ChildRights Information Bureau to Hold Review Workshop in Lagos, Unfolds activities
The Child Rights Information Bureau (CRIB) during the period under review was in Lagos on a five day Workshop on Infectious Diseases Risk Communication Plan Development, held on 16th -20th April, 2018 at Dover Hotel, Lekki Lagos
Participants were drawn from the Federal Ministries of Health and Information, National Orientation Agency (NOA) from Abuja Edo Jos and Lagos, National Primary Health Care Development Agency, UNICEF, State Health Educators from Abia and Kwara, Private Media Organizations and Nigeria Center for Disease Control, NCDC.
The Coordinator, Dr Femi Ayoola of Nigeria Centre for Disease Control welcomed the participants on behalf of the Director General of the NCDC. He thanked the participants for responding to the invitation letter, stating that the workshop was a national assignment and must be accorded all respect.
Dr Femi Ayoola explained that Nigeria Centre for Disease Control (NCDC) was established in the year 2011 in response to the challenges of public health emergencies and to enhance Nigeria’s preparedness and response to epidemics through prevention, detection, and control of communicable and non-communicable diseases. Its core mandate is to detect, investigate, prevent and control diseases of national and international public health importance.
The mission for the NCDC next five years (2017-2021) is
· To protect the health of Nigerians through evidence-based prevention, integrated disease surveillance and response activities, using a one health appChild Rights Information Bureau (CRIB)roach, guided by research and led by a skilled workforce. The core functions of the NCDC include:
· Prevent, detect, and control diseases of public health importance.
· Coordinate surveillance systems to collect, analyze and interpret data on diseases of public health importance.
· Support States in responding to small outbreaks, and lead the response to large disease outbreaks.
· Develop and maintain a network of reference and specialized laboratories.
· Lead Nigeria’s engagement with the international community on diseases of public health relevance
· Conduct, collate, synthesize and disseminate public health research to inform policy.
The workshop was based on development of an infectious Risk Communication Work plan, a unified document that is workable at the National, State, and LGA levels. The Risk Communication activities carried out by NCDC Team at Ebonyi State revealed the Risk Communication strategies employed and challenges encountered during the visit and solutions introduced.
NCDC’s first approach towards infectious disease eradication in Nigeria was in 2014 during Ebola outbreak which recorded a successful eradication of the disease from Nigeria and good reference to the West African countries.
Participants were encouraged to incorporate the NCDC Ebola Risk Communication Strategy in the Risk Communication plan documents to be developed.
Objectives of the infectious Diseases Risk Communication Plan
· To identify, assess and monitor risk perception of communities to infectious diseases, 2017-2022
· To develop an effective risk communication plan for infectious disease(2017-2022)
· To strengthen preparedness for effective response in Nigeria.
Risk Communication in Nigeria
The importance of health education before and during outbreak cannot be over emphasized; it requires the full participation of the community.
Before an outbreak, the populace must be well informed of preventive measures needed to protect against infection and its spread through continuous education and risk communication.
During an outbreak, the population must be informed of the epidemic and measures to be taken, including the importance of early case detection as well as knowledge that treatment can be easily accessed. Consult local authorities to adapt the messages to the local context, dispel rumors about superstitious beliefs claimed to have caused the outbreak
The communication function should be managed by the Risk Communication/Health Education department at the State Ministry of Health and nationally at the Nigeria Centre for Disease Control. States should coordinate the Advocacy, Communication and Social Mobilization activities around AWD outbreaks through their respective Social Mobilization Committees.
RISK COMMUNICATIONS AND PUBLIC EDUCATION
Before, during, and after a health emergency, the main purpose of communication is to provide timely, accurate, and easily-understood information and instructions to pandemic response personnel, local government, hospitals, the business community, and the public. Dissemination and sharing of timely and accurate information among public health and government officials, health care providers, the media, and the general public will be one of the most important facets of managing response to a pandemic. There will be widespread circulation of conflicting information, misinformation, and rumours, all of which must be adequately addressed. Communication must be coordinated among all relevant agencies to ensure consistent messages to the general public.
There will be great demand for accurate and timely information, including:
· General information concerning the pandemic / epidemic, including morbidity and mortality.
