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Risk Communication and Community Engagement Technical Assistance for 2022 Haiti Cholera Outbreak Response

Mushtaq Dualeh, MPH1, Alondra Baez Nieves, MPH2, Nadia Jn Charles, MD, MPH3, Ashley Andujar, MHSA4, Sara Bresee, MPH2, Lauren Balotin, MPH2 and Molly Gaines-McCollom, MPH, PhD5, (1)National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA, (2)CDC, Atlanta, GA, (3)CDC, (4)Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, (5)National Center for Injury Prevention and Control, CDC, Atlanta, GA

Background:

After more than three years of no confirmed cases, a cholera outbreak was reported in Haiti in October 2022. In response, the CDC, Haitian Ministry of Public Health and Population (MSPP), and other partners quickly collaborated to prevent, detect, and respond to the outbreak.

Program background:

CDC’s cholera response strategy closely aligned with MSPP's response strategy, which emphasized the importance of risk communication and community engagement as one of its five strategic pillars. To support MSPP, CDC provided technical guidance and supported the production and dissemination of cholera prevention, risk mitigation, and water, sanitation, and hygiene messages via traditional and digital media, awareness campaigns, door-to-door outreach, health promotion activities, and collaborated with local partners to train community health workers and promote prevention strategies.

Evaluation Methods and Results:

Despite challenges such as limited media access, political instability, and misinformation, the CDC response effectively supported MSPP in engaging with communities in cholera prevention through partnerships and community involvement. To overcome challenges in reaching people living in resource-limited areas, the response utilized door-to-door outreach and community engagement meetings to provide education and resources for cholera prevention. In addition, the response updated communication materials and training resources and employed social mobilization with oral rehydration solution distribution and water treatment to reach those unable to receive radio, television, or SMS messages. CDC collaborated with local partners and leaders to address the challenge of misinformation and lack of trust in health systems, building trust and investing in ongoing engagement to continue cholera prevention efforts. Furthermore, CDC rapidly expanded community engagement and health promotion efforts by developing new communication materials and training resources. Nearly 10,000 downloads were recorded for the new online cholera prevention resources, and 8 different cholera prevention radio spots were created and broadcast on popular stations in both Haitian Creole and French.

Conclusions:

CDC's technical support and guidance on risk communication and community engagement proved effective in responding to the 2022 Haiti Cholera outbreak. Through collaboration with local partners and MSPP, traditional and digital media were utilized to inform communities, promote safe water and hygiene practices, and foster partnerships and engagement with community members and leadership.

Implications for research and/or practice:

Improving health communication and disease prevention strategies can be achieved by prioritizing community engagement, leveraging multiple communication channels, addressing communication barriers, and collaborating with communities and key partners. This response provided valuable lessons for tailoring communication strategies to meet the specific needs of communities and building trust through community engagement and partnerships, which proved to be effective in reaching and engaging communities during the cholera outbreak response. Ongoing communication strategies and partnerships with local leaders can be vital to ensuring that accurate information is disseminated, and critical prevention behaviors are followed, particularly in resource-limited settings.