Type of Material: Reports and Studies

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Environmental and Behavioral Determinants of Lassa Fever: A qualitative exploration among communities and health care workers in Tonkolili and Kenema districts, Sierra Leone

Local health authorities have classified Lassa fever as a priority zoonotic disease in many sub-Saharan African countries, including Sierra Leone. While much research has been published about Lassa fever, it has primarily focused on clinical diagnosis and epidemiological surveillance. Few studies are available globally on the sociocultural and behavioral drivers of Lassa fever, and particularly from Sierra Leone.

This study— conducted by Breakthrough ACTION, based at Johns Hopkins Center for Communication Programs, in collaboration with the Sierra Leone One Health Risk Communication Technical Working Group (OHRC TWG)—explored community members’ perceptions, knowledge, and behaviors associated with rodents in general and rats that carry Lassa fever specifically.

Specific research objectives included describing and understanding the following:

  1. The context of Lassa fever in affected communities.
  2. Individual and community norms and behaviors that increase risk and vulnerability for Lassa fever.
  3. Personal experiences with rats during daily living and with Lassa fever sickness.
  4. The level of knowledge and awareness of Lassa fever among community members.
  5. Knowledge of what to do if one suspects that they or someone else has Lassa fever.
  6. Knowledge of ways to prevent Lassa fever among community members.
  7. Individual perceptions of behavioral and other drivers of Lassa fever.

The study results also support the following:

  1. Developing credible sources of information about the risk and transmission of Lassa fever.
  2. Generating findings to serve as a reference point for One Health sectors including the Ministry of Health and Sanitation (MOHS), Environmental Protection Agency, the Ministry of Agriculture and Forestry, and other health agencies working to strengthen sensitization to Lassa fever in the country.
  3. Mitigating potential rumors and misinformation about Lassa fever.
  4. Identifying credible sources and/or developing credible materials to promote behavior change.

This report summarizes key findings on the social and behavioral drivers of Lassa fever in the Kenema and Tonkolili districts of Sierra Leone.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: February 3, 2023

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Adaptation, Experiences, and Support Needs of Survivors of Ebola Virus Disease in Bombali and Kenema Districts of Sierra Leone: Formative Assessment in Kenema and Bombali Districts
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Adaptation, Experiences, and Support Needs of Survivors of Ebola Virus Disease in Bombali and Kenema Districts of Sierra Leone: Formative Assessment in Kenema and Bombali Districts

After Sierra Leone’s Ebola epidemic, the Government of Sierra Leone, USAID and other partners developed and implemented the Comprehensive Program for Ebola Survivors (CPES) to support access to care and improve livelihoods for survivors of Ebola virus disease (EVD). In spite of these program priorities, EVD survivors in Sierra Leone have reported stigma and discrimination based on their survivor status and fears of transmission of the virus.

A recent outbreak of EVD in Guinea in February 2021 was found to be genetically linked to the 2014–2016 Ebola outbreak and may possibly be linked to a latent or relapsed infection linked to an EVD survivor. This potential outbreak origin was reported in local news outlets and spread through some local communities, heightening EVD survivors’ fears of increased stigma and ostracization. Breakthrough ACTION collaborated with the Sierra Leone Public Information, Risk Communication, and Social Mobilization pillar and representatives of the Sierra Leone Association of Ebola Survivors (SLAES) to support Ebola preparedness planning in Sierra Leone.

This qualitative study among EVD survivors in Sierra Leone was based on recommendations from the WHO to increase understanding of how new knowledge about the potential for long-term latent infection and transmission of EVD affects EVD survivors’ perceptions of risk, psychosocial needs, concerns around health and stigma, and relationships with others including health workers. Informal discussion groups among EVD survivors were conducted in Kenema and Bombali districts to elicit information about these themes. The study was approved by the Johns Hopkins University Institutional Review Board and the Sierra Leone Ethics and Scientific Review Council, and was a collaboration between Breakthrough ACTION, the Sierra Leone Public Information, Risk Communication, and Social Mobilization (PIRCSM) pillar, and representatives of the Sierra Leone Association of Ebola Survivors (SLAES). The results may be used to identify information gaps that can be addressed through risk communication interventions to support EVD survivors.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: February 3, 2023

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Cocreation in Health Workforce Planning
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Cocreation in Health Workforce Planning to Shape the Future of the Health Care System in the Philippines

The need for an updated health workforce national plan for the Philippines was prompted by the passage in July 2019 of landmark legislation on universal health coverage (UHC), which guaranteed UHC for all Filipinos and prescribed complementary reforms in the health care system.

This program case study describes a cocreation process to generate and analyze data on health professions as part of strategic planning to inform the development of a national health workforce master plan for the Philippines. By describing both the process and findings, the study seeks to provide relevant lessons for policymakers, program managers, researchers, and other stakeholders who deal with health workforce issues in low- and middle-income countries.

Date of Publication: January 31, 2023

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More LESSONS LEARNED AND GOOD PRACTICES: COUNTRY-SPECIFIC CASE STUDIES ON IMMUNIZATION ACTIVITIES DURING THE COVID-19 PANDEMIC Resources

Lessons Learned and Good Practices: Country-Specific Case Studies on Immunization Activities During the COVID-19 Pandemic

The methodology for this report included a literature review of available documentation and research, key informant interviews, and focus group discussions with UNICEF country and regional offices and partners. The process led to a series of six case studies, which describe predominantly positive campaign experiences, documenting lessons and good practices that can inform future immunization programs carried out during COVID-19 or similar circumstances.

