Risk Communication

  • Communication with the public during a cholera outbreak is critical not only for the rapid control of the outbreak, but also to keep the public informed and reduce the risk of social, political and economic turbulence.
  • Risk communication is defined as the real-time exchange of information, advice and opinions between experts or officials and people who face a threat to their survival, health or economic or social well-being.
  • The purpose of risk communication is to ensure that everyone at risk for cholera is informed about how to reduce the risk of spreading the disease, take personal protective and preventive measures, and proceed if someone gets sick.
  • Public health officials must report, fully and rapidly, what they know, what they suspect and what they are doing to control the outbreak.
  • Best practices for effective risk communication include the following:
    • Create and maintain trust.
    • Acknowledge and communicate even in uncertainty.
    • Be transparent and fast with the first communication and all communications.
    • Be proactive in public communication, using a mix of preferred channels of affected populations, such as TV, radio, SMS, internet, social media, mass awareness initiatives, and social mobilization.
    • Understand local knowledge and behaviours (including beliefs and barriers) towards cholera and adapt the messages accordingly.
    • Involve and engage the community in the outbreak response through community leaders and influencers.

Clarifying Rumours and Community Concerns

  • Trusted information should reach people and rumours should be addressed by maintaining a very open flow of information from the beginning of the outbreak; rumours spread easily when information is incomplete or delayed.
  • Define a strategy to disseminate accurate information promptly, rather than responding to rumours.
  • Provide information that is easily understood, complete and free of misleading information.
  • Key messages to the public should help people to recognize symptoms of cholera and how it is transmitted and provide information about what to do for prevention and treatment, encouraging early treatment-seeking behaviour.
  • Information should include what cholera is, how it can be prevented, why, when and where to seek help, and how to care for family members with diarrhoea (see appendix 8 – key messages for health education).

Media Involvement in the Outbreak Response

  • Establish partnerships with the media to contribute to controlling the outbreak by providing:
    • information to people within and outside the affected area;
    • information in the appropriate language;
    • information through the appropriate channels (radio, press, TV);
    • the right type of information, with the right frequency.
  • When an outbreak starts, designate a single spokesperson who will be the focal point for the media.
  • Plan regular press releases and conferences. Prepare a set of frequently asked questions (FAQ) with responses.
  • Public health authorities are generally interested in using the media to provide information on preventive and control measures via public service announcements, while journalists may focus on disseminating news. A balance between the two interests should be established by negotiation.
  • The kind of information to be disseminated will depend on the levels of the media – local, national or international.

Community Engagement

  • Community engagement is a process of including at-risk and affected communities in the cholera control response throughout the process from planning and surveillance to implementation and monitoring. It promotes and facilitates community ownership in the response.
  • The purpose of community engagement – as a complementary strategy to risk communication – is to multiply the effect of information and communication about preventive actions.
  • Community engagement proceeds through in-depth interpersonal outreach and dialogue to plan local solutions that are specific to a community’s (or individual and family’s) needs. It recognizes challenges and builds upon locally defined opportunities for people to be able to practice behaviours that stop cholera transmission.
  • Outcomes of effective community engagement are foremost about community ownership of the response and include increasing trust, confidence and cooperation with response teams, community feedback and uptake of preventive practices.
  • Best practices for community engagement include:
    • identifying and using trusted, community-appointed people as entry points for response teams to work with the at-risk community;
    • facilitating a local risk assessment and using locally generated data to develop an implementation plan for the community to remain cholera free or to rapidly interrupt transmission;
    • forming a small local task team comprising trusted leaders, respected members of the community, religious representatives and youth and women’s group members who are responsible for engaging with the response teams and monitoring implementation of the local plan;
    • facilitating routine feedback and engagement between the community and the cholera response team to be able to change the strategy if needed;
    • supporting and building on the mass mobilization efforts of local churches, networks, teachers and vendors to improve the community’s confidence;
    • linking up and using mass media to promote community engagement activities and using local structures to discuss public health advice promoted in the media; and
    • using local communication channels (such as information boards, meetings, social media) to communicate which parts of the response are working, which are not working and how to improve the response.

For additional information:

  1. Outbreak communication: best practices for communicating with the public during an outbreak: Report of the WHO Expert Consultation on Outbreak Communications held in Singapore, 21-23 September 2004. World Health Organization. 2005 Click here
  2. Communicating for cholera preparedness and response. UNICEF Cholera Toolkit. 2013 Click here
  3. Health promotion materials. Centre for Disease Prevention and Control. Click here