Prepare communities with existing and upcoming situation of Covid-19: promoting a sustained social practice

The Covid-19 current situation reveals that the case detection incrementally upswing to reach at 10,566,002 and death toll rises at 513,277 while there

was a good number of recoveries appears at 5,825,876 but the new case detection still at its upward trend that found 175,343 on June 30, 2020

(Source: Worldometer) becomes a great threat for the world. Bangladesh situation is not that different from the world scenario which found

(Worldometer June 30, 2020) total cases to reach 145,483, total deaths 1847, recovery is 59,624 and new case detection is 3682. On the other

hand, the WHO is advising the countries of the world to cautiously lifting of the lockdown and become prepared for the second wave of Covid-

19 which is being experienced in few countries of Asian region includes; Singapore, South Korea and Iran. This disease outbreak affects all

segments of the population throughout the world including Bangladesh and is particularly detrimental to members of those social groups who

are in the most vulnerable situations, continues to affect populations; including people living in poverty situations, older persons, persons with

disabilities, youth, children, women, public mental health, rumors and brings fear and anxiety that led to social stigma and discrimination.

Bangladesh’s case detection along with death rate is sharply rising and it is having all characteristics of social affects beyond health crisis

equires appropriate addressing to the issues, dispelling misunderstanding with correct information and long-term planning to reduce these

social effects. As a developing country, Bangladesh is more likely to face the worst hit of these social and economic effects compare to the

developed countries.
In this situation communication for community awareness and promotion for increased household knowledge to inform and mobilize individuals

practicing required health behavior. This will bring about a collective model health behavior which is expected to become a social norm. Two major

communication intervention can really draw peoples’ attention about their behavior measures to undertake in this situation in reducing the curse

of Covid-19 effects and safe return to their social and economic life. This communication has been clustered as community engagement for ‘Risk

Communication and Community Engagement’ and social preparedness for ‘New Normal’ situation. Risk communications and community engagement
Risk communication and community engagement (RCCE) is a critical component of the response to any infectious disease outbreak. What this looks

like depends very much on the context and the disease in question: it could range from targeted radio campaigns to social mobilization in which

staff having face to face discussions with community members at their doorsteps, all the way through to large mass and social media campaigns,

sponsorship of public events that help describe the risks of catching a particular disease and how to protect ourselves. In a respiratory pandemic like

