Uganda

Research Terms of Reference: Risk Communication Community Engagement (RCCE) Assessment - Uganda (July 2020)

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The COVID-19 virus, which originated in Wuhan, China in December 2019, was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. To date, In Uganda, there has been a total recovery of 990 cases as of 28th July, 202011 , there are cumulative cases day by day with currently 1135 cases in-country.

Since 18 March12, 2020, the government of Uganda has taken several measures to curb the spread of the virus, such as closing borders, enforcing isolation, social distancing policies, affecting in particular gatherings of people, access to places of worship, schools, and public transport. However, public adherence to these restrictions and other preventative behaviors are observed to be relatively low. Recent KAP and other assessments13 have identified information gaps, misinformation, and rumors as drivers of this low adherence, but many also note that many individuals who do have access to and do trust correct information about Covid-19 still do not fully adhere to the restrictions or preventive behaviors. Therefore, increased access to information may not fully close the adherence gap. While there have been past KAP studies and assessments related to this topic, particularly around the Ebola response in Uganda, studies have been ad-hoc, smaller-scale, and only focusing on a particular region or geographic area.

As Coronavirus (Covid-19) swept across the world, The World Health Organisation (WHO) with the Ministry of Health (MoH) Uganda kick-started an eight-pillar response plan spearheaded by a national task force for public health emergency coordination and response. A key pillar of the response plan was risk communication, social mobilization and community engagement (RCSM-CE). Through key messaging on transmission, signs and symptoms, prevention and reporting mechanisms, the subcommittee has focused on raising awareness and thereafter promoting preventive behavioral practices.

The RCSM-CE sub-committee has further refined and dispatched purpose-built guidelines for community engagement that enable health educators to conduct awareness campaigns at district and village levels, within the framework of government restrictions. Humanitarian and governmental actors have also begun to provide multi-sectoral support during the Covid-19 response; particularly in terms of coordination and accountability towards the affected communities, through awareness and information campaigns on the virus, within the most affected communities with a focus on the high-risk districts14, but also throughout the territory where responding organizations were already implementing projects.

It is crucial to inform this response and assess whether community engagement is being conducted in an appropriate and inclusive manner, whether it is disseminating the information that people really need, and whether these information and communication messages are being disseminated through the right channels and are both well understood and interpreted in a way that leads to a healthy assessment of risks. In order to rapidly and effectively educate and accurately inform the general public about the pandemic, actors should know what the community beliefs are, the community level of participation, the community accessibility to timely and accurate information as well as what their main and trusted infromation channels are. Beyond that, actors need strategies to combat the tendency of individuals to lower their perceptions of risk over time, which is a trend that is common even when correct information about Covid-19 is readily available.

In addtion, this assessment seeks to continue tracking time-series data carried out by Ground Truth Solutions (GTS) on affected people’s perceptions of the humanitarian response over the last three years, and understand how COVID-19 has impacted these. In this vein, the role Accountability to Affected Populations (AAP) mechanisms can play in building trust in and strengthening the effectiveness of RCCE efforts, and in supporting the Covid-19 response more generally, will be explored in more detail.

To date, little is also known on how local social networks that underlie community communication channels can have an influence on community behaviour, risk awareness, and risk perception. Networks of community influencers, be they community members, local or religious leaders or local organisations and institutions, may have an important influence on community information ecosystems and could thus be of pivotal importance for effective risk communication and community engagement activities on community level.

In order to address these knowledge gaps, the Uganda Learning Evidence Accountability and Research Network (U-Learn), with support from GTS, started working on rumor tracking and assessments of AAP mechanisms, which are closely linked to this assessment. Effective RCCE (including two-way AAP) is a key operational approach in the response to influence communities’ risk perceptions, health behaviors and practices in such a way that they contribute to reducing the risk of an untenable spread of the Covid-19 virus. U-Learn believes that RCCE/AAP assessment(s) results will be key in building trust in communities, which is a prerequisite for any successful current and future response activities in Uganda.