Community Engagement During Public Health Emergencies Like COVID-19: An Action Framework and Toolkit
Bangladesh experienced a devastating second wave of COVID-19 from April to August 2021, fueled by the delta variant of SARS-CoV-2, with many districts showing a steep rise in infections and deaths. While the wave ultimately subsided, given the low levels of vaccination coverage at the time, it could well have reached a magnitude comparable to the neighbouring country. That would have been catastrophic due to Bangladesh’s large and dense population and inadequate healthcare infrastructure and resources especially in rural areas.
We are still by no means safe from future waves, as shown by the steep rise in “Omicron” infections since mid January 2022, and by the large numbers of repeat and breakthrough infections. It is imperative that we prepare proactively to prevent and fight future waves in a locally relevant and inclusive manner. We have to keep in mind addressing special needs related to gender, people with disabilities, sexual/ethnic minorities etc., and engaging communities and ensuring cooperation from all segments of society. Mass vaccination by accelerating the ongoing vaccination campaign is key to prevention and to contain the spread of the virus; for nationwide success with this campaign, addressing stigma related to vaccines is critical, which can only be achieved through effective engagement of all relevant stakeholders especially in underprivileged communities. We believe that engaging and coordinating other arms of the government and various community stakeholders under strong leadership by local health officials, and support by local elected representatives, can put up the most robust and effective response to COVID-19 and beyond, including mobilising people for mass vaccination. Moreover, this model has already proven effective in diverse geographies such as Chapainawabganj and Savar.
This handbook offers a simple framework of action for actors in local government, and in particular health leaders such as Civil Surgeons (CSs) and Upazila Health and Family Planning Officers (UHFPOs), to take ownership and leadership to combat COVID-19 at each District and Upazila respectively, with support and guidance from elected representatives and local administration, and through effective engagement of various segments of society including informal health care providers, religious leaders, journalists, police and law enforcement agencies, etc. It draws extensively from the experiences in Chapainawabganj, Savar and others, contains relevant best practises that have already proven effective in these places, and hence should be readily adaptable to various contexts.
It is important to note that while this framework has been developed in the context of COVID-19 and with related best practises, it is by no means limited to COVID-19. Indeed, the experience from Savar shows that the same approach has proven extremely effective in combating the dengue outbreak and the severe floods in 2020, and hence can be used to combat future public health emergencies in Bangladesh and similar contexts.