COVID-19, many of these face-to-face activities are hampered by the specific transmission mechanisms of the disease.
Community engagement is the process of supporting communities to consider themselves as partners in an outbreak response, and to have ownership in controlling an outbreak. It is a principle rather than a defined set of activities, and the approaches to this vary depending on factors such as local social structures, community coherence, preferred communication methods, and relationships with authority. Risk communication without proper community engagement takes a more ‘top down’ approach and risks ignoring local needs and customs, and ultimately being less effective as a result. Furthermore, the hard to reach communities can be reached through the community engagement process.
Risk communication and community engagement is a critical component of the response to COVID-19. It helps people make the right decisions about how to protect themselves, when to seek care, and to avoid contributing to panic about the disease and its effects:
• It is very important to make sure that people have the right information, delivered in the right way, to take appropriate and proportionate steps to protect themselves.
• Where possible, effective risk communications should be clear and easy to understand e.g. by focusing on easily achievable tasks (such as handwashing, avoiding face touching or maintain social distancing).
• Panic about COVID-19 has its own consequences that are harmful both to outbreak control, and to societal cohesion. Panic and fear can result in the stigmatization of might preventing people to seek for health services.
The speed at which COVID-19 is spreading means there is an imperative to try and develop risk communications approaches including communication materials that are applicable in many different settings of our country. Further, while messaging for some aspects of COVID-19 risk communication materials will be similar throughout Bangladesh but guidance on care-seeking may differ based on health system capacity and structure that are prevalent locally. Risk communications also needs to consider specific guidance for vulnerable or potentially vulnerable groups, whose experiences and risk will also vary depending on location (for example those with existing health problems, women especially the pregnant women, children and the elderly). The 'New Normal' cannot be 'business as usual' Governments and civil society leaders must help prepare the population for the "new normal" after the lockdown period because "business as usual" is no longer an option. We need to think of new ways to reorganize life, economy and society to ensure that people can live full lives with their wellbeing assured. Physical distancing and other precautions, including sanitary measures, will be critically necessary until a vaccine is developed and available to all. Mass media and community level campaigns with the support of communication materials can be an effective way preparing community to display required behavior in the New Normal situation.
Wearing masks must be encouraged as national policy. Even homemade face coverings provide some protection – especially when many people who have the coronavirus show no symptoms, and infectious aerosol droplets are commonly emitted by the infected during normal social interactions. Physical distancing also to be encouraged in the new normal situation and be maintained together with using of mask.
There is a great deal of attention to digitization and digital transformations of certain industries and services, which may well accelerate investments to enable employees to work remotely. People will also have to change their social lives to reduce physical contact, even proximity, and mass gatherings. However, the following flow chart represents determining the new normal situation by considering the level of Alerts.   COVID-19 risk alert levels
Alert Level 4 Very High Risk Widespread outbreak that is growing with many undetected cases. Take strong measures to limit all contact. Alert Level 3 High Risk Many cases including community spread, with undetected cases likely. Limit everyday activities to increase safety. Alert Level 2 Moderate Risk Moderate number of cases with most cases from a known source. Increase efforts to limit personal exposure. Alert Level 1 New normal Cases are rare and contact tracing can be used to control the virus. Take everyday precautions. Returning to normal
Although health experts urge caution, governments are under extreme financial pressure to reopen their economies. Now, when these measures are prompting more people to venture outdoors and even gather in groups. Public health experts had a few suggestions on what the new normal might look like.
• Wearing a mask: While a growing number of countries including Bangladesh mandate mask-wearing, holdouts remain – and many people simply refuse to do what they’re told. Strong communication interventions can promote citizens to wear cloth masks in all public places.
• Physical distancing: Measures and movement restrictions are effective in slowing the spread of the virus by limiting contact between people. A widespread and repeated communication intervention can encourage people adopting this behavior.
• Motivations not fines: Some governments including Bangladesh have imposed fining people who don’t wear masks in public or keep sufficient space with others, to combat social distancing disorders. However, several studies show that people have been complying with coronavirus guidelines because they’re motivated – not because of threats. • The search for treatments: At least 90 vaccines are under development as governments of different countries aim to immunize their populations from the virus as soon as possible. WHO promised vaccine this year – they do see room for hope.
In the backdrop of above situation, we really need to inform people at their accessible points of communication by considering the hard to reach people with repeated communication and multi-media approaches to undertake desired and standard behavior during and immediate after the Covid-19 situation. People requires motivations, participation and engagements – not only by forcing and penalizing. When people get mobilized understanding their own well-being will be ensured with these practices they will start practicing in their household and community. Once these behaviors come as a common practice a sustained social behavior will prevail in the community.

Creating next generation researchers against tobacco use

A series of mentoring workshops for the selected tobacco control grantees under its Tobacco Control Policy Research Grant Program were organized by BCCP. The 1st Mentoring Workshop on Research Methods, Procedure and Data Collection was held during June 8-9, 2020 under the 2020 Tobacco Control Policy Research Grant Program. The purpose of the workshop was to increase the knowledge and skills of the research grantees on research instrument development and field data collection. Considering the COVID 19 pandemic situation, the workshop was organized on Zoom Cloud Meetings this year. Eight research grantees and their Co-Principal Investigators attended the workshop. The workshop initiated with a welcoming speech by Mr. Mohammad Shahjahan, Director and CEO, BCCP. In his speech, Mr. Shahjahan mentioned about the salient features of the Research Grant Program. He said that the mentoring workshops were designed such a way so that the grantees could able to learn about various research steps through the peer-learning methods as well from the experts. In the workshop, different aspects of survey research and research design including data collection methods and procedures were discussed. In particular, BCCP research team shared their experiences to develop research instrument(s), conduct enumerators' training and pre-test research instrument(s), and supervise field data collection. The research grantees presented their draft data collection instrument(s) along with the research objectives in the workshop. Members of BCCP research team and the research grantees joined in providing feedback to each other.
A practical session on data entry, editing and coding was also conducted in the workshop. The workshop was highly participatory. The research grantees were found very spontaneous to provide feedback to each other.
While making comments at the end of the workshop, one grantee said that the way of conducing the mentoring workshop was fantastic. He also said that the grantees were fortunate as they received the seed grants as well as the opportunity to take part at the capacity building initiatives.

