This study focuses on the Sierra Leone Ebola crisis as the main public health issue in this paper. The pandemic started in May 2014 and has so far claimed more than 10,000 lives (Fox, 2015). Health experts believe that the deadly disease emerged from an incident where a small child contracted the disease after eating bush meat (Fox, 2015). Ebola (mainly) spreads through contact with fluids from an infected person or corpse. As part of global efforts to manage the disease, health workers have introduced public health programs to educate people about how they could prevent new infections and manage infected persons (Fox, 2015). This paper focuses on this public health issue by highlighting the possible failures of public health campaigns and the possible improvements of Ebola management programs in Sierra Leone. Since the health crisis is ongoing, public health workers could learn from present-day mistakes and successes achieved through managing the disease in Sierra Leone. This is the main reason for choosing this health issue.
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Residents of Sierra Leone and public health workers are the target audiences for this paper. Concerning residents of Sierra Leone, this paper pays a close attention to possible behavioural changes that public health workers could achieve by promoting behavioural change among residents of the West African country. Comparatively, this paper targets public health administrators and the health agencies that are take part in public health planning because these professionals design and implement public health campaigns. Through their stewardship, they could use the findings of this paper to improve their campaigns and increase the success of their public health programs (Vaughan & Tinker, 2009). Lastly, through their experience in public health program implementation these professions could use the findings of this paper to improve health care service delivery. Stated differently, while this paper provides a theoretical focus on how to improve public health campaigns, public health administrators could use their practical knowledge on the same topic to improve the efficacy of public health campaigns (Vaughan & Tinker, 2009).
This paper chooses the theory of reasoned action as the most appropriate theory for creating a public health program to manage Ebola in Sierra Leone. This theory could predict the success, or failure, of the public health campaign because most health challenges, reported by public health workers in the West African country, stem from attitudinal issues in the society (Fox, 2015; Glanz & Bishop, 2010). For example, many medical reports from the region show that cultural inhibitions (especially in rural areas) have undermined the efficacy of public health programs in the country (Fox, 2015). This paper focuses on the theory of reasoned action as the best theoretical framework for the proposed public health campaign because it could explain how attitudinal factors affect people’s health behaviours.
Public health campaigns are often dynamic (Vaughan & Tinker, 2009). The proposed strategy, for developing public health campaigns, outlines the three main parts of a public health campaign – planning, implementation and monitoring. From a planning perspective, the public health campaign would include partnerships with community groups, public health agencies and private health agencies to meet the proposed health goals. As part of the implementation strategy, the public health campaign would use media platforms to reach its audiences. Lastly, as part of the monitoring phase, the public health campaign would use health statistics to evaluate whether the campaign was successful, or not. Collectively, these dynamics present an overview of the first plan intended for the public health campaign.
The proposed campaign would use media to reach its audiences. Researchers have documented its effectiveness (Pittman, 2010). For example, public health workers have often highlighted its efficiency in reaching wider audiences and in changing people’s health behaviours (Eytan, Benabio, Golla, Parikh, & Stein, 2011). As part of the design strategy, this paper shows that the proposed health campaign would seek partnerships with groups, public health organisations and private health agencies. Their participation would start from the first stage of the campaign formulation process. Involving them would create community “buy-in” and promote stakeholder involvement for a broader acceptance of the proposed health strategies (Eytan et al., 2011). These partnerships would also create grass-root support for health-promoting behaviours among community members. The partnerships would merge with the implementation strategy of the public health campaign (using media) because community leaders could consult with local media outlets to design public health interventions that resonate with social, economic, and political community dynamics. This provision would accommodate the different dynamics that characterise the Sierra Leone population. Broadly, these dynamics explain the selection criteria for the public health campaign methods.
The main goal for implementing the proposed public health campaign is to minimise the rate of Ebola infection in Sierra Leone and end the disease altogether. To do so, the campaign aims to create social change in Sierra Leone by encouraging people to adopt health promoting-behaviour, such as refraining from eating bush meat, isolating sick people, and improving personal hygiene to minimise the risk of infection. