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Prepare a community engagement and mobilization strategy for an emergency response plan for an outbreak of the Ebola virus. Your strategy should clearly state a step-by-step approach that ensures that communities are engaged to have an active role alongside authorities and health agencies in the plan to rapidly respond to the threat of the spread of the disease. The strategy should use headings for each stage of engagement, consultation, participation, organisation, capacity building, action and possibly empowerment. Explain your decision to use either a top-down and/or bottom-up approach.

Understanding Ebola Virus

Ebola (also known as Ebola virus disease) is a fatal illness that affects both human beings and non-human mandrills. This condition is known to be the most dangerous viral hemorrhagic fever among all. It is caused by an infectious virus of family Filoviridae and ebolavirus type. Ebola disease virus manifest in two principal strains; Ebola-Zaire and Ebola-Reston. The spreading rate of Ebola depends wholly on the strain that is present in a given setup. The deadliest of all is Ebola-Zaire which has a fatality rate of about 90%. The other strain is never known to have affected human beings (Moon et al., 2015).  For the Ebola virus to spread, one has to come into direct contact with body fluids or tissues of an infected being. Patients suffering from this deadly infection often need to be intensively taken care of. However, in offering them care, one must take caution as this disease has no known cure. Some of the most common symptoms found in most patients suffering from Ebola conditions include the rapid start of fever, muscle pains, a severe weakening of the body, severe headaches and finally the sore-throat. Many awareness programs have been put in place in the recent past to educate all communities in most parts of the world. All these are geared towards involving such communities in programs aimed at the prevention of Ebola among people (Norris, Stevens, Pfefferbaum, Wyche, & Pfefferbaum, 2008).

Top-down is a centralized approach which integrates the directive or rather administrative plans and strategies laid, expertise and governance models, conjoining with other organizations with the same goals within the country and connecting with the neighboring nations who at a risk of epidemics, mobilization of the human resource management and financial sectors and finally communicating the strategies laid down to the relevant persons. In the West African outbreak case, for instance, the WHO stood up and through the guidance offered by the standard rule provided by the IHR, it was able to declare a Public Health Emergency of International Concern. As a result, the neighboring countries were advised to declare national emergency within their respective geographical boundaries, ensure the activation of tragedy controlling tactics and strategies, make sure their citizens undergo screening for the virus detection and finally discourage mass gatherings among its' citizens. If not managed properly, the Top-down approach may result in the increased mistrust among people or nations, instances of mislead and lack of compliance among countries and their citizens (Henstra, 2010).  

Top-down and Bottom-up approaches to Ebola Virus Control

Bottom-up approaches: this is said to have occurred when the community pushes an action. This may comprise of cooperative intellect, open-forums, dialogue establishment, promotion of proper governance, encouraging respect for local viewpoints and laying down strategies that are aimed at growing confidence among communities. During the Liberian Ebola outbreak, for instance, the poor-health system setup forced people to establish their resolutions. This helped to contain the virus within one region thus enabling psychosocial and contributory support within that particular region. In advocating for public safety, however, a combination of these two methodologies (top-down and bottom-up approaches) arevery essential. As of the case of the Liberian outbreak, it is right to say that any given community is at a position to develop strategies that could help them remain safe and that all that they require is awareness, mobilization and the guidance in executing their plans (Shuaib et al., 2014).

Involvement/participation: to ensure the effectiveness of the procedures and plans set in responding to the Ebola outbreak emergency, the involvement of the interested members of the community affected is thought to be inevitable and should work hand in hand in making the decision or in looking for solutions for the problems affecting them. This should be done, maintaining a very close relationship with the authorities and health agencies involved (Chandra et al., 2013).