MoHFW planned for HPN SBCC Best Practice share fair: an opportunity for better learning and replication

Following the national level comprehensive SBCC strategy and the detailed SBCC action plan the Ministry of Health and Family Welfare (MoHFW) identified ‘Best Practice’ documentation as a critical element of knowledge management and sharing and get it replicated in Health Population and Nutrition (HPN) programs of GoB and NGOs for attaining better impact. Best Practice documentation is unique because it focuses on examining and documenting helpful changes made during the process of a program (management systems, design, delivery, recipient uptake, etc.) and not just on the results of the program. Commonly, Social and Behavioral Change Communication (SBCC) programs and practices occur most effectively and efficiently when they are adapted to their local context and culture. By documenting the adaptations, innovations, and reforms that improve each organization’s programs, all organizations are able to learn and benefit from each other’s experiences.
Best Practice documentation facilitates communication within and between organizations and programs allowing them to use each other as a resource. For organizations and programs facing challenges, Best Practice documentation provides them with an opportunity to learn from the solutions of similar organizations and programs. This also gives organizations and programs that have developed and implemented Best Practices an opportunity to share their achievements and collaborate with other organizations and programs.
In view of the above circumstances the National Implementation & Monitoring Committee for Comprehensive SBCC Strategy of MoHFW decided in their last meeting to organize ‘Best Practice’ share fair event. USAID Ujjiban SBCC Project is providing technical assistance in developing this concept and implemeting the event. Public Health (PH) Wing of Health Services Division of MoHFW has initiated the process in last May 2020 to organize ‘Best Practice’ share fair event. PH-2 section circulated a letter to all related stakeholders to submit their relevant information in a given format. It is expected that the documentation of Best Practices from the GoB, NGO, INGO & DPs as well as the BCC Working Group member organizations and programs allows the BCC Working Group to better advocate for and support the SBCC activities of these organizations and programs.

DBL on eToolkit/eLearing course found very effective increasing field level service providers proficiency to better communicate with the community - Ms. Shahan Ara Banu, Director General Family Planning

A Distance Based Learning (DBL) to train-up FWA, FPI, FWV and SACMO of Dirai upazila of Sunamganj district. This was the second batch of DBL course while the first course was held for the Doarabazar upazila. A total of 44 participants from these service providers group attended this 2-day long course on June 15, 2020. This virtual course was planned to hold in the Zoom platform and participants mostly get connected through their tabs as were provided from HQs while few of them used their own available devices in case the tabs are not functioning or not available with them. This course was formally inaugurated with the presence of Ms. Shahan Ara Banu, Director General Family Planning while the Director-IEM, Dr. Ashrafunnesa along with other IEM officials and the DDFP of Sunamganj attended the inauguration ceremony. In her inauguration remarks Director-IEM termed this virtual course as very useful considering the current situation when Covid-19 is preventing us to maintain usual practice of communication for training programs. She thanked Ujjiban for their technical support in designing this DBL course. As her inauguration speech Ms. Shahan Ara Banu-DGFP emphasized to continue this course beyond Covid-19 period and also thanked Ujjiban in designing and implementation of this virtual course in the Zoom platform. She particularly mentioned that this DBL on eToolkit/eLearing course found very effective increasing field level service providers proficiency to better communicate with the community.

The participants of this course found very interested and proactive to take part in the discussion followed by the facilitators instructions to go through navigating and installation of the eToolkit/eLearing course in their respective devices and get practiced with it. The most interesting feature of this course is that the participants ability in connecting with Zoom platform and navigating through various features was almost universal.

Our joint effort combatting the havoc of Covid-19 is the demand of time to address through SBCC interventions - Dr. Ashrafunnesa, Line Director-IEM