· Disease control efforts, including availability and use of vaccines and anti-viral medications.
· Infection control measures for implementation by the public.
· The status of essential community services
· Steps being taken by the Government to respond to the pandemic and to mitigate suffering and loss of life.
Because of anticipated shortages of both anti-viral medications and pandemic influenza vaccine, the messaging concerning acquisition, distribution and use of these medications must be addressed very carefully. Additionally, any success at containing or slowing viral spread will depend on the timeliness and accuracy of public information and education efforts. Effective communication will also play a large part in reducing panic and unnecessary demand on healthcare resources.
Federal Ministry of Health Avian Influenza Plan Pre-pandemic preparation.
The potential for a pandemic disaster to begin quickly makes it imperative that all ministries and other government agencies conduct effective communications planning. Planning must include:
· Identification of Public Information Officers (PIO) that will coordinate the planning of communications activities for a pandemic response.
· Identification and training of spokesperson(s).
· Development of pre-prepared “prescriptive messages” and media materials for use during pandemic response operations.
· Identification of communication channels to be used during pandemic response operations.
Risk Communication Structure.
An outbreak is a public health emergency, which calls for an immediate response and requires the rapid mobilization of resources. A response should take place at the lowest jurisdictional level for the affected areas. Depending on the severity of the outbreak, the response effort may be scaled up to include direct involvement, technical assistance or resource support from the State and/or National Level. In addition, preparedness activities and advance planning for an outbreak should take place at all governing levels.
During outbreaks, the NCDC adopts and implements the Incident Management System (IMS) to coordinate the much needed multi-sectoral preparedness and response in collaboration with the State Ministries of Health and other stakeholders. The IMS is led by an assigned Incident Manager (IM) who oversees the preparation, planning, resource management, and overall operation of an emergency response. The IMS staff conducts its preparedness and response activities from the Emergency Operation Centre (EOC); a physical structure where meetings can be held and decisions made.
The IM should be vested with appropriate legal and policy authorities to response to the emergency, as well as financial and other resources from the government.
The key pillars within the IMS structure include:
• Laboratory diagnosis
• Case management and Logistics
• Risk communication/social mobilization
EXISTING INSTITUTIONAL FRAMEWORK FOR RISK COMMUNICATION IN NIGERIA
There is a clear definition of functions of ministries, departments and agencies which have enabled the NCDC constitute a multi sector working group for risk communication. The public national media exists is overseen by the Ministry of Information and has a wide reach. In addition regular press releases occur during disease outbreaks targeted at key national media ensured appropriate reach across the country in States participate in developing Information, Education and Communication materials and stakeholder engagement which yields nationwide output which is achieved in record time.
There National Youth Service Corp also participates in Community Development Services and Have a network that can be leveraged on to transmit information to affected communities.
Multiple event based surveillance systems exists including but not limited to the NCDC connect centre, community-based rumor reporting system through community informants and VCMs via the UNICEF structure etc.
Risk communication in Public Health Emergencies
Risk Communication is the process of informing people about hazards to their environment or their health. Communicating risk is a two-way exchange in which organizations inform target audiences of possible risks, and gather information from those affected by the risk. Risk communication is a critical step in effectively defining and managing any crisis situation. Communicating a message with specific instructions and alternatives regarding a public health or environmental risk to a community can lead to successful risk management of a crisis.
Benefits of Risk Communication:
While we talk a lot about risk communication, it is also important to talk about the benefit that would accrue from the risk communication, which is the ultimate aim of all risk communication. It is of utmost importance that we convey the benefits also from the improved behaviour compliance that is expected to follow risk communication.
Risk communication improves decision-making, patient understanding, and care, compliance with treatment and required behaviour for preventive actions, promotes transparency and accountability and builds trust with individuals, community leaders, health workers, and policymakers.
Role of risk communication in Public Health emergency:
1.3.1 Customer focus
· Acquire necessary facts.
· Empower decision-making.
· Be an involved participant, not a spectator.
· Provide feedback to responders.
· Watch Guard resource allocation.
· Recover or preserve well-being and normalcy.
