Recovery, Renewal, Resilience

TMB Issue 38 discussed the importance of community involvement in tackling disease outbreaks and presented the recommendations set out by the Independent Panel for Pandemic Preparedness and Response. This briefing offers examples of good practice in community participation during the COVID-19 pandemic. Consider:

• Tanzania: local government co-produced infection control measures with business leaders based in markets to integrate leaders’ understanding & knowledge of the challenges of implementing such measures
• Nigeria: the “community informer model” was employed by local authorities for COVID “surveillance, tracing and monitoring” – community informers are key trusted individuals in a community (e.g. faith leaders)
• Pakistan: community volunteers “set up quarantine wards, manufactured and provided free protective suits for medics”, and distributed food to vulnerable people
• India: Community volunteers came together to investigate and identify unknown (“hidden”) COVID-19 fatalities. The volunteer group comprised of expert physicians and data analysts who developed comparisons of official health data and other reports. This encouraged a review of the national death audit process and resulted in improvements in the process so that COVID-19 deaths were accurate and transparent
• USA: Volunteers built a public “Testing Site Locator” app which visualized the geographical location of testing centres to support collection of testing centre-related information and dissemination at the national level. This supported people to locate the nearest available testing centres and also the “health system to plan and distribute centres more effectively”

The pandemic, and previous disasters, have evidenced that communities play a crucial role when preparing for, responding to and recovering from, crisis. Communities and civil societies should be “partners early on in the design, planning, implementation, and assessment of preparedness and response efforts on all levels”, particularly at the local level. We have covered community participation and co-production with communities in various briefings, see TMB Issue 38; Issue 34; Issue 33.

There has recently been a new spotlight shone on the impact that communities have had on their local response. A key message from the UK’s Integrated Review was the need to build whole-of-society resilience through enhancing capabilities in local resilience (see a recent TMB case study). TMB has often highlighted the renewal of community resilience through building a Local Resilience Capability (TMB Issue 30, as well as Briefing A in this current issue). Communities are being seen in a new light in local resilience.

This has been further identified in a paper by the Independent Panel for Pandemic Preparedness and Response, titled ‘Centering communities in pandemic preparedness and response’. This paper emphasizes the importance of community involvement in tackling disease outbreaks and advises of the need to:

• Establish partnerships to work with communities to design, plan, implement and monitor local and national pandemic preparedness and response, for example:
  • In Sur, Oman, the city government developed an intervention of response in partnership with civil society (e.g. community sports clubs, the Omani Women Association, youth groups and voluntary organisations). These groups supported activities to “arrange, maintain, and supervise” pandemic response activities
• Improve community engagement through “clear structures and sustained funding”, recognising that continuous effort is needed (not just a one-off effort during crisis). This can help to develop trust between communities and official service providers
• Recognise that risk communication is key to community engagement, and one part of local resilience capabilities: two-way, bi-directional and co-produced communications are essential to understand needs, communicate responsibilities, and gain feedback (see TMB 37 ‘Risk communications as part of the Local Resilience Capability’)
• Community resilience requires a “sustainable framework for community empowerment and recovery”, including:
  • “Invest in civic mindedness” to establish a culture of social connectedness and empower communities to take responsibility through co-production to understand risk preparedness, response and recovery
  • Establish partnerships between governments and community-based groups/voluntary organisations/businesses to integrate communities into the planning and leadership of interventions that enhance their local resilience
  • “Invest in social and economic wellbeing, and in physical and psychological health” to ensure access to health services