Engaging from a distance during COVID-19

Key lessons on Risk Communication and Social Mobilization in Uganda

By Hope Ejang Muzungu
coronavirus, COVID-19, stay at home, community engagement, communication for development, risk communication, social mobilization
UNICEF Uganda/2019/Bongyereirwe
11 May 2020

How do you prepare a country for a global pandemic?

No one saw the pandemic coming, at least not at the beginning, but as Coronavirus (COVID-19) swept across the world, 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 is risk communication, social mobilization and community engagement (RCSM-CE). 

In March 2020, before Uganda registered any case of COVID-19,, the RSCM-CE sub-committee activated a pre-existing response plan developed from prior experience in public health emergencies, most recently Ebola Virus Disease (EVD). 

"We started our preparedness immediately as it was a matter of time before the virus would reach the country" 

Richard Kabanda, notes.

Kabanda is the Chairman of the sub-committee and acting Commissioner Health Services at the Ministry of Health.

UNICEF, which co-chairs the sub-committee took the lead in resource mobilization and mass printing of nine different Information, Education and Communication materials translated into 30 languages and distributed to 135 districts. The languages and type of materials were agreed upon in the RCSM-CE biweekly meetings. 

Through key messaging on transmission, signs and symptoms, prevention and reporting mechanisms, the subcommittee focused on raising awareness and thereafter promoting preventive behavioural practices.

On 21 March 2020, as Uganda entered a government directed lockdown and registered its first COVID-19 case, the RCSM sub-committee was presented with a novel challenge- how to mobilise and engage a public in lockdown.

Social mobilization while social distancing

‘We have had to reinvent the wheel to suit the changes’, Tabley Bakyaita, the deputy chairman of the RCSM-CE subcommittee and acting Assistant Commissioner Health Services at Ministry of Health says. ’Whereas in the past physical interaction was a key part of social mobilization, this time we have had to engage from a distance.’  Instead of physical meetings, the sub-committee has intensified electronic media use and adopted the use of audio mobile vans that drive through different villages broadcasting messages, distributing flyers and responding to queries.

"We need to engage the community but protect it as well, so when crowds start gathering, the vans simply drive off",

Tabley adds.

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. The task force also is involving various leaders across the board including local councils and village health teams in the planning and implementation of preventive measures. The RCSM-CE Chairman, Mr. Kabanda explains why; ‘Their voices are key in this struggle.’ 

In it together

Shortly after the awareness campaigns started, various individuals and organizations approached the task force offering resources, talent, knowledge and skill, to combat the spread of the disease. One fine artist offered to illustrate the key messages, an association of film actors offered a short play on prevention and multiple organizations offered communication expertise and financial resources.  

A group of social and behaviour change communication specialists voluntarily offered their expertise to the subcommittee and developed a mass and social media campaign dubbed Tonsemberera, Luganda for ‘keep your distance’.  The campaign, which encourages distancing as well as other precautionary measures recommended by the national task force has since been adopted by the subcommittee and has been launched as the official national campaign for the Uganda COVID-19 response.
 
‘Each one came with what he has’, noted the RCSM-CE chairman, ‘We are all learning and we are in it together.

The community took our messages seriously

An April 2020 Ministry of Health online survey of over 12,000 social media users, revealed that 98 per cent of respondents were significantly aware about COVID-19 and 100 per cent perceived the severity of the outbreak. During the fourth week of April 2020 alone, a total of 7979 calls were received at the Ministry of Health call centres set up by the RCSM-CE subcommittee, inquiring about the disease or reporting suspected cases.

At a popular rest-stop on the Kampala-Masaka Highway towards western Uganda, handwashing is enforced to the letter. On his way to the restroom, a member of the RCSM-CE subcommittee was accosted by a waitress, ‘Please wash your hands sir’. An explanation was met with the same instruction, ‘First wash your hands sir.’ 

Though the communities have been highly responsive, the social economic impact of an extensive lockdown is challenging the risk perception in the communities. 

Mandi Chikombero, UNICEF Uganda’s Communication for Development Specialist, explains that communities perceive risk when, in addition to other factors, they ‘see’ death, and with a zero COVID-19 death rate in the country, there is a possibility of laxity as communities pursue improved economic livelihoods. As at 6 May, Uganda had confirmed 100 cases, 55 of whom have been discharged, with no deaths registered.

"It is clear that collective effort, consistent communication and innovation in community engagement are playing a key role in country preparation and response to COVID-19"

Mandi adds.

‘As co-chair of the RCSM-CE task force, UNICEF is continually reviewing and documenting the key lessons learned, to further enhance the response strategy for this and any future epidemics. The ultimate goal is awareness and safety for every child and their families.’

Other members of the evolving RCSM-CE task force include Airtel, AMREF Health Africa, BRAC, Center for Disease Control and Prevention, Communication for Development Foundation Uganda, Development Media International, Health Communication Resources Community Development Centre, Uganda Red Cross, Kampala Capital City Authority, Living Goods, Marie Stopes, Medical Teams International, MTN, Restless Development, Save the Children, Social and Behaviour Change Communication professionals, Ubuntu Bafumbira United Association, Uganda Peoples Defence Forces, Uganda Police, UNCDF, UNHCR, USAID, Water Aid, WHO and World Vision.