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Communication for health: How to contain Zambia’s cholera outbreak
- The country could contain the outbreak through a message strategy that appeals to risk and efficacy behavior change.
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Zambia's cholera death toll is rising. Source: ZNBC. |
*The Pilgrim, January 19, 2024
By VICTOR KALALANDA
Zambia’s potentially ravaging cholera outbreak since October last year has claimed at least 400 lives.
The government is panicking
because of the possible and obvious economic impact of such a pandemic,
including other ramifications relating to social and political upheaval.
Hotspots in the capital city
include townships such as Kanyama, where slums are prevalent, and unemployment
and poverty are endemic.
The other day a news story
popped up, on the Zambia National Broadcasting Corporation (ZNBC), which tended
to underscore widespread reluctance to adopting protective action among the
affected population.
As an enthusiast of social and
behavior change communication, I took an interest.
It's been established in health communication research that a fear-based theory should underpin strategy aimed
at containing disease outbreak associated with unhealthy behavior.
This is especially true for pandemics
such as cholera, which can, in a trice, escalate to a public health emergency
that can bring an entire country to its knees.
As government adopts a
multisectoral approach to fighting the pandemic, it’s important to consider the
utility of the Extended Parallel Processing Model (EPPM), which draws attention
to the importance of perceived risk and perceived efficacy in reducing the risk
of such an outbreak.
Developed by American scholar
Kim Witte, EPPM would entail that the government and its cooperating partners
conduct research to determine how various segments of the population perceive
their own risk and efficacy vis-à-vis cholera.
Four variables are central to
EPPM, namely perceived severity, perceived susceptibility, response efficacy
and self-efficacy.
Perceived severity addresses the
significance of the consequences of a possible cholera infection on an
individual level, while perceived susceptibility poses the following question:
How likely is it that one might get infected with Vibrio cholerae bacteria?
Response efficacy addresses
the notion that suggested solutions are effective in protecting individuals
against the said pandemic, while self-efficacy focuses on whether people have the
confidence needed to take up the proposed solutions or remedies.
Having determined the
behavioral attributes of the different segments of the population, the
government would have to develop a message strategy, informed by EPPM, that
appeals to risk and efficacy behavior change.
In this case, EPPM contends
that if perceptions of the threat posed by cholera are strong and perceived
levels of efficacy have gone through the roof, cholera will begin to dissipate.
It follows that if the
perceived threat is powerful, but perceptions of efficacy are low, the response
from the population will be utter adamancy, as is being suggested by the ZNBC
news story.
If we are going to contain
cholera in Zambia and totally end its spread across the country’s capital, we must
develop a robust health communication strategy.
If people believe that cholera
is deadly, the government should provide cues to action, clearly explaining how
people can mitigate the risk. For example, should they take vaccines? Or indeed
should they wash their food? Or bury shallow wells?
If people believe that cholera
is nothing serious and that one could go about eating street food in reckless
abandon, or indeed drinking contaminated water, then sensitize people to what risk the pandemic poses. Show them the
statistics. Reach through a variety of communication channels.
Indeed, if there is absolutely
no response to such an intervention, let us educate the populations in Lusaka
and other parts of the country about the risk and solutions associated with
cholera.
Human behavior is complex, and
the country cannot afford taking a lackadaisical approach to such an outbreak.
I saw that the country was on
Sky News the other day for the same reasons. What this means is that the
pandemic is clearly becoming an indictment of urbanization and unplanned
settlements in Zambia, and therefore a shame of the country.
The government must embrace
concerted efforts that thrive on tried and tested public health messaging, and
indeed intervention.
Cholera could be a nuisance of the past.
*This column is published every Friday in Zambia's leading newspaper, the Zambia Daily Mail. The author has a bachelor’s degree in mass communication from the University of Zambia and a Master of Science in media studies from Southern Illinois University at Edwardsville in the United States. He is a PhD student and graduate teaching assistant in the Department of Journalism and Media Communication at Colorado State University.
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