Source: UNICEF

Date of Publication: January 18, 2023

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More Afghan Safe Migration Resources

Afghan Safe Migration

Afghans engage in migration through irregular means due to a multiplicity of factors such as the continued and worsening security and economic situation in Afghanistan, lack of rights, high unemployment, and environmental hazards.

The Afghan Safe Migration project supported Afghan diaspora organizations in Denmark, Germany, and the Netherlands to deliver protection information based on the needs among potential and current migrants from Afghanistan.

The required information was determined through research and data collection, including in-depth consultations with Afghan diaspora groups in Europe, migrants en route, prospective migrants, and returnees in Afghanistan. The capacity of Afghan diaspora organizations engaged in providing protection information was increased, and networks were established, to ensure targeted messages and information on protection assistance in English, Farsi/Dari, and Pashto to strengthen safe and protective migration environments for vulnerable people from Afghanistan.

Visit the “Safe Migration Information for Afghans” web page for more information.

Source: Danish Refugee Council

Date of Publication: January 12, 2023

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The Context of Rabies in Bombali District, Sierra Leone: Formative Research and Baseline Outcomes Monitoring Assessment Report

Rabies is the second most important priority zoonotic disease (PZD) in Sierra Leone. There is little information about community-level perceptions and behaviors that influence rabies risk in Sierra Leone, and community needs for effective rabies prevention and control. Understanding community needs and their resources and capital for supporting a comprehensive rabies control program can guide development of behavior change interventions and facilitate community engagement with social and behavior change (SBC) programs.

Formative research was conducted to understand the socio-cultural context of rabies in Sierra Leone. Fifteen focus groups were conducted with children and adults in five constituencies and 16 communities of Bombali District. This analysis explores the question: What are the perceived community needs for rabies prevention and risk reduction, and how may they inform design of a communication campaign for rabies prevention? Data analysis was coded to organize the data into themes and relationships.

Perceived community needs for SBC messages included: education, guidelines for safe human-animal interactions, responsible animal ownership, vaccines and medicines, access to trained animal health workers including new cadres of animal health workers, and regulatory and reporting structures for risk incidents. The findings reinforce the need for an intersectoral approach to rabies prevention that includes communities, health, education, and agriculture sectors, and supply chain management. The findings support also the WHO guiding framework for global action to eliminate rabies, specifically understanding socio-cultural context for behavior change, increasing awareness and knowledge, strengthening animal and public health systems, and intersectoral partnership and coordination.

Source: Johns Hopkins Center for Communication Programs

Date of Publication: December 2, 2022

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Connect Project - Formative Research Brief
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Promising Directions and Missed Opportunities for Reaching First-time Mothers with Reproductive, Maternal, Newborn, and Child Health Services: Findings from formative assessments in two countries

In many settings, young, first-time mothers (FTMs) face additional barriers that limit their use of reproductive, maternal, newborn, and child health (RMNCH) services, including postnatal care (PNC) and postpartum family planning (PPFP), and are vulnerable to poor health outcomes, including rapid repeat pregnancies. This brief describes findings from a formative barrier and facilitator analysis conducted in Bangladesh and Tanzania. The formative research used a participatory journey mapping approach to identify FTMs’ touch-points with the health system for antenatal care, delivery, PNC, immunizations, and PPFP, and the factors that influenced their use (and often non-use) of these services. The brief describes windows of opportunity (and many missed opportunities) to reach FTMs with integrated services responsive to their needs, to foster supportive families and communities through effective SBC approaches, and to support continuity of RMNCH care across the continuum of care.

Source: Save the Children

Date of Publication: November 7, 2022

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World AIDS Day Report 2021
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Rapport de la journée mondiale de lutte contre le sida

POURQUOI UNE ACTION AUDACIEUSE CONTRE LES INÉGALITÉS EST NÉCESSAIRE POUR METTRE FIN AU SIDA, ARRÊTER LE COVID-19 ET SE PRÉPARER AUX FUTURES PANDÉMIES?
L’humanité est menacée par un nombre croissant de pandémies. Le sida entre en collision avec la COVID-19 avec des effets mortels, car une grande partie du monde reste dangereusement sous-préparée et sous-financée pour faire face aux pandémies d’aujourd’hui et de demain.
Au cours des quatre dernières décennies, les progrès dans les investissements dans la science, les droits humains et la santé publique ont conduit à des succès remarquables dans la lutte contre le sida pour certaines régions et populations. Ces progrès ont montré ce qui est possible lorsque les pays et les communautés luttent ensemble contre une contagion mortelle.

Source: ONUSIDA

Date of Publication: October 25, 2022

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Mining for Social and Behavior Change: Human-centered design research around malaria care-seeking behaviors in gold mining communities of Guyana

This resource presents a visual format summarizing Breakthrough ACTION Guyana’s Design and Test report. The full report goes into detail on the project’s methodology and solutions developed to improve malaria outcomes among gold mining communities in Regions 7 and 8.

View the visual essay here
View the full insights report here

Source: Johns Hopkins Center for Communication Programs

Date of Publication: September 26, 2022

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More Big Problem Resources

There’s Gold in Social and Behavior Change: Human-centered design research around malaria care-seeking behaviors in gold mining communities of Guyana

This resource presents a visual format summarizing Breakthrough ACTION Guyana’s Insights Report. The full report goes into detail on the project’s methodology and using human-centered design to improve malaria outcomes among gold mining communities in Regions 7 and 8.

  • View the visual essay here
  • View the full insights report here

Source: Johns Hopkins Center for Communication Programs

Date of Publication: September 26, 2022

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