A virtual meeting of 27th HPN Coordination Committee was held on April 28, 2020 on the inter-unit coordination issues as per set agenda that also focused on unit’s effort on the Covid-19 related SBCC interventions. Chaired by Dr. Ashrafunnesa, Line Director-IEM, this meeting was also attended by Dr. S M Mustafizur Rahman, LD-NNS, Dr. Md. Abu Zaher, LD-LHEP, Dr. Md. Shamsul Hoque, Line Director, MNCAH and Mr. Abdul Aziz, Chief, BHE. Other attendees include; Program Managers and Deputy Program Managers represents NNS, MH, CCSDP, FP-FSD, MIS, CBHC, IEM and BHE. The SBCC activities as brought for discussion in this meeting covers the January-March 2020 period while unit wise key activities include: National Nutrition Service (NNS) - Several BTV and Bangladesh Betar program focused on nutrition and MNCAH issues - Conduct an NNS related message design workshop for the Bangladesh Betar officials - Diet for boosting up body resistant uploaded in the Facebook focusing on Covid-19 - Vitamin-A campaign program designed and implemented. Bureau of Health Education (BHE) - Conduct multiple campaign activities on the eve of World Health Day in various channels - Organize 5 days training on Environmental and Occupational Health awareness for Senior and Junior Health Education Officer - Printing/distribution of 200,000 leaflets to support Covid-19 awareness raising campaign - Organize 15 days long basic training for Health Education Officer & Health Educators. Information Education and Motivation (IEM) - Conducted eResource and IPC ToT along with field level training - Media Fellowship Award for Journalist of print, electronic and social media - Media campaign on covid-19, long acting FP method, call center, danger sign, ANC, PNC through airing of TVC for 1200 times in 8 private TV channels - Development of materials and awareness campaign on covid-19 at field level.
Key decisions:
This meeting focused on Covid-19 related SBCC effort and activities that individual units has undertaken in combatting the havoc of this disease outbreak with future planning. Key decisions include; - IEM’s planned virtual training on eToolkit and eLearning course would have continued - NNS will continue its TV and Radio campaign programs on nutrition aspects with body resistant necessary for protecting Covid-19
- Three TVC will be developed on the situation aroused with Covid-19 related stigma and discrimination, gender-based violence and mental health for its common use in all three HPN units. Ujjiban will provide TA support in developing the TVC script on these three issues.
In her concluding remarks the Chairperson and Line Director-IEM Dr. Ashrafunnesa emphasized on addressing the Covid-19 situation and told that our joint effort combatting the havoc of Covid-19 is the demand of time to address through SBCC interventions.

eLearning course on WASH for field workers is very effective course in this pandemic situation when much emphasis is given on hand washing- Dr. Md. Abu Zaher, Line Director, LHE&P, DGHS

A virtual workshop was held on May 19, 2020 at 12.00 pm to review the course content on WASH eLearning course by the officials of Health, Population and Nutrition (HPN) Units. A total of 23 attendees took part in the workshop includes; Program Managers and Deputy Program Managers representing NNS and BHE of DGHS and IEM of DGFP. The workshop was inaugurated by Dr. Md. Abu Zaher, Line Director-L&HEP. Dr. Zaher thanked Ujjiban to organize this workshop in this pandemic situation. He ensured L&HEP’s necessary support to provide making the course worthy for the users. Dr. Ashrafunnesa, Line Director-IEM and Mr. Abdul Aziz, Chief, BHE also participated in the review discussion and expressed satisfaction of adding the WASH course in the eLearning. The workshop was planned to be held in 2 steps. At the first step, the unit officials reviewed the course contents separately on Health, Population and Nutrition in 3 small groups and prepared their feedback and recommendations. As second step, the three groups connected virtually to share their review feedback and recommendations in the bigger forum.
Overall feedback highlighted the contents as well-written while the entire 9 modules of the course with its sequencing was well organized having appropriate images and videos.
Specific feedback and recommendations were as follows: - Revisit the language of some areas of module 3: Personal hygiene of the course to make the module more simplified. Also suggested to include cough etiquette and waste management to have a healthy environment. Add: - menstrual hygiene management at school level and safe disposal of sanitary napkin. - roles of SACMOs, Kishore Kishori groups of school health program to enhance community engagement. - arsenic related diseases in the section of waterborne diseases in the module: 5 - types of sanitary latrine generally used in Bangladesh to add with proper use of those in the module: 2 - normal range of presence of arsenic in the tube well water in module: 8 The workshop informed about the next step that Ujjiban CSS team will incorporate feedback/recommendations provided by units as appropriate and bring it for sharing if required.