1.3.2 Organizational focus
· Execute response and recovery efforts
· Gain support for crisis management plans
· Avoid misallocation of limited resources
· Ensure that decision-makers are well informed
· Reduce rumors
· Decrease illness, injury, and deaths
· Avoid wasting of abundant resources
1.3.3 Contributors to an inadequate public response to recovery plans
· Mixed messages from multiple experts
· Tardy release of information
· Paternalistic attitudes
· No reality check on recommendations
· Not immediately countering rumors and myths
· Public power struggles and confusion
1.3.4 Formula to meet customer and organization goals
· Execute a solid communication plan.
· Be the first source of information.
· Express empathy early.
· Show competence and expertise.
· Remain honest and open.
· Remain dedicated to the customer.
· Apply emergency risk communication principles.
1.4.0 Objectives of Risk Communication:
The objectives of communication expected behavioral outcomes, the present behavioral patterns and the barriers (in terms of logistics, cultural patterns, group practices) of each group needs to be known, so as to understand the need of each group and the requirements for making appropriate tailor-made risk communication messages for each group. The Risk communication needs to be specifically tailor-made for various target groups with the end result of delivery of safe health services, safe population, and reduction of risk to health care workers, institutions for safe health services which reduce the risk to health workers and build confidence in services. The risk communication message also intended for health workers to identify the population sharing symptoms of diseases. Communication surveillance is the task of the communicator, and he is obliged to understand the public beliefs, opinions, and knowledge about specific risks.
DEFINITIONS OF SITUATION ANALYSIS
Effective infectious disease risk communication is an essential element of outbreak management. When the public is at risk of a real or potential health threat, treatment options may be limited, direct interventions may take time to organize and resources may be few.
Communicating advice and guidance, therefore, often stands as the most important public health tool in managing a risk. Pro-active communication encourages the public to adopt protective behaviors, facilitates heightened disease surveillance, reduces confusion and allows for a better use of resources – all of which are necessary for an effective response.
1. STAKEHOLDERS AND STRUCTURES IMPLEMENTING RISK COMMUNICATION
At the national level risk communication activities are spearheaded primarily by FMOH, FMARD, NPHCDA, NOA and until recently NCDC.
Major role is on the capacity building of State structure like SHE and Social mobilization officer, Environmental Health Officers and Agricultural extension officer, veterinarians etc.
Usually the States ministries, Departments, Agencies and Partners cascade capacity building of the Local Government officers responsible for risk communication.
State health educator is saddled with conducting advocacy, sensitisation and coordination of activities of the social mobilisation committee
State social mobilisation committee
Comprises of relevant line ministries and organisations and cascades information down to their various organisations for implementation
The State Health Educators play a pivotal role and are also responsible for giving mandate to the State social mobilization committee (with members pooled from line ministries, religious leaders, traditional leaders, media, NGO etc.) who now convey the messages to their various organization for implementation.
However, there are conflicts of roles and responsibilities between the SMOH and the SPHCDA Health education and social mobilization officers, as to who should do what and when. Also, there are issues of who should coordinate/lead the activities.
LOCAL GOVERNMENT LEVEL
Implementation of capacity building and risk communication activities is through the relevant program officers who give mandate to the LGA social mobilization committee (members pulled from relevant departments and units, religious leaders, traditional leaders, Chief Orientation and Mobilization officers, CBOsetc.) who now carry out implementation at the community level.
Implementation of capacity building and risk communication activities is through relevant program officers to ward focal persons/supervisors in the LGA
Social mobilisation committee
This comprises representatives from relevant departments and units, traditional and religious leaders, market women, youth organisations, artisans, chief orientation and mobilisation officers (NOA COMOS).
Ward focal persons
The focal persons coordinate and monitor the activities of the participants at the grassroots level feedback data to the LGA officers, in return, LGA program officer compile the data and send same to the State.
Most of the tools used for risk communication are handed over to these focal persons to implement the intended program/activity.
CURRENT TRENDS AND PRACTICE OF RISK COMMUNICATIONS (TOOLS):
During the deployment of any risk community activities a number of tools usually are employed to strengthen public health education and reinforce communication:
b. Songs and slogans
c. Public service announcement
d. Drama and Documentary