COVID-19—A Review of Community Participation

COVID-19—A Review of Community Participation

Citizen participation can reduce damages caused by the pandemic and—crucially—help identify a sustainable path forward

The photo shows a darkened classroom with several students facing the camera.
Students attend a class at the beginning of the school year amid fears of the spread of the coronavirus disease (Covid-19) in Sanaa, Yemen, on October 18, 2020. REUTERS/Khaled Abdullah

In recent years, the intersection between effective public health response and community engagement has come into greater focus. In 2009, the World Health Organization (WHO) convened a body of experts to develop standards and identify best practices for community engagement in public health emergencies. The group concluded that there was a general under-appreciation of the behavioral imperative that underlies responses to public health emergencies, despite the fact that human behavior drives epidemic emergence, transmission, and amplification. Similarly, in a March 20, 2020 report, the Joint United Nations (UN) Program on HIV/AIDS also emphasized the importance of community participation.

Unpopular measures risk low compliance

Community participation matters because residents can best identify solutions for their respective communities: they know what knowledge and rumors are circulating; they can provide insight into stigma and structural barriers; and they are well placed to work with others from their communities to devise collective responses. Unpopular measures risk low compliance. On the importance of community participation, the novel coronavirus, COVID-19, pandemic is not unique.

The photo shows a rite of passage ceremony with a crowd of young and old men holding sticks and kicking up a lot of dust.
Communities are each impacted by the coronavirus in their own way. This Olng'esherr (meat-eating) passage ceremony of Maasai men in Kajiado, Kenya, was postponed and then took place on Sept 23, 2020. REUTERS/Thomas Mukoya

As of October 19, 2020, there are 40.2 million confirmed cases of COVID-19 worldwide. This figure suggests that the pandemic is likely to have long-lasting consequences for everyone, making now the time for governments to find sustainable ways forward by learning from countries that have successfully responded to the pandemic. The pandemic has exposed community engagement and community-centered approaches as important components of health emergency preparedness and response. From compliance with lockdown measures to the needed steps as countries ease restrictions to community support through volunteering, community participation is essential in the collective response to COVID-19.

Steps to ensure community participation and guarantee collective responsibility in COVID-19 responses

Governments should work on building a culture of solidarity, trust, and kindness. Rather than lay down unexplained or draconian restrictions, relevant authorities should provide empowerment and guidance to ensure that those within the community can act without fear of losing their livelihoods, can put food on their tables, and can look out for their neighbors’ well-being. The following are steps that governments can take to ensure community participation and guarantee collective responsibility in their COVID-19 pandemic responses. These guidelines were implemented in countries that have successfully handled their COVID-19 outbreaks.

The photo shows a line of girls facing a woman holding a thermometer gun.
A local worker checks the temperature of students entering class in Peshawar, Pakistan, on September 23, 2020—after the government allowed the reopening of schools from grade 6–8 amid coronavirus. REUTERS/Fayaz Aziz

Communicate Clearly About the Risks Involved

Clear communication channels between the government and all sectors is necessary for translating policy into action. Consistent and transparent information communicated by a trusted leader promotes the acceptance of policy measures.

Consistent and transparent information communicated by a trusted leader

Concise, public messages tailored to the community and its cultural norms accelerate public awareness of health crises, which facilitates public trust in leadership and promotes cooperation in containment efforts. In Singapore, a government-sponsored task force frequently provided transparent situational updates on the pandemic and issued new guidance, along with its associated rationale, through traditional channels, social media, and regular press conferences. Also, understanding that these nationwide communication channels were susceptible to misinformation, the Ministry of Health regularly clarified misinformation and encouraged the public to follow accurate and reliable information from official channels.

The photo shows a busy street bustling with foot traffic, and strikingly every single person appears to be wearing a mask. The photo shows
Singapore has the highest level of mask usage in the world—evidenced in this street scene in the Orchard Road shopping district as the city state reopens amid the COVID-19 pandemic on June 19, 2020. REUTERS/Edgar Su

Consistently Highlight the Role Social Responsibility Plays During a Pandemic

The government, through its ministry of health, should consistently emphasize that social responsibility is essential to slowing transmission and encourage individuals to wash their hands frequently, avoid touching their faces unnecessarily, use masks appropriately, minimize contact with others, seek medical care at the earliest onset of any respiratory symptoms, and refrain from doctor shopping.

