Gobena Dabesa, Gudina Esayas Kebede, Fetensa Getahun, Degfie Tizta Tilahun, Debela Tessema, Tamiru Afework, Bayissa Zenebu Begna, Diriba Dereje, Sarbessa Tarekegn, Bekele Daniel, Teferi Natinel, Layesa Achalu, Zewdie Abate, Ayele Dawit Worku, Mersha Meron Debebe, Bafikadu Chala, Wake Senahara Korsa, Abebe Lemi, Kebebew Tesfaye, Goshu Tefera, Kenate Birhanu, Dessie Yadeta, Mekonnen Zeleke
Public Health Emergency Management and Health Research Directorate, Oromia Health Bureau, Addis Ababa, Ethiopia.
School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.
Trop Med Health. 2025 Jan 13;53(1):4. doi: 10.1186/s41182-024-00679-0.
Oromia regional state experiencing cholera outbreaks in a protracted pattern despite various interventions at local and regional levels. This study aimed to examine the implementation of Risk Communication and Community Engagement (RCCE) activities for cholera outbreak control in the region.
We conducted a quantitative and qualitative mixed-method study. The study included 422 respondents for quantitative, 22 key informant interviews (KII), and 4 Focus Group Discussions (FGDs) for the qualitative methods. Risk Communication and Community Engagement (RCCE) activities were assessed using standard questionnaires adapted from national cholera guideline later categorized as poor, satisfactory and good. The findings have also been derived qualitatively from three distinct themes or pillars, specifically (coordination and logistics, RCCE, and the Oral Cholera Vaccine). The quantitative data were analyzed using Stata, version 14.0, and ATLAS.ti9 software was used for qualitative data analysis. An ordinal logistic regression model was applied to identify factors associated with the RCCE status, and a thematic content analysis was performed for the qualitative study. Odds Ratios with 95% confidence intervals (CI) were used to present the findings from the quantitative analysis.
Only 53% (223) of participants had received health information on cholera of whom 22.8% (96) had material for Social Behaviour Change (SBC) in the local language (Afan Oromo). The overall RCCE implementation status was rated as poor by 73% of the respondents, satisfactory by 23%, and only 4% rated it as good. Level of education and occupation of the house are among the factors affecting the implementation of RCCE. The qualitative findings revealed a lack of regular community dialogues, and community engagements were notably minimal during the early phase of the outbreak. Overall, the RCCE implementation activities were characterized by inconsistency, a lack of comprehensiveness, and uniformity across all levels.
The RCCE-related intervention activities were found to be minimal, inconsistent and less focused. The RCCE interventions and awareness creation need to begin with the small units of the community structures, including individuals and families and have to happen continuously with the community, and health workers' involvement at all level. Preliminary evaluation of Social and Behaviour Change (SBC) materials before their distribution should be made, and adopting diverse communication modalities to control the outbreak.
尽管在地方和区域层面采取了各种干预措施，但奥罗米亚地区州仍长期遭受霍乱疫情的困扰。本研究旨在考察该地区为控制霍乱疫情而开展的风险沟通与社区参与（RCCE）活动的实施情况。
我们开展了一项定量与定性相结合的混合方法研究。定量研究纳入了422名受访者，定性研究包括22次关键 informant 访谈（KII）和4次焦点小组讨论（FGD）。风险沟通与社区参与（RCCE）活动通过根据国家霍乱指南改编的标准问卷进行评估，之后分为差、满意和好三个等级。研究结果还从三个不同的主题或支柱进行了定性分析，具体为（协调与后勤、RCCE和口服霍乱疫苗）。定量数据使用Stata 14.0版本进行分析，定性数据使用ATLAS.ti9软件进行分析。应用有序逻辑回归模型来确定与RCCE状况相关的因素，并对定性研究进行主题内容分析。定量分析结果采用95%置信区间（CI）的优势比来呈现。
只有53%（223名）参与者收到了关于霍乱的健康信息，其中22.8%（96名）拥有当地语言（阿凡奥罗莫语）的社会行为改变（SBC）材料。73%的受访者将RCCE的整体实施状况评为差，23%评为满意，只有4%评为好。家庭的教育水平和职业是影响RCCE实施的因素之一。定性研究结果显示缺乏定期的社区对话，在疫情早期社区参与明显很少。总体而言，RCCE实施活动的特点是不一致、缺乏全面性且各级之间缺乏统一性。
发现与RCCE相关的干预活动很少、不一致且重点不突出。RCCE干预和意识提升需要从社区结构的小单元入手，包括个人和家庭，并且必须持续与社区以及各级卫生工作者的参与相结合。在分发社会和行为改变（SBC）材料之前应进行初步评估，并采用多种沟通方式来控制疫情。
