some community More community Better community Community Strong relationship
Involvement involvement involvement involvement

Provides Gets information or Involves more Forms partnerships Strong partnership

community with feedback from the participation with with community on structure is formed
information community community on each aspect of the
issues project – from
development to
solution
Optimally Develops Visibility of Partnership Broader health
established connections partnership building, trust outcomes affecting
communication established with building broader
channels and increased community. Strong
channels for cooperation bidirectional trust
outreach built

http://www.dse.vic.gov.au/effective-engagement/introduction-to-engagement/what-is-community-engagement
http://www.atsdr.cdc.gov/communityengagement/pdf/PCE_Report_508_FINAL.pdf

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 Principles of community engagement
Planning phase
● Clarify purpose/goal

● Understand the community's culture,

perception, economic condition, social
networks, political and power structures,
norms, values, demographic trends, history,
past experience

● Establish relationships, build trust, work with

formal and informal leaders, seek their
commitment for mobilizing the community

● Map and leverage existing community

engagement mechanisms, e.g. for polio,
immunization campaigns, HIV work, red cross
volunteers, etc. Photo: http://www.unicef.org/cbsc/images/UNI102880-620x350.jpg

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 Principles of community engagement
Implementation phase
● Partner with community to create change and
improve health.
● Recognize and respect diversity; and ensure
that the most vulnerable are reached and
engaged.
● Identify, mobilize assets and strengths in
developing the community's capacity and
resources to make decisions and take action.
● Be prepared to release control of actions and
Photo: WHO/A.Bhatiasevi
interventions to the community. Be flexible to
meet the changing needs.

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 Challenges
● Maintaining community involvement over
time
● Overcoming differences between responders,
community and different influencers
● Working with unique, especially vulnerable, or
hard to reach communities
● Communities and responders may not Image: http://blogs-
images.forbes.com/steveolenski/files/2014/09/bigstock-
Challenges-Road-Sign-3530978.jpg
perceive risk in the same ways
Community engagement is
● Communities have complex social dynamics complex, hard work requiring
and changing power relationships which expertise and dedicated
influence how we engage them resources

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 Know the community
● Community structure
– Formal and informal
– Opinion leaders and influencers

● Community dynamics
● Power relationships
● Sources of information
● Beliefs and practices
● Available resources
● Others
Photo: WHO/A Bhatiasevi

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 The perception trap - 2014 Ebola in
West Africa
Trap 1- Fear: Ebola = death Trap 2- Disbelief due to
● Everybody who has Ebola will die distrust
● Ebola is a curse ● The authorities can't handle the
situation
Trap 3- Dismissal ● The foreigners are here to extract
organs for scientific experiments
● Don't want to know
● Don't want to believe
● Don't want to accept

Photo : WHO /A.Bhatiasevi

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 Community engagement came late in Ebola outbreak in
Liberia
Retrospective analysis of the Ebola response

Response Phase 1 Phase 2 Phase 3

Predominant risk Crisis communications Awareness-raising, social Community engagement
communication mobilization
strategy
Rationale Past experiences of Ebola Ebola spread in major cities. Community as part of the solution.
outbreaks with 90% deaths, Increased survival rates, but unsafe Bring back trust
occurs in remote settings burials and other dangerous
practices continue

Key message Ebola kills. There is no cure. Bush Ebola is real. Signs & symptoms. Avoid contact with dead bodies. Early
meat consumption spreads the Hotline treatment increases survival rates. De-
disease stigmatize survivors

Intervention Mass media, posters, radio Campaign mode. Hotline. Mass
media – print, broadcast, posters,
radios, town criers, loud speakers on
trucks & motorbikes, volunteers for
social mobilization
Interpersonal communications.
Community meetings, etc. Community
awareness and training. Engage
influencers including religious and tribal
leaders

Outcomes Denial. Perception that Ebola Demand exceeds response capacity. Community influencers are part of the
spreads in remote areas, No Lack of confidence in response, lack response. More decentralized,
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cure = No treatment = stay at campaigns in hotspots
 Applying sociological approaches in community
engagement
● Lots of documented evidence from Ebola in West Africa
(2014-2015), of where anthropology and other applied
social sciences played a key role in understanding
communities

● Insights on socio-cultural and political contexts of

affected communities to build locally acceptable
interventions. Some examples include:
– Understanding myths, beliefs
– Managing rumours, misinformation
– Decoding 'fear' 'resistance' 'risky health practices',
etc.
– Working on community based interventions
– Adapted safe and dignified burial rites for Muslims
and Christians Photo : WHO /A.Bhatiasevi

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 Tools for creating community discussion*
Community map Discussion groups Individual Interviews
Household and Seasonal Community walk and
facility observations calendar/event observations
Timeline

Storytelling Causes and effects Emergency scenario

Bean ranking Communication Visions for action
circles

* Source: Bringing the community together to plan for Disease Outbreaks and other Emergencies.
http://www.globalhealthcommunication.org

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 Reminder
● Communities must be at the heart of any public health intervention,
especially during an emergency
● It is critical to know and understand communities in order to effectively
work with them in all phases – preparedness-response-recovery of a
health emergency
● Multiple strategies and tactics should be used to engage communities

Photo: WHO/A. Zouiten

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