Risk Communication Guide for Zika Virus, Dengue and Chikungunya

From the United Nations Children's Fund (UNICEF) Regional Office South Asia (ROSA), this guide aims to help Country Offices in South Asia support national and local governments' preparedness in the case of disease outbreak. Designed as a practical resource package with templates and pictorial materials, it provides a step-by-step guide to risk communication planning and community engagement that can be adapted to country-specific contexts for disease prevention.

UNICEF ROSA explains that "[c]ommunicating the risk of Zika virus to populations with diverse audiences requires skills in public communication. Providing accurate information and addressing rumours and misconceptions about a disease are essential steps to be practiced from the beginning of an outbreak. Persuading people to change their behaviors in order to prevent and control a disease requires behaviour change communication. While mass media can reach huge populations and provide the information and impetus for large scale changes necessary to prevent transmission, individual behavior change and supportive social norms and practices in the prevention of diseases can be driven through community engagement, participation and coordination with key influential and stakeholders such as religious leaders, health workers and teachers. Therefore, country teams need to be cognizant about the national level context, competent in risk communication and also have the right tools to execute the steps of effective risk communication and community engagement."

This resource package contains three parts and a supporting document on monitoring and evaluation (M&E):

• Part 1 titled "Risk Communication Planning for Preparedness and Response" describes the process and steps involved in executing a national risk communication plan. It also provides operational guidelines and tools to execute these steps. Part 1 has 13 units, and each unit is composed of 3 components: (i) key concept or the risk communication step; (ii) case studies that give a practical explanation of how this concept was operationalised in a past outbreak; and (iii) procedural guidelines and tools for operationalising the risk communication step with relation to the Zika virus (ZIKV). The units are:
  1. Role of Preparedness in Fighting a Zika Outbreak
  2. Formation of a Risk Communication Operational Structure
  3. Working with Partners
  4. Dynamic Listening & Rumour Management
  5. Stakeholder Engagement
  6. Audiences for Risk Communication
  7. Communication Channels
  8. Spokesperson & Message Maps (Talking Points)
  9. Media Engagement
  10. Social Media Engagement
  11. Community Engagement
  12. Monitoring & Evaluation
  13. Guidelines for Research
  Appendices include: Risk Communication Competencies; List of Readings and Resources on Risk Communication Competencies; and Resources on Zika Virus Disease and Risk Communication.
• Part 2 titled "Materials for Public Communication and Community Engagement" focuses on the design and development of appropriate communication materials for risk communication and behaviour change associated with the prevention of Zika. UNICEF's "Zika Virus Preparedness and Response Plan" states that although UNICEF will not implement or support vector control interventions directly, it will contribute to promoting behaviour change to strengthen prevention at the individual, family, and community levels, including reduction of breeding sites, access to safe water sources, appropriate waste management, and personal protection, as well as prevention of sexual transmission and access to contraception and counselling. This part provides inputs for the entire cycle of planning, preparing, and disseminating communication materials on Zika prevention. In addition, Part 2 reviews existing materials on Zika prevention, and offers guidelines for adapting such materials. It has has 8 units:
  • Units 1 and 2 orient readers to ZIKV by tracing its historical spread, outlining its consequences, describing the epidemiology, and explaining the chain of transmission and methods to break this chain. This description sets the background for readers to understand the critical behavioural actions and key messages described in Unit 3.
  • Unit 4 describes a framework for reviewing and finalising these messages.
  • Unit 5 presents a set of print communication materials developed by UNICEF, Pan American Health Organization (PAHO), and the Centers for Disease Control and Prevention (CDC) for the prevention of ZIKV, mosquito-borne diseases, and vector control. It also provides a review of selected print materials and recommendations for adaptation.
  • Unit 6 offers guidelines to adapt any health communication material, produced in English or other languages, and make them relevant and appropriate to the country context, without losing the scientific correctness, core concepts, and messages of the original version.
  • Unit 7 provides sample communication for development (C4D) materials on Zika and vector control for country offices in South Asia. These materials can be used as templates for adapting and developing C4D materials based on the country context and culture.
  • Unit 8 provides guidelines for pre-testing and printing communication materials.
• Part 3 titled "Prevention through Community Engagement" presents a systematic process for community engagement in order to control the mosquito vector and prevent Zika virus disease and other Aedes aegypti-borne diseases such as dengue and chikungunya. It is organised around the government-led, 6-step COMBAT model, which involves:
  • C = Create awareness and felt need in community
  • O = Organise community action teams
  • M = Meetings to finalise community engagement plan and conduct capacity building
  • B = Bring resources together
  • A = Activate the plan, ensure communication leads to required actions
  • T = Track progress and ensure feedback into the process
• Supporting document titled "Plan for Monitoring and Evaluation of Risk Communication and Community Engagement" offers a logical framework and tools for M&E of the risk communication process in the context of Zika. Unit 1 describes and provides (along with a flowchart) a comprehensive framework for the M&E of national risk communication efforts for prevention and control of ZIKV. Units 2, 3, and 4 detail the underlying concepts and processes in M&E and discuss these concepts in relation to ZIKV. Unit 5 briefly describes formative evaluation by using the case study of Brazil and the formative research and work done there.

This resource is based on the principles and recommendations of the global guidance document: Risk Communication and Community Engagement for Zika Virus Prevention and Control: A Guidance and Resource Package for Country Offices for Coordination, Planning, Key Messages and Actions (see Related Summaries, below). The resource package follows the global guidance document principles of ensuring that risk communication and community engagement is evidence-based, contextualised, driven by local communities, tailored to the needs of different population groups, attentive to vulnerable groups, respectful of reproductive rights, and inclusive of dengue and chikungunya.