Updated COVID-19 Risk Communication and Community Engagement Strategy - Africa

"If health and risk communication information and approaches remain static and are not updated to reflect the changing concerns, questions, and suggestions from communities, they will not remain relevant or trusted by people and the epidemic response will fail."

This update to the risk communication and community engagement (RCCE) strategy for COVID-19 in Africa first set out in March 2020 (see Related Summaries, below) reflects lessons learned since the start of the pandemic and focuses on what the International Federation of Red Cross and Red Crescent Societies (IFRC) is aiming to achieve over the coming year, including on building and maintaining trust in the vaccine.

In November 2020, the IFRC community engagement and accountability (CEA) regional team conducted a satisfaction survey with CEA focal points in African National Societies (ANS) to better understand how useful the support from regional and cluster teams has been, where improvements need to be made, and what kind of support ANS would like to receive moving forwards. These data have been used to inform the updated strategy for 2021.

Broad trends from the behavioural data and community insights gathered from NS across Africa indicate that people believe that COVID-19 is a threat but more so to others than themselves. Declining risk perceptions and fatigue with the pandemic may result in people failing to comply with the advice of health professionals and to follow preventative measures. This has been compounded by fears of job losses during lockdown and people being forced to make the decision to prioritise their livelihoods over their health. Certain myths among those surveyed could impact the level of trust and acceptance that communities have in government-led response efforts, including their willingness to accept the COVID-19 vaccine, such as:

• Beliefs that governments have been inflating the number of cases to secure funding from the international community (and subsequently misappropriating those funds);
• Beliefs that governments have been hiding the number of cases so they can keep economies and borders open;
• Beliefs that international figures, such as Bill Gates, have ulterior motives for funding the response or vaccine development; and
• Beliefs that alcohol, herbal treatments, traditional medicines, or prayers will prevent people becoming infected.

Within IFRC, there is a COVID-19 vaccine 5 pillar global strategy that was launched at the end of 2020. The 5 pillars of the strategy are: advocate; trust; health; reach; and maintain. The work of RCCE falls under the trust pillar and seeks: to shift from "messaging" to community engagement and participatory approaches; to understand how communities perceive the disease and the response; to generate real-time data on community perspectives; to act and adapt response activities; and to co-create solutions in partnership with communities. In Africa more specifically, the region has launched a 2021-2022 immunisation plan, which reflects the global 5-pillar strategy as well as an integrated plan to support the 42 Advanced Market Commitment (AMC) countries in Africa, prioritised for support by the COVAX Facility, which is co-led by Gavi, the Vaccine Alliance, the Coalition for Epidemic Preparedness and Innovations (CEPI), and the World Health Organization (WHO), in partnership with many other multilateral agencies and vaccine manufacturers. This work will be challenging in Africa due to the fact that "lack of trust has led to the refusal of many people to follow sound public health advice to limit the spread of COVID-19. The roll-out of a vaccine will only be successful if there is an immediate effort to build trust in communities, especially those isolated from or wary of governments."

The focus on trust in this RCCE strategy is also appropriate in light of the overabundance of information circulating in traditional and social media, which has contributed to an "infodemic" that makes it hard for people to identify what information is reliable and trustworthy. Among the activities being undertaken in the Africa region by IFRC to address this: More than half of the ANS (33) have been working with the media during the COVID-19 response by sharing community insights and supporting journalists to address these, organising webinars or workshops with journalists, and/or conducting interviews on TV, radio, or newspapers, where health advice or rumours and misinformation are addressed.

In this context, RCCE will continue to be a key pillar of the Red Cross Red Crescent response to COVID-19 in Africa in 2021. The priority of the RCCE approaches, which will be mainstreamed and coordinated with health and psychosocial support activities, will be to:

1. Understand the beliefs, fears, rumours, questions, and suggestions circulating in communities about the COVID-19, including the vaccine, and to use this to inform the response.
2. Reduce community fear, stigma, and misinformation, including on the vaccine.
3. Build trust in the response and the health advice shared, including on the vaccine.
4. Share timely, accurate information about COVID-19, and the vaccine, through the most trusted channels, to support people to adopt safe health practices, accept the vaccine, and reduce the risk of the spread of infection.
5. Identify and support community-led solutions for preventing the spread of infection and bringing the outbreak under control, fostering people's active participation in the response.
6. Ensure that the most vulnerable groups are included in the above approaches and that their needs, feedback, and preferred and trusted communication channels are considered.

Specifically, the revised strategy focuses on achieving 3 primary objectives: (i) strengthening community-led approaches to improve the quality of community engagement activities; (ii) using disaggregated feedback data to drive decision making; and (iii) building capacity to ensure localised and culturally sensitive responses. For each of these objectives, charts toward the end of this document outline outcomes, indicators, and activities; examples of community-led solutions in practice are included.

For instance, the Kenya Red Cross Society (KRCS) ran a perception survey in October 2020 that indicated that 38% of people get COVID-19 information from social media, while 43% still believed that the disease doesn't exist. A graduate teacher who does part-time comedy worked in partnership with KRCS to translate COVID-19 messages and share them as videos or audios on various social media platforms, including Facebook, WhatsApp, and Instagram. The messages were also used during community sensitisation sessions through focus group discussions (FGDs) and on public address systems. In the video viewable below, the teacher dispels rumours by showing pictures of senior government officials taking the test and one showing the burial function of a brother to another government official who passed away due to COVID-19. He keeps encouraging people that Coronavirus is real and that people must continue observing government measures.

The document concludes with links to various strategic documents, training packages and webinars, Africa community feedback reports and information products, and content on the COVID-19 vaccine and approaches for engaging with vulnerable people.