Involving the affected community helps in keeping them active and productive in the process of planning how to respond to the emergency. This may also work in the best interest in building linkages, reinforcement relations, extending a sense of ownership and finally in the development trust among people. This involvement usually is narrow and only involve representatives for each community; however, in the cases of emergencies such as that communicated by Ebola outbreak, it is imperative that but it is essential that the participation allow multiple entries so as to encourage as many people as possible to participate in these programs and also help them understand the necessity for the involvement. Besides, valuing input through contribution can assist in driving out fear and develop a sense of control around Ebola. With evolving technologies, the participation may be made through the social media. When using the social media, the contribution may be on a real-time basis and easily accessible to a vast number of people. This is seen as the best way to explain the bottom-up approach. This type of crowdsourcing offers an information pool for surveillance and communication, including understanding community reactions, conducting contact tracing, and assessing health service availability (Santibañez, Siegel, O'Sullivan, Lacson, & Jorstad, 2015).

Involvement and Participation in Community Engagement

Engaging communities in making decisions and laying strategies that are geared towards protecting such communities from emergencies is an essential step in the development and actualizing emergency response plans (Top-down). Engagement helps to motivate people to acquire the ability to contribute and collaborate in laying down such strategies. This is also important as it is geared towards solving issues that affect there. Informing the communities of the various risks, how to what levels they might be affected and how they can be involved in formulating the necessary plans is an essential practice. To enhance the expected results, community context must be well understood. That is the consideration of complications, multiplicity, governance, and linkages. Engaging communities by pushing out communications through mass media, print and face-to-face approaches such as workshops, broadcasting on TV, posters, newsprint articles and social media, is useful in creating awareness on Ebola and which helps to reduce stigma among communities (Ebi, & Semenza, 2008).

Each community has its’ own history, experiences, and resources that are valuable in responding to emergencies. However, an attempt to mobilize any community, it is vital to record their assets and social capital. This includes checking with leaders. The process presents opportunities for communities to participate in deciding and solving the problem for the areas. This helps to establish trust and respect among the community and its’ expertise (Gamboa-Maldonado, Marshak, Sinclair, Montgomery, & Dyjack, 2012).

This uses existing setups in implementing reaction strategies. Communal wealth is a great asset. Local spokespeople who already have valued authority in communities can be recruited to guide emergency responses processes (Top-down). Social networks can be used in ensuring that contagion anticipation and regulatory assets are widely spread. Besides, when health facilities are overcome, experienced community helpers may offer substitutional healthcare facilities, help in data collection, distribution of resources and offer sustenance to affected families and forefront workforces (Hounton, Byass, & Brahima, 2009).

Skill building is vital for empowering individuals and communities to participate actively. For example, public health education should not only detail what Ebola is but also acknowledge what people can do, how they can be prepared and self-sufficient. This may include training in recognizing Ebola, using protective equipment, or conducting infection control precautions Capacity building involves learning opportunities, building on strengths, increasing knowledge, skills, and readiness for action. It includes not only developing the public's capabilities but also ensuring that leaders are prepared to manage community responses. Emergent community leaders act as trusted conduits between authorities and communities, link communities with external sources to attain resources, facilitate community responses and build connections. It is thus crucial in planning, to develop community skills registers, training packages and protocols, especially for leaders and volunteers. For example, local volunteers could be trained to administer questionnaires regarding the public's knowledge, attitudes, and practices around Ebola prevention and amass results to inform future risk communications or local airport/seaport workers could receive training in screening travelers (Gillespie et al., 2016).

Engaging Communities for Effective Ebola Emergency Response Plan

The key to community involvement in emergency response plans is that communities are given opportunities to contribute actively. The work relates to ownership, developing relationships, building capacity and shifting toward empowerment, as people come together to apply their collective skills, to achieve shared goals (Top-down). For example, communities can be involved in exchanging information, case reporting, referring infected individuals to appropriate services, caregiving and distributing protective equipment (Lettieri, Masella, & Radaelli, 2009)

An empowered community can appreciate, weigh risk and apply the necessary actions. It is thus hoped that with community commitment as an essential element in responding to emergencies, several communities will be allowed to make choices, be accountable, and involve themselves in viable mutual action and communal decision-making. Empowerment communicates the ability of communities to be responsible. For example, rather than waiting for top-down instruction, an empowered community initiates an action such as convening a town hall meeting and inviting experts to provide Ebola outbreak updates/answer questions from the local population (Kapucu, 2012).

