This study aimed to determine the effectiveness of World Vision’s community‐based intervention strategies implemented on EVD knowledge, preventive and treatment care‐seeking practices of community members. The study also explores differences between households containing both children sponsored by World Vision and a documented case of Ebola, and those without.
With more than half of the cases of the epidemic persistently registered in the Western Area District of Sierra Leone, and cases continuing to rise, in late November 2014, the need for the ‘Western Area Surge’ was established.
The overall goal of the Surge was to interrupt the alarming upward trend with intensive community engagement and improved service provision over the period 15th December, 2014 to 31st December, 2015 in order to break the chain of transmission.
The Surge was designed around the inter-dependence of supply and demand factors within the wider enabling environment. In the lead up to the Surge, it was evident that the supply side was not adequately delivering services. A lack of trust in the health system and the wider response had developed which undermined any further demand creation. Therefore, the first step in the Surge involved drastically increasing the quality and quantity of all services, and communicating this to build confidence and encourage the public to come forward at the earliest possible stage.
Supported and launched at the highest level, His Excellency the President, Dr. Ernest Bai Koroma, went on National television and radio on the evening of 18 September and declared a “sit at home” for the period from 19 to 21 September 2014 to facilitate the implementation of the nationwide House to House Family Sensitization Campaign. Council chairmen and traditional leaders replicated this symbolic launch with similar events at districts and chiefdoms across the country. The MOHS, in collaboration with UNICEF, WHO, other partners, and line Ministries, conducted the campaign.
The goals were to:
• Achieve community ownership and participation in the EVD response;
• Engage the community in contact tracing and mitigating transmission risk; and,
• Lay a foundation for health sector recovery via interactive confidence building.
The objectives of the campaign were to:
• Reach 100% of households in the country with correct information on EVD;
• Increase community acceptance of EVD affected persons, especially children;
• Promote hand washing with soap at the household level;
• Rebuild public confidence and trust in the health system; and,
• Install neighborhood watch structures at community level.
The “Hotspot Busters Initiative” was aimed at reducing and eliminating the spread of EVD in hotspot areas as soon as cases appeared. It became a key element of UNICEF’s response to the Ebola outbreak in Sierra Leone. UNICEF and the Ministry of Health and Sanitation (MOHS), in partnership with the Health for all Coalition (HFAC), a local community-based organization with a network of social mobilizers in the field, implemented this intervention at the ward level across the country.
How does Hotspot Busting work?
A hotspot was defined by HFAC as ‘any two suspected cases from a community’.
The activities of this initiative aimed to:
• Sensitize Paramount Chiefs and traditional leaders on the need for intensification of the EVD response in the hotspot communities, including dissemination of chiefdom by-laws on EVD;
• Undertake intense door to door community sensitization;
• Provide key messages via SBCC materials;
• Facilitate community referrals; and,
• Report on suspected cases.
These brief case studies reflect the contribution of numerous partners in the social mobilization pillar co-chaired by UNICEF and the Ministry of Health
An unprecedented Ebola Virus Disease (EVD) epidemic began in the Kailahun District of Sierra Leone in the spring of 2014 and reached its peak in November. The epidemic which has ravaged Sierra Leone, Guinea and Liberia has been characterized by WHO as “the largest, most complex and most severe we’ve ever seen.” With cases surging, there was a need to identify “hotspots” of outbreak and coordinate efforts to conduct social mobilization activities immediately in order to reduce spread and educate the community members and empower them as partners in fighting the disease.
The enduring Ebola epidemic has taught the world some hard lessons over the last 12 months, which we must take to heart. This guest essay and analysis from CIvicus’ 2015 State of Civil Society report argues “we should reflect on the role civil society must play in response, and how it can spur on mandated international bodies to shake off their paralysis and act decisively during crises, instead of leaving it to private organisations, such as MSF, to respond.”
This Field Guide was developed for the Social Mobilisation Action Consortium (SMAC). SMAC is comprised of BBC Media Action, U.S. Centres for Disease Control and Prevention, FOCUS 1000, GOAL and Restless Development. The CLEA approach builds on a history of Participatory Rural Appraisal (PRA), and takes inspiration from the Community-Led Total Sanitation (CLTS) approach and its success in Sierra Leone.
- BBC Media Action
- U.S. Centers for Disease Control and Prevention (CDC)
- Focus 1000
- Restless Development
Social Mobilization in the Freetown Peninsula during the Ebola Epidemic 2014-2015
The Knowledge, Attitudes and Practice (KAP) study was conducted between December 7th and 22nd, 2014, to gauge the success of social mobilization efforts to educate the general public on key Ebola prevention messages in the country. The study design included quantitative and qualitative components. A questionnaire survey from a representative sample of 1,140 households was conducted in 6 purposely selected counties (Montserrado, Grand Gedeh, Lofa, Nimba, River Cess and Grand Cape Mount). Counties were selected to cover a range in the timing and impact of the Ebola epidemic in different parts of Liberia. The qualitative component was included to provide social context, collective understanding, and evolving debates behind static survey responses. It consisted of a series of 28 focus group discussions among 224 men and women conducted around the same time period in the same six counties. Groups were divided by gender and urban-rural residence, with additional groups for those in professional occupations. The topic guide generally followed a similar structure to the survey questionnaire in order to facilitate comparison across both data sources.
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