Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions: evidence from a mixed methods observational study in Busia and Mandera counties.
Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions: evidence from a mixed methods observational study in Busia and Mandera counties.
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DOI：
10.1136/bmjopen-2022-062686
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发表时间：
2023-05-16
期刊：
影响因子：
2.9
通讯作者：
Harding, Seeromanie
中科院分区：
文献类型：
--
作者：
Kaduka, Lydia;Olale, Joanna;Karamanos, Alexis;Mutai, Joseph;Coultas, Clare;Ahmed, Ismail;L'Esperance, Veline;Read, Ursula;Dazzan, Paola;Cruickshank, John Kennedy;Muniu, Erastus;Harding, Seeromanie
肯尼亚与其邻国的边界漫长且漏洞百出。这些地区主要居住着流动性强的农村社区，具有牢固的跨境文化联系，在管理人员流动和 COVID-19 预防措施方面面临重大挑战。我们的研究旨在评估肯尼亚两个边境县对 COVID-19 预防行为的了解、这些行为如何因社会经济 (SEC) 因素而变化以及参与和实施的挑战。我们使用家庭电子调查（Busia，N=294；Mandera，N=288；57% 女性，43% 男性）和定性电话访谈（N=73：Busia 55；Mandera 18）对政策制定者、医护人员、卡车司机和贸易商以及社区成员进行了混合方法研究。使用框架方法对访谈进行转录、英文翻译和分析。使用泊松回归探讨了 SEC（财富五分位数、教育水平）与 COVID-19 预防行为知识之间的关联。参与者大多受过小学教育（54.4% Busia，61.6% Mandera）。对 COVID-19 预防的了解因行为而异：洗手 - 86.5%、使用洗手液 - 74.8%、戴口罩 - 63.1%、打喷嚏或咳嗽时遮住嘴巴 - 56.3% 和保持社交距离 - 40.1%。不同地区、教育水平和财富指数的知识差异很明显，曼德拉、受教育程度较低的人和穷人的知识差异最大。对利益相关者的采访揭示了健康信息传递、社会心理和社会经济因素、卡车过境准备不足、语言障碍、否认和生计不安全等方面的挑战，这些挑战是在边境地区参与和实施 COVID-19 预防行为的主要挑战。 SEC 差异和边界动态对 COVID-19 预防行为的知识和参与的影响要求采取适合具体情况的风险沟通策略，该策略要认识到社区需求和当地信息流模式。协调跨境应对措施对于赢得社区信任和维持基本经济和社会活动至关重要。
Kenya has long and porous borders with its neighbouring countries. These regions, predominantly inhabited by highly mobile rural communities with strong cross-border cultural ties, present major challenges in managing movement of people and COVID-19 preventive measures. Our study sought to assess knowledge of COVID-19 prevention behaviours, how these varied by socioeconomic (SEC) factors and the challenges of engagement and implementation, in two border counties of Kenya. We conducted a mixed methods study using a household e-survey (Busia, N=294; Mandera, N=288; 57% females, 43% males), and qualitative telephone interviews (N=73: Busia 55; Mandera 18) with policy actors, healthcare workers, truckers and traders, and community members. Interviews were transcribed, English translated and analysed using the framework method. Associations between SEC (wealth quintiles, educational level) and knowledge of COVID-19 preventive behaviours were explored using Poisson regression. Participants were mostly educated to primary school level (54.4% Busia, 61.6% Mandera). Knowledge of COVID-19 prevention varied by behaviour: hand washing-86.5%, use of hand sanitiser-74.8%, wearing a face mask-63.1%, covering the mouth when sneezing or coughing-56.3% and social distancing-40.1%. Differences in knowledge by area, educational level and the wealth index were marked, greatest for Mandera, the less educated and the poor. Interviews with stakeholders revealed challenges in health messaging, psychosocial and socioeconomic factors, lack of preparedness for truck border crossings, language barrier, denial and livelihood insecurity as key challenges to engagement with and implementation of COVID-19 prevention behaviours in the border regions. The influence of SEC disparities and border dynamics on knowledge and engagement with COVID-19 prevention behaviours calls for contextually appropriate risk communication strategies that are cognisant of community needs and local patterns of information flow. Coordinating response measures across border points is crucial in winning communities’ trust and maintaining essential economic and social activities.
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影响因子：
4.5
作者：
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通讯作者：
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DOI：
10.1126/science.abk0414
发表时间：
2021-11-19
期刊：
Science (New York, N.Y.)
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影响因子：
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作者：
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