Research Unit on Health in Situations of Fragility, Institute for Global Health & Development, Queen Margaret University, Edinburgh, UK.
Independent researcher, San Salvador, El Salvador.
Int J Equity Health. 2021 Oct 9;20(1):222. doi: 10.1186/s12939-021-01559-3.
Social mobilisation is potentially a key tool in the prevention of non-communicable diseases (NCDs) in fragile settings. This formative study addressed existing and potential social mobilisation mechanisms seeking behaviour to tackle NCDs in El Salvador, with an emphasis on the implications in the context of the current COVID-19 pandemic.
We conducted 19 semi-structured interviews with health workers, government officials, NGO leaders, and community members. Interviews addressed mechanisms for social mobilisation which existed prior to COVID-19, the ways in which these mechanisms tackled NCDs, the impact of COVID-19 on social mobilisation activities and new, emerging mechanisms for social mobilisation in the wake of the COVID-19 pandemic.
Findings indicate a growing awareness of NCDs within communities, with social mobilisation activities seen as valuable in tackling NCDs. However, major barriers to NCD prevention and treatment provision remain, with COVID-19 constraining many possible social mobilisation activities, leaving NCD patients with less support. Factors linked with effective social mobilisation of communities for NCD prevention included strong engagement of community health teams within community structures and the delivery of NCD prevention and management messages through community meetings with trusted health professionals or community members. There are gender differences in the experience of NCDs and women were generally more engaged with social mobilisation activities than men. In the context of COVID-19, traditional forms of social mobilisation were challenged, and new, virtual forms emerged. However, these new forms of engagement did not benefit all, especially those in hard-to-reach rural areas. In these contexts, specific traditional forms of mobilisation such as through radio (where possible) and trusted community leaders - became increasingly important.
New mechanisms of fostering social mobilisation include virtual connectors such as mobile phones, which enable mobilisation through platforms such as WhatsApp, Facebook and Twitter. However, traditional forms of social mobilisation hold value for those without access to such technology. Therefore, a combination of new and traditional mechanisms for social mobilisation hold potential for the future development of social mobilisation strategies in El Salvador and, as appropriate, in other fragile health contexts.
社会动员是在脆弱环境中预防非传染性疾病（NCDs）的潜在关键工具。这项形成性研究解决了萨尔瓦多现有的和潜在的社会动员机制，强调了这些机制在当前 COVID-19 大流行背景下的影响。
我们对卫生工作者、政府官员、非政府组织领导人和社区成员进行了 19 次半结构化访谈。访谈内容包括 COVID-19 之前存在的社会动员机制、这些机制应对 NCD 的方式、COVID-19 对社会动员活动的影响以及 COVID-19 大流行后新出现的社会动员机制。
研究结果表明，社区对 NCD 的认识不断提高，社会动员活动被视为应对 NCD 的重要手段。然而，NCD 预防和治疗提供方面仍然存在重大障碍，COVID-19 限制了许多可能的社会动员活动，使 NCD 患者得到的支持减少。与社区为 NCD 预防进行有效社会动员相关的因素包括社区卫生团队在社区结构中的强有力参与以及通过社区会议由值得信赖的卫生专业人员或社区成员提供 NCD 预防和管理信息。在 NCD 体验方面存在性别差异，女性通常比男性更参与社会动员活动。在 COVID-19 背景下，传统形式的社会动员受到挑战，新的虚拟形式出现了。然而，这些新的参与形式并不能使所有人受益，尤其是那些难以到达的农村地区的人。在这些情况下，特定的传统动员形式，如通过广播（在可能的情况下）和值得信赖的社区领导，变得越来越重要。
促进社会动员的新机制包括移动电话等虚拟连接器，这些连接器可通过 WhatsApp、Facebook 和 Twitter 等平台进行动员。然而，对于那些无法使用这种技术的人来说，传统的社会动员形式仍然具有价值。因此，新的和传统的社会动员机制的结合为萨尔瓦多未来社会动员战略的发展提供了潜力，在适当情况下，也为其他脆弱健康环境提供了潜力。
