Online Program

Preparing for the next Ebola: A community- engaged approach to infection prevention and control

Tuesday, November 3, 2015 : 9:09 a.m. - 9:22 a.m.

Meredith Minkler, DrPH, MPH, Department of Community Health Sciences, UC Berkeley School of Public Health, Berkeley, CA
Frederick Marais, PhD, Division of Community Health, Western Cape Government: Health and Stellenbosch University, Cape Town, South Africa
Nancy Gibson, PhD, CIET Department of Family Medicine, McGill University, Montreal, QC, Canada
Shaheen Mehtar, FRC (Path) FC, MD, Department of Family Medicine and Health Sciences, Infection Control Africa Network and Stellenbosch University, Cape Town, South Africa
Sama Banya, MD, Freetown, Sierra Leone
Critical reflection on the worst Ebola outbreak in human history suggests that while rigorous adherence to infection prevention and control precautions and safety standards was essential, a  key missing link lay in the in the failure to adequately apply principles of community engagement. These include the early, active and sustained involvement of affected communities, and their trusted leaders, networks and lay knowledge, to help inform what control teams do, and how they may better do it, in partnership with communities.

Drawing on the experience of health care workers and residents in Sierra Leone, Liberia, South Africa, Kenya and other African nations; organizations including CDC, WHO and the Infection Control Africa Network; and of leaders in community engagement and infectious disease, we present an eight step model for creating an environment emphasizing reciprocal learning and trust, multi-method, bi-directional communication, assessment, and building for sustainability.  Using examples of changes in burial and other practices in west Africa that were culturally relevant yet maintained safety, we illustrate how often minor adjustments to the IPC protocol, taking  into account the “community protocol” (cultural values, customs and practices) were able to improve community receptivity and discourage practices such as the hiding of ill family members and unsafe burials.

 Outbreaks of Ebola tend to occur in 4 year cycles, with similar cyclic patterns seen with other Viral Hemorrhagic Viral Fevers (VHFs).  Although preparation for the next such outbreak must include greatly improved health and social care infrastructure, particularly in informal settements and other deeply impoverished areas,  methods for approaching and actively engaging community leaders and members must also be a much greater part of infection prevention and control efforts.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related education

Learning Objectives:
Identify 3 principles of community engagement that hold relevance for improving the prevention control of Ebola and related diseases Describe 2 examples of small adjustments to a traditional Viral Hemorrhagic Fever IPC safety protocol that may result in improved adherence, without compromising safety. List 3 questions that may be asked of residents to help identify respected informal community leaders

Keyword(s): Cultural Competency, Community-Based Partnership & Collaboration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a professor of health and social behavior at UC Berkeley, I spent years studying community engagement and developing community health partnerships. I have co-presented NIH- and Fulbright sponsored courses on community engagement to improve global health in South Africa, and worked with colleagues in and beyond Africa to develop a community-engaged response to Ebola. We subsequently submitted a successful CDC grant in this area to pilot this approach in Liberia
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.