This document outlines risk communication and community engagement strategies in response to a cholera outbreak in Shashemene town, Oromia region, Ethiopia. It discusses introducing key risk communication interventions like developing messaging around cholera prevention, producing multi-media educational materials, training community health workers, and engaging religious and community leaders. The strategies aim to inform communities about cholera symptoms and transmission, encourage early treatment and preventive behaviors, build trust in the response, and involve communities in outbreak control.

1. Risk Communication and Community Engagement
in response to Cholera Outbreak
By: Chala Kenenisa(BSc, MSc, MBA)
May, 2023
Shashemene town
Oromia Health Bureau

2. Outline
• Introduction
• Key RCCE interventions
• Community engagement
• Key Messages

3. Brainstorming
• What is risk communication?
• What are the benefits of risk communication?
Oromia Health Bureau

4. Introduction to RCCE
• Risk Communication refers the real-time exchange of information,
advice and opinions between experts or officials and people who
are at risk of cholera
• The purpose of risk communication is to ensure that everyone at risk
for cholera is informed about how to reduce the risk of spreading
the disease, take personal protective and preventive measures
• Public health officials must report fully and rapidly, what they
know, what they suspect and what they are doing to control the
outbreak.

5. Significances of RCCE
• Enable the community to take an informed decision to save lives a
nd minimize adverse consequences.
• Prevent “infodemics” (an excessive amount of information about a
problem that makes it difficult to identify a solution)
• Builds trust in the response and increases the probability that health
advice will be followed.
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6. Significances of RCCE…
• It minimizes and manages rumors and misunderstandings.
• Bridge the gap between different risk perception.
• It involves communities in the response and develops acceptable a
nd beneficial interventions.
• It is essential for surveillance, case reporting, contact tracing, cas
e management, and logistic for the response.
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7. Risk Communication Strategies
1. precaution advocacy
• When hazard is high, and outrage is low
• To alert people to be serious about risks.
• “Watch out!”
2. Outrage management
• When hazard is low, and outrage is high
• Reassure the people excessively upset about small risks
• “Calm down!”

8. Risk Communication Strategies
3. Crisis communication
• When hazard is high, and outrage is also high
• Help the people cope with serious risks. Deal with emotions and
• “We will get through this together.”
4. Health education
• When hazard and outrage are both low
• Dialogue with interested people about a significant but not urgent risk
• To create resilient health system by regular health education and promotion
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9. Stages of Cholera Emergency RCCE Intervention
• Risk communication is a continuous process that needs to
be conducted before, during and after cholera outbreaks
Oromia Health Bureau

10. Before Emergency (preparedness)
• Inform and alarm the public on risk of cholera and encourage
implementation of appropriate safety measures
• Identify stakeholders and conduct sensitization, advocacy or
consultative meetings
• Establish or revitalize coordination system
• Conduct joint or integrated planning with communities and
stakeholders
• Map core messages and sensitize medias
Oromia Health Bureau

11. Initial Phase (when case is confirmed)
• Empower and encourage the public on safety messages and what
to do during emergency
• Regular early warning continues (alert letter, media brief, press
release…)
• Review or update messages with updated evidences known and
channels
• Update RCCE technical working group.
• Conduct regular media monitoring and media engagement activities
Oromia Health Bureau

12. During Cholera Response Phase
• Disseminate warning messages, announcement on the progress of
the disease and messages to strength compliance to preventive
methods
• Call for the public to maintain preventive measures
• Continue community engagement and ownership
• Monitor the process and output of each intervention
• Continue stakeholder mapping and regular reviewing meeting
Oromia Health Bureau

13. Maintenance and Recovery
• Advocate for cholera response integration with developmental or routine
activities
• Create resilient community through sharing testimonials & lesson learned
• Maintenance of preventive behaviors and community cohesion/ownership
• Conduct perception and behavioral survey or assessment
• Conduct after action review and documentation of lesson learned, best
practices and challenges
Oromia Health Bureau

14. Best practices for effective risk communication
• Create and maintain trust.
• Acknowledge and communicate even in uncertainty.
• Be transparent and fast with all communications.
• Be proactive in public communication, using a mix of preferred channels
such as TV, radio, SMS, internet, social media, mass awareness
initiatives, and social mobilization.
• Understand local knowledge and behaviors (including beliefs and
barriers)
• Involve and engage the community in the outbreak response

15. Clarifying Rumours and Concerns(1)
• Trusted information should reach people and rumours should be
addressed by maintaining a very open flow of information from th
e beginning of the outbreak; Define a strategy to disseminate ac
curate information promptly, rather than responding to rumours.
• Provide information that is easily understood, complete and free
of misleading information.
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16. • Key messages to the public should help people to recognize sy
mptoms of cholera and how it is transmitted and provide inform
ation about what to do for prevention and treatment, encouragin
g early treatment-seeking behaviour.
• Information should include what cholera is, how it can be preve
nted, why, when and where to seek help, and how to care for fa
mily members with diarrhoea
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Clarifying Rumours and Concerns(2)

17. Key RCCE Activities
• High level advocacy with policy makers, law enforcers, religious
structures, private sectors, medias, regional and lower level gov’t leaders
• Develop evidence based comprehensive social behavior change
communication (SBCC) strategy for cholera prevention and control
• Production and dissemination of context specific messages through
multi-media channels (print, radio, TV) and mobile-audio visual vans
• Capacity strengthening and development of job aids for community
mobilizers, volunteers, HEWs, and other frontline workers

18. Key RCCE Activities
• Conduct social mobilization and Interpersonal Communication
(House to house sensitization and community dialogue)
• Engage with community key influencers including religious leaders,
community and clan leaders
• Train key mobilizers including; WDA, HEWs, faith-based organizations,
community-based organizations, youth groups
• Implement hygiene promotion interventions in schools, orientation
of teachers, School WASH clubs as champions and school committees
• Implement hygiene promotion interventions in religious institution

19. Key messages for cholera prevention
What is cholera?
• Cholera is a diarrheal illness caused by a
bacterial infection in the intestine
• Cholera causes severe watery diarrhea and
may cause vomiting
• Cholera can cause death from dehydration
within hours if not treated.

20. Thank You
Oromia Health Bureau