Principal Investigator: Sian White, London School of Hygiene and Tropical Medicine (LSHTM)
Community engagement has been recognised as a core pillar of outbreak response. This study found evidence that a new approach, the Community Perceptions Tracker (CPT), helped to track trends in community attitudes towards the COVID-19 pandemic which then informed adaptations to preventative programmes.
The aim of the research was to understand how community perceptions towards COVID-19 and response programmes change over the course of the outbreak. The research explored three objectives:
We set out to improve the quality of community engagement and behaviour change communication programmes so as to strengthen communities’ trust and acceptability of these processes. The research aimed to improve understanding of behavioural enablers and barriers for communities affected by COVID-19, and to enable humanitarian actors to rapidly adapt and correct their programme activities in line with people’s understanding, priorities and needs, with resulting behaviour change that helps minimise infection risks.
The CPT is a novel approach for enabling community engagement throughout the course of an outbreak. By conducting this research, we hope to understand how it is utilised by staff to improve programmes and whether this results in meaningful improvements for populations. LSHTM are excited that this research will also enable us to strengthen local research capacity.
Tracking perception trends: The CPT identified changes in the patterns of community perceptions over time. For example, early on perceptions primarily related to questions about the origin of the disease and preventative actions. As time went on people were concerned by the secondary socio-economic impacts of COVID, government responses, and vaccine hesitancy.
Programme improvements: CPT staff felt the process allowed them to develop closer relationships with communities and be more systematic about the way they undertook community engagement. They reported the CPT led to more frequent programmatic adaptations. This included being able to update communication materials to address common perceptions, modifying programming where new needs emerged (e.g. adding masks to hygiene kits to address shortages or shifting their programming to focus more on facilitating vaccine uptake) and advocating on behalf of communities.
There was also some evidence to indicate that the CPT process made programmes more acceptable and relevant to crisis-affected communities.
Tracking perceptions on a rolling basis is critical during outbreaks, as community perceptions were found to change over the course of the pandemic in response to transmission dynamics, government trust and policies, the spread of misinformation and community norms. Invariably, these changing perceptions affect community responses to public health measures.
The CPT was valued by humanitarian staff as it supports development of active listening skills, programmatic reflection, and the discussion of crosssectoral and inter-agency issues. It was found to be an interactive and feasible way of learning from populations, though it requires critical analysis and reflections from staff to translate insights into programmatic improvements. The CPT could be used to complement standardized approaches to programmatic learning, monitoring or accountability.
The evaluation identified opportunities to improve the CPT. These are being used to develop more detailed guidance on training, data collection and analysis, and the tracking of programme adaptations. Guidance will be published to enable other humanitarian organisations to replicate the CPT in their own areas of work.
Key outputs from the research will be a Monitoring and Evaluation (M&E) framework for use of the CPT in public health programmes. We will also publish two articles in peer-reviewed journals.
The CPT data will be used to influence decision-making mechanisms that communities cannot access on their own. Humanitarian implementation organisations are exploring how the CPT approach can be used in future outbreaks and other types of emergencies. In Zimbabwe, teams are cascading the approach to the village level so that community members can also collect perceptions.
In this blog the team reflect on using the Community Perception Tracker approach, and how they have used the unusual pandemic context to strengthen elements of their research.View
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