Editorial: Changing behavior and preparedness for the new normal situation

The COVID 19 brings a lot of behavioral considerations in our lives that requires change in our behavior and practices like; social distancing, wearing mask, work from home, online education, and so on. Although we are trying to adjust with the new practices, but still we are also experiencing dilemma with adapting some of the new behavior. This dilemma might appear as; is there any need to change our beliefs, values, socials norms, family and social bondage? Why it happens, because people differ in their own perspectives. People’s have their own comprehension and understanding of what they are getting communicated. .
When the required change demands for optimal scientific health behavior – not panicked behavior; social distancing – not emotional distancing, stay safe – not without care to other, thinking logically – not with wrong beliefs, online education – not distance with books and teachers; we need to consider people’s perception as well. This will give us planning for a strategic communication targeted for changing behavior in the current perspective of pandemic situation and appropriate response of the community and people.
Community as a whole and people is living with a real sense of hardship in this pandemic situation and country with global economy, social peace and stability, stigma, discrimination, and social violence along with the public health hazards are bringing a catastrophic impact on our society. In this purview Bangladesh’s case detection along with death rate is sharply rising and it is having all characteristics of social affects beyond health crisis requires appropriate addressing to the issues, dispelling misunderstanding with correct information and long-term planning to reduce these social effects. As a developing country, Bangladesh is more likely to face the worst hit of these social and economic effects compare to the developed countries.
In this situation communication for community awareness and promotion for increased household knowledge to inform and mobilize individuals practicing required health behavior is very necessary. This will bring about a collective practice of model health behavior which is expected to become a social norm. We really need to draw peoples’ attention about their behavior measures to undertake in this situation in reducing the curse of Covid-19 effects and safe return to their social and economic life. In attaining this, community requires to get engaged with the risk communication and they need to prepare for new normal situation as well.
We need to think of new ways to reorganize life, economy, and society to ensure that people can live full lives with their wellbeing assured. Physical distancing and other precautions, including sanitary measures and wearing mask will be critically necessary until a vaccine is developed and available to all. Mass media and community level campaigns with the support of communication materials can be an effective way preparing community to display required behavior for adopting such a new normal situation.

Indian community’s Knowledge, Attitude & Practice towards COVID-19

Abstract: As COVID-19 pandemic has caused unprecedented human health consequences. Knowledge, attitude, perception of general population of India towards the transmission and prevention plays vital role for effective control measures. The study was conducted to assess the knowledge, attitude and practice of the general public of India on COVID-19. In this study, a web-based cross-sectional survey was conducted between 10th March to 18th April 2020. A 19-item questionnaire was generated, Cronbach’s alpha was used to measure the internal consistency of the questionnaire & randomly distributed among the public using Google forms through social media networks. The chi-square test or Fischer exact test was used to compare categorical data and multiple linear regression was used to identify factor influencing KAP. Among 7978 participants, the overall knowledge, attitude and practice score was 80.64%, 97.33% and 93.8% consecutively. Majority of Indian population demonstrated preceded good knowledge, positive attitude and good practice regarding COVID-19 pandemic. Source: Website

Knowledge, attitudes, and practices towards COVID-19 among Nepalese Residents: A quick online cross-sectional survey

ABSTRACT: Covid-19 was declared as a public health emergency of international concern on January 30, 2020 by WHO. Despite all efforts the virus continues to spread and WHO declared it a pandemic on March 11, 2020. In Nepal the first case was tested positive on 23rJanuary and ever since numbers are increasing as days passed by. Residents of the country are the most important stakeholders to control the spread of such viruses. Nepal is a land locked country situated between India and China and is one of the vulnerable areas among SAARC nations. In spite of being such a vulnerable nation there was a lack of previous studies detecting the degree of awareness among Nepalese residents towards COVID 19. Aims and Objectives: This study aims to assess the current level of awareness towards COVID 19 among Nepalese residents and to analyze their attitudes and practices towards COVID 19 which is very important for people’s active participation to control this pandemic. In this study we investigated Nepalese residents KAP towards COVID-19. Material and Methods: This is cross sectional online study. A self-developed online questionnaire was completed by the participants. There were a total 29 questions among which 15 questions assessed knowledge, 6 questions assessed attitude and remaining 8 questions assessed practice. Results: Among the respondents (n=760),65.7 % were male,50.3 % were healthcare workers, overall range of correct answers for knowledge questionnaire was 60.0-98.7% %, that for attitude was 77.9-96.4% and for practice was against COVID 19 compared with the general population.
Conclusion: Findings of this study: Practice against COVID requires a sense of responsibility, though the respondents with medical background had better sense of act against COVID prevention practice. Key words: Knowledge; Attitude; Practice; COVID-19; Nepal show that knowledge among people of Nepal about COVID 19 is satisfactory. Yet a signicant number of participants are lacking condence when compared to other countries. Better 78.2-95.0 %. Participants with a medical degree had statistically signicant better practice Source: Asian Journal of Medical Science (slightly potted)

Front Line health Workers' (FLWs) perceptions and opinions on their personal safety while attending suspected or confirmed COVID-19 patients in Bangladesh


 

Pins and needles at the time of a pandemic:Learning from the RMG workers through a rapid survey conducted by BRAC JPGSPH


 

Lived Experiences of the Urban Poor in Slums during the COVID-19 Shutdown:Study conducted by BRAC JPGSPH