Exploring the use of health communication in health policy implementation : response to the Ebola outbreak in Sierra Leone

Abstract

Background: During 2014 and 2015, Sierra Leone suffered the worst Ebola outbreak registered, which also affected Guinea and Liberia. The Government of Sierra Leone, supported by the World Health Organization, issued an accelerated response plan to reduce morbidity and mortality due to Ebola. This plan was initially built on previous experiences in Ebola outbreaks in other countries, albeit much less severe than this current outbreak. The response plan included Communication and Social Mobilization as one of its pillars. Aim: The aim of this degree project was to explore the use and contribution of health communication during the implementation of a health policy. This was achieved through identifying the health communications strategies used in Sierra Leone during the 2014-2015 Ebola outbreak, in the context of other implementation activities. Methods: This is a qualitative exploratory single case study covering a timeframe from April 2014 to April 2015 using thematic content analysis. Data from high-profile key informants was collected using semi-structured interviews. Documents from UNICEF and UNMEER were also analysed. Results: Health communication was used actively in the Ebola response in Sierra Leone, and its utilization changed over time in order to adapt to the outbreak situation and lessons learnt. The interviews highlighted moments and decision making during the response and jointly with the documents enabled identifying trends in strategies. It was possible to understand the rationale and context behind health communication decisions, studying communication styles changes over time and identifying particular lessons learned. Conclusion: Five main phases were identified in health communication usage during the Ebola response in Sierra Leone, each one characterized by a unique communication style, specific messages according to the outbreak situation or a different approach in the implementation of the response plan. Some best practices from the studied Ebola response in Sierra Leone were also highlighted.