COMMUNITY SENSITIZATION & ENGAGEMENT

When entering a community to establish or strengthen a CBS program, it is important to be mindful of the conditions within the community as well as the community perceptions of the health system or polio program.

Photo © GPEI

CONSIDER: what experiences has the community had with the health system in the past? What are the community’s feelings toward the health system? Does the community have access to accurate information?

THOUGHTFULLY AND INTENTIONALLY ENGAGING WITH THE COMMUNITY WILL BUILD TRUST. Community-based surveillance depends on the investment and buy-in of community members. Community members may be more likely to listen to healthcare messaging from a trusted source and one who actively listens to the community.

TAKE THESE STEPS TO SENSITIZE AND ENGAGE WITH THE COMMUNITY.

WHAT TO DO BEFORE ENTERING A COMMUNITY

Get permission from government agencies, international organizations, or non-state actors to enter the community.
Review any international regulations regarding negotiating with non-state actors, as applicable.
Gather information about conditions in the community, including security. It may be necessary to speak with local security forces to understand any security concerns.
Ensure that some of the people who will enter the community have linguistic or cultural knowledge of the community. If possible, ensure that a neutral person who will be acceptable to everyone, especially if there are fractions between different tribes or ethnic groups, is part of the delegation going to the community.
Ensure individuals (including women of all castes and ethnic backgrounds) who come from the community or region where you will work are well represented in the delegation going to the community.
Ensure that all team members understand the gender issues in the community and confirm they have no history of sexual exploitation, abuse, or harassment and will not engage in it in the future.

WHAT TO DO ONCE YOU HAVE ENTERED A COMMUNITY

Identify key community actors to engage and gain their support for CBS. These actors could include members of a local NGO, local and religious leaders, traditional healers, midwives, traditional birth attendants, or members of women's groups. Be sure to engage both women and men and consider the social norms of the community. It may be necessary for women to meet with other women and men meet with other men, rather than in mixed gender groups.
Sensitize and brief the key actors about polio and the importance of detecting and reporting of AFP cases.
Actively listen to community leaders about their health concerns and priorities. This will help inform a discussion about the value of immunization and surveillance.

HOW TO ORGANIZE A COMMUNITY MEETING

Holding a community meeting upon entering a community is a great opportunity to listen to and converse with community members and key actors. Keep in mind that gender-mixed meetings may not be possible in some communities. You may need to organize separate meetings for women and men to ensure all are equally engaged.

Take these steps to organize a community meeting:

Include people of all ages, genders, and religious and economic backgrounds.
Invite community gatekeepers (such as pastors or imams).
Consider paying for bus fares or other costs if some community members are not close to the meeting location. Doing this can help ensure equitable participation, particularly for women and community members with limited means.
Schedule community meetings at times that work best for women to ensure they are able to participate. Consider if there are other restrictions on women’s participation, such as based on caste or social group, that need to be considered.
Moderate the meeting to allow equal opportunities to speak and provide input. It may be helpful to have female moderators who could encourage other women to provide input during the meetings.
Practice active listening. Listening to community input and concerns will help build trust.

GENDER CONSIDERATIONS FOR COMMUNITY ENGAGEMENT

Women may be more likely to identify acute flaccid paralysis in their children. Once AFP has been identified, in some contexts it may be more socially acceptable for female volunteers to work with mothers. Therefore, gender must play a key role in both setting up the teams to send to communities as well as the early recruitment of volunteers.

Consider an exploratory trip to the community before you implement your CBS program to find out how to engage both women and men and capture their views. Spend time in the community to have meaningful conversations with community members about how to best approach the community. Consider if women feel confident sharing their thoughts. You may need to use participatory methods to explore women’s ideas and instill confidence to share their views.

Consider the possible household and social restrictions women may face for participating as well as “hidden costs” such as time-pressures since they may be expected to complete household chores and childrearing. Developing an understanding of the challenges a community faces will help build trust.

If you are interested in learning more, read the comprehensive Gender and Polio profile drafted by the Global Center for Gender Equality in the resource section below.