Risk communication and community engagement for health emergencies: learning lessons from COVID-19 in the Western Balkans

The COVID-19 pandemic has shown, perhaps as never before, the importance of risk communication and community engagement (RCCE) for emergency preparedness and response. Communicating the risks from the virus has proven vital to ensuring people can make informed decisions and take actions to protect themselves and others, and has thus helped reduce the pandemic’s impact on health systems and economies.

The involvement of communities in COVID-19 responses, which has led to greater acceptance and uptake of vaccines and other protective measures, has also helped build trust in authorities.

The success of response measures to health emergencies is therefore highly dependent on effective RCCE. This was the starting point of Europe’s first workshop on lessons learned in RCCE from the COVID-19 response. The event brought together 25 participants from the Western Balkans and the Republic of Moldova in Tirana, Albania.

Taking stock of the lessons learned across the WHO European Region as well as in individual countries, participants developed suggestions for their subregion to improve the effectiveness of RCCE interventions for the future.

The workshop came at a timely moment, as a plateau in vaccination rates in the Western Balkans signals the need to prepare effective RCCE responses now to boost vaccine uptake in advance of a likely uptick of COVID-19 cases in autumn.

In her address to workshop participants, Dr Mira Rakacolli, Deputy Minister of Health and Social Protection of Albania, stressed, “Communicating about the risks is not always easy, especially when the science behind them is complex and constantly evolving.” She added that, more than any previous emergency, “This pandemic has shown that health authorities need the trust and support of the communities they serve if they are to stop an epidemic.”

Dr Rakacolli noted that the lessons identified and the actions proposed for the subregion will be highly important: “High-quality risk communication and community engagement by health authorities are crucial for gaining their trust and support.”

Ms Geraldine McWeeney, WHO Representative to Albania, added that the mutual learning and partnership gained through RCCE can benefit the entire Region: “This technical workshop, and others like it, pool knowledge and expertise, identify common challenges, and then lead to united action with support from WHO and international partners – resulting in better health for all our communities.”

Dr Abebayehu Assefa Mengistu, Coordinator of the WHO Health Emergencies Balkan Hub, pointed out that all of our key disease control strategies, from case finding and contact tracing to preventive measures such as face masks, distancing and vaccination, depend on trust and support from communities. “Now is the time to take stock of the immense learning from COVID-19 and not let it go, but instead translate it into stronger health systems for future epidemics and emergencies.”

Ms Cristiana Salvi, RCCE Adviser for WHO/Europe, explained, “With this meeting, we wanted to establish a role model that brings RCCE to the next level as a core public health intervention in the response to both outbreak and humanitarian emergencies. The health sector can rise to this task by putting in place the right structures, systems and skills for when the next emergency strikes.”

Ms Salvi added, “The lessons identified in this event will be relevant not only for the Western Balkans region, but to everyone working in health emergency responses across Europe and the world.”

Dr Audra Diers-Lawson, Associate Professor at Kristiania University College in Norway and Editor of the Journal of International Crisis and Risk Communication Research, said, “There is a growing body of social science evidence from this pandemic and previous health emergencies on the factors that influence whether people will accept or reject advice on how to protect themselves. The data shows that 3 factors are key: whether they believe the risk is both imminent and severe, whether they think the institution giving the advice is technically competent, and whether they trust the institution giving the advice.”

Dr Diers-Lawson continued, “Tracking and analysing communities’ perceptions of the risk and attitudes about institutions are key to designing a good communication strategy. The tricky bit is how to do this in a way that is rapid and practical enough to give evidence for action by health response teams.”

The workshop emphasized the need for intersectoral cooperation, collaboration and information sharing, and showed how subregional and regional exchange of best practices and lessons learned during the COVID-19 pandemic can help strengthen countries’ RCCE capacity before, during and after public health emergencies.

The suggestions for improving RCCE capacity developed as a result of this workshop will include actions to be taken by Member States of the European Region and by WHO itself. Participants from the workshop will also be advising their health authorities to use the recommendations in developing country- and area-specific RCCE action plans.

WHO is committed to providing further support to countries to implement these recommendations, which are in line with the Roadmap for Health and Well-being in the Western Balkans (‎2021–2025)‎ and the European Programme of Work 2020–2025‎ – “United Action for Better Health in Europe”.