To ensure compliance with these guidelines, Singapore appointed COVID-19 ambassadors, who were deployed at various premises to facilitate compliance with social distancing measures. Real-time updates of crowd levels in parks and malls allowed individuals to make informed visits while maintaining social distance. Other initiatives to help individuals during the outbreak were made publicly available on Singapore’s government agency website.

The photo shows a multi-level mall with several young people riding an escalator in the foreground.
People wearing protective face masks ride an escalator at a shopping mall in Singapore July 14, 2020. Local authorities have given real-time updates of mall crowds during the coronavirus outbreak. REUTERS/Edgar Su

Consciously be Mindful of Those Who Have Been Affected Economically

In Singapore, to ensure public access to personal protection equipment, nationwide reusable cloth mask distribution drives were conducted on three separate occasions. In line with the ‘circuit breaker’ measures implemented by the government of Singapore in response to the pandemic and with parents telecommuting from home, the Ministry of Education in April 2020 suspended in-person classes and implemented a full home-based learning system. Limited social-support services were provided for parents in essential jobs without alternative care arrangements for their children.

In Singapore, nationwide reusable cloth mask distribution drives were conducted on three separate occasions

Mid-year school holidays were brought forward from June to May, to provide a respite from a period of hard work and adjustment for parents, students, and teachers during the month of home-based learning. In China, realizing that people who live in shared apartments, condominiums, student housing, or transitional housing may have challenges with social distancing, authorities took a dramatic step to curtail the formation of small outbreaks among those living in close quarters. Officials put anyone with a fever or who had been in close contact with someone believed to be infected by the coronavirus into a “centralized quarantine.” Though certain actions by the Chinese government imposed upon people’s civil liberties, such as freedom of movement, these efforts undeniably helped bring China’s domestic outbreak under control. Without the compliance and efforts of individuals who placed the community first, such a success would likely have been impossible.

The photo shows multiple levels of an apartment building-type structure with several people on one of the floors exercising in the open-air walkway.
People who have been cured of COVID-19 and discharged from hospitals exercise at a centralized quarantine facility in Wuhan, China, the epicenter of the novel coronavirus outbreak, on March 12, 2020. REUTERS/China Daily

Create Economic Measures and Policy Response to COVID-19

Both an epidemic and a government’s response to it can have severe consequences for people’s livelihoods, employment, and access to food and essential services. People risk losing their salaries or employment if they are required to isolate or if businesses are asked to shut down.

75 Percent

The Danish government announced it would give private companies 75 percent of their workers' salaries for thirteen weeks

This risk is acute for people in precarious employment situations or in employment without paid sick leave. Understandably, the fear of losing one’s job might prevent people from taking all necessary precautions, such as seeking testing and treatment or, in the case of COVID-19, from self-isolating. Because by doing so people are more empowered to look after their health, to self-isolate, and to improve the response to the epidemic. Danish authorities responded to the ongoing crisis quickly and forcefully through various initiatives. In mid-March, the Danish government announced that it would give private companies 75 percent of their workers' salaries for thirteen weeks. There was one caveat, however; companies could only receive that money if they did not fire workers. This initiative was meant to encourage workers to self-isolate if they felt unwell.

The photo shows the PM speaking at a podium while the police chief in the background looks on.
Danish Prime Minister Mette Frederiksen and Thorkild Fogde chief of police in Copenhagen, Denmark, attend a COVID-19 news conference in the Prime Minister's Copenhagen Office on September 18, 2020. REUTERS/Ritzau Scanpix/Martin Sylves

To achieve community participation, it is crucial to understand that meaningful relationships between communities and authorities are hard to establish rapidly. They need to be cultivated overtime to cement sustainable and inclusive participation. Handling such relationship requires being sensitive to and conscious of the different types of knowledge and experiences brought by diverse communities and individuals. Citizen participation carries the assurance of reducing the damages already caused by the pandemic and, crucially, of finding a sustainable way forward.

Oluwatemilorun Adepeju Adenipekun is a public health lawyer and a doctoral student at Wake Forest University School of Law.

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