A comparative analysis of experienced uncertainties in relation to risk communication during COVID19: a four-country study

Background During outbreaks, uncertainties experienced by affected communities can influence their compliance to government guidance on public health. Communicators and authorities are, hence, encouraged to acknowledge and address such uncertainties. However, in the midst of public health crises, it can become difficult to define and identify uncertainties that are most relevant to address. We analyzed data on COVID-19-related uncertainties from four socio-economic contexts to explore how uncertainties can influence people’s perception of, and response to Risk Communication and Community Engagement (RCCE) strategies. Results This qualitative study, which adopts an interpretative approach, is based on data from a documentary review, key informant interviews (KII), and focus group discussions (FGD) with members of the general public and people with barriers to information from Germany, Guinea, Nigeria, and Singapore. Transcripts from the KII and FGD were coded and analyzed thematically. We interviewed a total of 155 KIs and conducted 73 FGD. Our analysis uncovered a divergence between uncertainties deemed relevant by stakeholders involved in policy making and uncertainties that people reportedly had to navigate in their everyday lives and which they considered relevant during the pandemic. We identified four types of uncertainties that seemed to have influenced people’s assessment of the disease risk and their trust in the pandemic control strategies including RCCE efforts: epidemiological uncertainties (related to the nature and severity of the virus), information uncertainties (related to access to reliable information), social uncertainties (related to social behavior in times of heightened risk), and economic uncertainties (related to financial insecurities). Conclusion We suggest that in future outbreaks, communicators and policy makers could improve the way in which affected communities assess their risk, and increase the trust of these communities in response efforts by addressing non-epidemiological uncertainties in RCCE strategies.Peer Reviewe

Determinants of Transmission Risk During the Late Stage of the West African Ebola Epidemic.

Understanding risk factors for Ebola transmission is key for effective prediction and design of interventions. We used data on 860 cases in 129 chains of transmission from the latter half of the 2013-2016 Ebola epidemic in Guinea. Using negative binomial regression, we determined characteristics associated with the number of secondary cases resulting from each infected individual. We found that attending an Ebola treatment unit was associated with a 38% decrease in secondary cases (incidence rate ratio (IRR) = 0.62, 95% confidence interval (CI): 0.38, 0.99) among individuals that did not survive. Unsafe burial was associated with a higher number of secondary cases (IRR = 1.82, 95% CI: 1.10, 3.02). The average number of secondary cases was higher for the first generation of a transmission chain (mean = 1.77) compared with subsequent generations (mean = 0.70). Children were least likely to transmit (IRR = 0.35, 95% CI: 0.21, 0.57) compared with adults, whereas older adults were associated with higher numbers of secondary cases. Men were less likely to transmit than women (IRR = 0.71, 95% CI: 0.55, 0.93). This detailed surveillance data set provided an invaluable insight into transmission routes and risks. Our analysis highlights the key role that age, receiving treatment, and safe burial played in the spread of EVD

Communicating risk during early phases of COVID-19: Comparing governing structures for emergency risk communication across four contexts

BackgroundEmergency risk communication (ERC) is key to achieving compliance with public health measures during pandemics. Yet, the factors that facilitated ERC during COVID-19 have not been analyzed. We compare ERC in the early stages of the pandemic across four socio-economic settings to identify how risk communication can be improved in public health emergencies (PHE).MethodsTo map and assess the content, process, actors, and context of ERC in Germany, Guinea, Nigeria, and Singapore, we performed a qualitative document review, and thematically analyzed semi-structured key informant interviews with 155 stakeholders involved in ERC at national and sub-national levels. We applied Walt and Gilson's health policy triangle as a framework to structure the results.ResultsWe identified distinct ERC strategies in each of the four countries. Various actors, including governmental leads, experts, and organizations with close contact to the public, collaborated closely to implement ERC strategies. Early integration of ERC into preparedness and response plans, lessons from previous experiences, existing structures and networks, and clear leadership were identified as crucial for ensuring message clarity, consistency, relevance, and an efficient use of resources. Areas of improvement primarily included two-way communication, community engagement, and monitoring and evaluation. Countries with recurrent experiences of pandemics appeared to be more prepared and equipped to implement ERC strategies.ConclusionWe found that considerable potential exists for countries to improve communication during public health emergencies, particularly in the areas of bilateral communication and community engagement as well as monitoring and evaluation. Building adaptive structures and maintaining long-term relationships with at-risk communities reportedly facilitated suitable communication. The findings suggest considerable potential and transferable learning opportunities exist between countries in the global north and countries in the global south with experience of managing outbreaks

How culturally unique are pandemic effects? Evaluating cultural similarities and differences in effects of age, biological sex, and political beliefs on COVID impacts

