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J Health Commun ; 22(sup1): 39-50, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28854137


This article describes the development of standard operating procedures (SOPs) for social mobilization and community engagement (SM/CE) in Sierra Leone during the Ebola outbreak of 2014-2015. It aims to (a) explain the rationale for a standardized approach, (b) describe the methodology used to develop the resulting SOPs, and (c) discuss the implications of the SOPs for future outbreak responses. Mixed methodologies were applied, including analysis of data on Ebola-related knowledge, attitudes, and practices; consultation through a national forum; and a series of workshops with more than 250 participants active in SM/CE in seven districts with recent confirmed cases. Specific challenges, best practices, and operational models were identified in relation to (a) the quality of SM/CE approaches; (b) coordination and operational structures; and (c) integration with Ebola services, including case management, burials, quarantine, and surveillance. This information was synthesized and codified into the SOPs, which include principles, roles, and actions for partners engaging in SM/CE as part of the Ebola response. This experience points to the need for a set of global principles and standards for meaningful SM/CE that can be rapidly adapted as a high-priority response component at the outset of future health and humanitarian crises.

Participação da Comunidade , Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/prevenção & controle , Mobilidade Social , Doença pelo Vírus Ebola/epidemiologia , Humanos , Serra Leoa/epidemiologia
Glob Health Sci Pract ; 4(4): 626-646, 2016 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-28031301


Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component-which UNICEF refers to as communication for development (C4D)-of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. This article describes the lessons learned about social mobilization and community engagement in the emergency response to the Ebola outbreak, with a particular focus on UNICEF's C4D work in Guinea, Liberia, and Sierra Leone. The lessons emerged through an assessment conducted by UNICEF using 4 methods: a literature review of key documents, meeting reports, and other articles; structured discussions conducted in June 2015 and October 2015 with UNICEF and civil society experts; an electronic survey, launched in October and November 2015, with staff from government, the UN, or any partner organization who worked on Ebola (N = 53); and key informant interviews (N = 5). After triangulating the findings from all data sources, we distilled lessons under 7 major domains: (1) strategy and decentralization: develop a comprehensive C4D strategy with communities at the center and decentralized programming to facilitate flexibility and adaptation to the local context; (2) coordination: establish C4D leadership with the necessary authority to coordinate between partners and enforce use of standard operating procedures as a central coordination and quality assurance tool; (3) entering and engaging communities: invest in key communication channels (such as radio) and trusted local community members; (4) messaging: adapt messages and strategies continually as patterns of the epidemic change over time; (5) partnerships: invest in strategic partnerships with community, religious leaders, journalists, radio stations, and partner organizations; (6) capacity building: support a network of local and international professionals with capacity for C4D who can be deployed rapidly; (7) data and performance monitoring: establish clear C4D process and impact indicators and strive for real-time data analysis and rapid feedback to communities and authorities to inform decision making. Ultimately, communication, community engagement, and social mobilization need to be formally placed within the global humanitarian response architecture with proper funding to effectively support future public health emergencies, which are as much a social as a health phenomenon.

Fortalecimento Institucional/métodos , Participação da Comunidade/métodos , Doença pelo Vírus Ebola/terapia , Saúde Pública/métodos , África Ocidental , Surtos de Doenças , Emergências , Humanos , Organização Mundial da Saúde
Front Public Health ; 4: 271, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28194396


STUDY OBJECTIVES: To document the progression of school health and nutrition and its integration within the education sector in sub-Saharan Africa between 2000 and 2015. BACKGROUND: School health and nutrition programs have contributed to "Education for All" objectives by helping ensure that children benefit from quality education and reach their educational potential. METHODS: Analysis of education sector plans (ESPs) in terms of the Focusing Resources on Effective School Health (FRESH) framework and the World Bank Systems Approach for Better Education Results (SABER) School Health survey from a set of countries in sub-Saharan Africa. RESULTS: Between 2000 and 2015, the presence and scope of school health and nutrition as reflected in the four FRESH pillars grew substantially in ESPs. Three of these pillars have large, upfront costs. The fourth pillar requires recurring annual budgetary allotments. CONCLUSION: Governments clearly recognize that evidence-based, contextually designed school health and nutrition programs can contribute to education sector goals. Moving into the post-2015 era, these programs can also help draw the last 10% of children into school and enhance their readiness to learn.

J Acquir Immune Defic Syndr ; 66 Suppl 2: S144-53, 2014 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-24918590


OBJECTIVES: To examine levels and patterns of HIV prevalence, knowledge, sexual behavior, and coverage of selected HIV services among adolescents aged 10-19 years and highlight data gaps and challenges. METHODS: Data were reviewed from Joint United Nations Programme on HIV/AIDS HIV estimates, nationally representative household surveys, behavioral surveillance surveys, and published literature. RESULTS: A number of gaps exist for adolescent-specific HIV-related data; however, important implications for programming can be drawn. Eighty-two percent of the estimated 2.1 million adolescents aged 10-19 years living with HIV in 2012 were in sub-Saharan Africa, and the majority of these (58%) were females. Comprehensive accurate knowledge about HIV, condom use, HIV testing, and antiretroviral treatment coverage remain low in most countries. Early sexual debut (sex before 15 years of age) is more common among adolescent girls than boys in low- and middle-income countries, consistent with early marriage and early childbirth in these countries. In low and concentrated epidemic countries, HIV prevalence is highest among key populations. CONCLUSIONS: Although the available HIV-related data on adolescents are limited, increased HIV vulnerability in the second decade of life is evident in the data. Improving data gathering, analysis, and reporting systems specific to adolescents is essential to monitoring progress and improving health outcomes for adolescents. More systematic and better quality disaggregated data are needed to understand differences by sex, age, geography, and socioeconomic factors and to address equity and human rights obligations, especially for key populations.

Infecções por HIV/epidemiologia , Adolescente , Envelhecimento , Criança , Epidemias , Feminino , Infecções por HIV/mortalidade , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Prevalência , Comportamento Sexual , Adulto Jovem