Recommendation and Conclusion

Ebola is one of the deadliest viral caused infection among all beings. In taking care of the infected people, one should be extra careful since the disease is highly contagious. In the case where there is emergency relating to the Ebola virus, government, health care agencies, and the affected communities should work together in curbing the spread of this virus. For the regions where people do not know much about the Ebola virus, governments and other agencies should establish programs that are geared towards creating awareness among such communities. In effective control of Ebola virus among communities, it is highly recommendable that this awareness is created by the responsible agencies and with the full support of the governments involved. To achieve this with ease, the use of both Top-down and Bottom-up approaches is very essential. This is because each of them carry with it some added advantage over the other and if both are combined, the better (Moon, et al., 2015).

References

Chandra, A., Williams, M., Plough, A., Stayton, A., Wells, K. B., Horta, M., & Tang, J. (2013). Getting actionable about community resilience: the Los Angeles County community disaster resilience project. American Journal of Public Health, 103(7), 1181-1189.

Ebi, K. L., & Semenza, J. C. (2008). Community-based adaptation to the health impacts of climate change. American journal of preventive medicine, 35(5), 501-507.

Gamboa-Maldonado, T., Marshak, H. H., Sinclair, R., Montgomery, S., & Dyjack, D. T. (2012). Building capacity for community disaster preparedness: a call for collaboration between public environmental health and emergency preparedness and response programs. Journal of environmental health, 75(2), 24.

Gillespie, A. M., Obregon, R., El Asawi, R., Richey, C., Manoncourt, E., Joshi, K., ... & Quereshi, S. (2016). Social mobilization and community engagement central to the Ebola response in West Africa: Lessons for future public health emergencies. Global Health: Science and Practice, 4(4), 626-646.

Henstra, D. (2010). Evaluating local government emergency management programs: What framework should public managers adopt?. Public Administration Review, 70(2), 236-246.

Hounton, S., Byass, P., & Brahima, B. (2009). Towards reduction of maternal and perinatal mortality in rural Burkina Faso: communities are not empty vessels. Global health action, 2(1), 1947.

Kapucu, N. (2012). Disaster and emergency management systems in urban areas. Cities, 29, S41-S49.

Kapucu, N., Augustin, M. E., & Garayev, V. (2009). Interstate partnerships in emergency management: Emergency management assistance compact in response to catastrophic disasters. Public Administration Review, 69(2), 297-313.

Lettieri, E., Masella, C., & Radaelli, G. (2009). Disaster management: findings from a systematic review. Disaster Prevention and Management: An International Journal, 18(2), 117-136.

Moon, S., Sridhar, D., Pate, M. A., Jha, A. K., Clinton, C., Delaunay, S., ... & Goosby, E. (2015). Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. The Lancet, 386(10009), 2204-2221.

Norris, F. H., Stevens, S. P., Pfefferbaum, B., Wyche, K. F., & Pfefferbaum, R. L. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American journal of community psychology, 41(1-2), 127-150.

Santibañez, S., Siegel, V., O'Sullivan, M., Lacson, R., & Jorstad, C. (2015). Health communications and community mobilization during an Ebola response: partnerships with community and faith-based organizations. Public Health Reports, 130(2), 128-133.

Shuaib, F., Gunnala, R., Musa, E. O., Mahoney, F. J., Oguntimehin, O., Nguku, P. M., ... & Nasidi, A. (2014). Ebola virus disease outbreak-Nigeria, July-September 2014. MMWR. Morbidity and mortality weekly report, 63(39), 867-872.

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