Despite being bio-epidemiological phenomena, the causes and effects of pandemics are culturally influenced in ways that go beyond national boundaries. However, they are often studied in isolated pockets, and this fact makes it difficult to parse the unique influence of specific cultural psychologies. To help fill in this gap, the present study applies existing cultural theories via linear mixed modeling to test the influence of unique cultural factors in a multi-national sample (that moves beyond Western nations) on the effects of age, biological sex, and political beliefs on pandemic outcomes that include adverse financial impacts, adverse resource impacts, adverse psychological impacts, and the health impacts of COVID. Our study spanned 19 nations (participant N = 14,133) and involved translations into 9 languages. Linear mixed models revealed similarities across cultures, with both young persons and women reporting worse outcomes from COVID across the multi-national sample. However, these effects were generally qualified by culture-specific variance, and overall more evidence emerged for effects unique to each culture than effects similar across cultures. Follow-up analyses suggested this cultural variability was consistent with models of pre-existing inequalities and socioecological stressors exacerbating the effects of the pandemic. Collectively, this evidence highlights the importance of developing culturally flexible models for understanding the cross-cultural nature of pandemic psychology beyond typical WEIRD approaches

Guinee (2010): Determinants de l'utilisation systematique du condom chez les travailleuses de sexe avec les clients Deuxieme Passage

La presente etude vise a connaitres le niveau d'utilisation du condom chez les travailleuses de sexe ainsi que les determinants de l'utilisation systematique du condom avec leurs clients. La taille de l'echantillon pour cette etude etait de 1006 travailleuses de sexe sur l'ensemble des sites de prostitution de l'axe PSAMAO et des zones minieres a Conakry-Kendeka, Kamsar-Sangaredi et Pamelap

GUINEE (2009): ENQUETE TRaC DE BASE SUR LA PRATIQUE DE L'EXCISION PREMIER PASSAGE

Depuis decembre 2007, grace a un financement de la KfW, PSI/Guinee a mene un projet de lutte contre les mutilations genitales feminines dans 2 region pilotes de la Guinee (La Moyenne Guinee et la Haute Guinee). Puis en 2009, ce projet a ete etendu sur le territoire national. Cette etude vise a mesurer le niveau de l'intention de ne pas exciser les filles et des determinants de cette pratique. La taille de l'echantillon inclus dans ce rapport etait 1207 femmes et 1334 hommes de 18-55 ans en charge d'au moins une fille en age d'etre excisee de 4-12 ans

GUINEE (2008): DETERMINANTS DE L'UTILISATION D'UN DESINFECTANT DE L'EAU ET L'UTILISATION SYSTEMATIQUE DU PRODUIT SUR'EAU PAR LES FEMMES EN CHARGE DES ENFANTS DE MOINS DE CINQ ANS EN GUINEE : CAS DE LA VILLE DE CONAKRY ET LA PREFECTURE DE LABE PREMIER PASSAGE

Cette etude vise a mesurer le niveau d'utilisation actuelle d'un desinfectant et d'utilisation systematique de Sur'Eau et les determinants qui influencent ce niveau d'utilisation. Les donnees proviennent d'une enquete quantitative aupres des femmes en charge d'enfants de moins de cinq ans vivant dans la ville de Conakry et la prefecture de Labe. La methodologie utilisee est celle d'une enquete menage. Dans chaque menage selectionne toutes les femmes en charge d'enfants de moins de cinq ans ont ete enquetees; au total 1124 femmes

Guinee (2007): Enquete TraC-M sur l'exposition aux activites de Communication Interpersonnelle concernant la Prevention des IST/VIH/SIDA en Moyenne Guinee Premier Passage

L'objectif principal de cette enquete etait de mesurer les niveaux d'exposition des populations beneficiaires des projets finances par la KfW en Moyenne Guinees (projets hydralique villageoise et construction ecole) aux activites de sensibilisation sur les IST/VIH/SIDA. Elle a touche les femmes et le hommes en age de procreer vivant dans les zones beneficiant ces projets. La methode TRaC-M a ete utilisee pour mesurer la portee et le rappel des messages promus dans le cadre de la communication pour la sante. Elle emploie une strategie, le LQAS, qui permet de savoir rapidement quelle proportion de la population cible a ete touchee par les activites, tout en reduisant substantiellement le cout d'une telle operation

Guinee (2010): Determinants de l'utilisation systematique du condom chez les miniers en union dans les zones d'intervention du projet Premier Passage

La presente etude vise a connaitre le niveau d'utilisation du condom chez les miniers ainsi que les determinants de l'utilisation systematique du condom. Cette etude a utilise une approche de collecte de donnees simple. Au total 1159 miniers ont ete enquetes proportionnellement a la taille des sites ou au nombre de miniers de chaque site concerne par l'etude

GUINEE (2012) : Pre-Test du spot du nouveau produit Orasel au gout orange accompagne d'une plaquette de dix comprimes de Zinc.

Dans le cadre du programme Sante Maternelle et Infantile, deux spots ont ete produits pour informer les femmes en charge des enfants de moins de 5 ans, avec pour finalite ultime de favoriser un changement de comportement en matiere d'utilisation du SRO accompagne du Zinc pour les enfants lors de leurs episodes diarrheiques. L'objectif principal de ce pre-test etait d'assurer au programme que les messages vehicules dans les spots sont clairement percus et peuvent effectivement susciter un changement de comportement. Un approche qualitative, notamment les discussions de groupes a ete utilisee. Pour chaque groupe homogene variant entre 8-12 participants. Les participants ont ete invites a donner leurs points de vue sur les messages percus et d'apprecier les images et son qui accompagnaient les messages