Understanding knowledge, attitudes and practices to fight Zika

In an outbreak communities are the frontline in the fight to stopping the spread of disease. However, with new diseases now frequently emerging due to impacts of urbanisation, climate change and increasingly mobile global populations, it is difficult for people to keep up with the pace of new information and know what to do to protect themselves. Between June and October 2018 thirteen Caribbean Red Cross National Societies completed large scale efforts to find out more about what communities know, how they think about, and what they do to prevent Zika.

“In order to help people combat the threat of this disease now and in the future, we need to understand what they already know about it how they have been already working to prevent it. We want to tackle people`s misconceptions about the virus and help them to collectively protect their communities and support those people who may be affected.” said Nasir Khan, Caribbean Zika Prevention and Response Project manager for IFRC.

The Caribbean region is no stranger to viruses transmitted by mosquitoes, with Dengue and Chikungunya, spread by the same Aedes mosquito, now commonplace in the region. However, Zika has another dimension to it with the risks of congenital Zika syndrome (including microcephaly) and the fact that it can also be sexually transmitted. To find out more about what people knew, how they understood and what practices they engaged in to prevent Zika a Knowledge Attitudes and Practices (KAP) survey was carried out in 13 countries that are part of IFRC’s Caribbean Zika Prevention and Response Project supported by USAID.

In total 1667 surveys were collected across English speaking countries in the Caribbean and Suriname. Carrying out data collection from households at this scale can be a challenge, especially when it comes to making sure all data is captured and made quickly available for analysis. To meet this challenge Caribbean National Societies were supported with training and support to use Open Data Kit (ODK) an open source tool that is used widely in humanitarian organizations to collect field data.

Results of the KAP survey showed that people were concerned about Zika and while most knew it was caused by a mosquito, few were aware that it could also be sexually transmitted. Some people were engaged in actions that might help mosquitoes stop breeding but are likely to need more support to scale up actions to protect the wider community.

A great strength of the Red Cross is our ability to stand alongside our communities, to hear and understand what is going on at the ground level. The information we get from listening to community voices is invaluable to us and other partners in the Caribbean region in addressing Zika and the health challenges of the future.” explained Erin Law, Global Zika Advisor for IFRC.

The Knowledge Attitudes and Practices Survey on Zika in the Caribbean was conducted by Red Cross National Societies in Antigua and Barbuda, Barbados, Belize, Dominica, Grenada, Guyana, Jamaica, St Kitts and Nevis, Saint Lucia, St Vincent and the Grenadines, Suriname, The Bahamas and Trinidad and Tobago. Technical support was provided by the IFRC Country Cluster for the English-speaking Caribbean and Suriname, IFRC Innovation Team in the Americas Regional Office and the Caribbean Disaster Risk Management (CADRIM) Reference Centre in Barbados.

Read the Knowledge, Attitudes and Practices Survey Report

Download the pdf Caribbean Red Cross Success Story

Caribbean National Societies unite to teach others how to fight mosquito borne diseases

We’ve all had the experience of being bitten by a mosquito. We also know that in some places mosquitoes are more present than others. Aside from spraying ourselves with mosquito repellent, what can we do stop the bites?

Mosquitos that carry Dengue, Chikungunya and Zika like to live near humans. We provide them with blood meals and places for them to breed. Mosquito eggs, which can turn quickly from egg to flying mosquito in around a week, get laid in the small amounts of water that can accumulate in trash left around where humans live and tanks and barrels that are not covered or regularly cleaned.

Cleaning up communities has been central to the fight against diseases carried by the Aedes aegypti mosquito in Red Cross’ work around the globe, but how does it get practically done? Red Cross National Societies from the Caribbean region developed the “How to do a Community Clean-up” guide in September 2019 to help answer this question.

All of the National Societies in our region have been working at the community level to reduce the risk of the Aedes mosquito. But we found that many others wanted to understand what the best way to do a clean up was. It is a logistical undertaking that needs more than academic theory. And no-one can tell us better how to do this than the project managers and field officers themselves” said Chantal Braithwaite, Senior Public Health Officer for the IFRC Caribbean Country Cluster Support Team in Trinidad and Tobago.

The short guide is a combination of experiences brought together by the International Federation of Red Cross and Red Crescent (IFRC) Caribbean Country Cluster Office. The simple and easy-to-adopt 13 step process was developed by 11 National Societies who were asked to order, vote, and add what was missing from previous guides. The guide also draws on the content explained in the Zika, Dengue and Chikungunya Toolkit, which lays out a community risk mapping process to drive longer term behaviour change.

The guide is available here.

The “How to do a Community Clean-up” guide was developed thanks to the Red Cross National Societies from Antigua and Barbuda, Barbados, Belize, the Bahamas, Dominica, Grenada, Guyana, Jamaica, Saint Lucia, St Kitts and Nevis, St Vincent and the Grenadines, Suriname and Trinidad and Tobago who provided recommendations, technical support and collaboration during the process.

Download the .pdf of this success story here

Guyana Red Cross is listening to rumours to combat disease outbreaks

Versión en español

by Erin Law, IFRC public health expert and global advisor on Zika

In the early days of the Zika outbreak, Andrea Phillips, coordinator of the Guyana Red Cross Zika outbreak response, and her team of volunteers at Guyana Red Cross realised they had a challenge. Zika, a mosquito-borne and sexually transmitted virus was getting a lot of global attention and scientists were scrambling to learn more about the virus and the risks it posed to unborn infants.

Zika was previously unknown in Guyana and Andrea and her team were quick to get essential messages out to communities. Decreasing the risks for being bitten by the Aedes aegypti mosquito that spreads the virus and decreasing the risk of transmission to pregnant women were key. But they were hearing questions from communities that did not align with facts: people were asking whether Zika was made in a lab on purpose, whether it was really spread by mosquitoes, and whether it was just a method of population control.

The Guyana Red Cross team would be collecting data on where they were working, who they would reach and what messages they would be giving; but this other kind of feedback they were hearing seemed too important to ignore. “If people believed these rumours they might not take action to protect themselves and their communities.” says Andrea.

Before starting household visits Andrea briefed her team of volunteers on the importance of capturing this feedback. She explained that, “Even when the information is wrong, I need to understand the rumours that are spreading so I can make sure our volunteers are equipped to respond and I can develop messages to combat these rumours.

At the end of every day of household visits Andrea debriefs the volunteers on what they heard and how they responded. The next day, before they return to the field she briefs them on what rumours to be ready for and address through improved messaging. Andrea documents the rumours in a simple spreadsheet, recording when and where they were heard. She uses this spreadsheet to make sure Guyana Red Cross messages are addressing community concerns and combatting misinformation.

We work closely with communities and they are the experts, so we don’t just want to tell them what to do. Every time we are in communities we are there to have a conversation, we are there to both share and listen” explains Andrea.

The work that Andrea has pioneered in Guyana will help them to respond to future health threats and disease outbreaks. The experience of Guyana Red Cross was used in the development of a brief regional guide on Rumour management “Rumours: Listen, Verify, Engage!”. The guide is based on the CDAC Network rumour guide “Rumour has it: a practice guide to working with rumours” and helps 13 countries in the Caribbean in their response to the Zika outbreak.

Download the .pdf of this success story here

The Caribbean Zika Prevention and response project works in 13 countries in the Caribbean to reduce the risk of Zika virus and other Aedes mosquito-borne diseases in the English-speaking Caribbean and Suriname. This work is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of USAID PIO Infectious Diseases Grant 2008-2018 Grant No. GHA-G-00-08-00006. The contents of this article do not necessarily reflect the views of the United States Government.

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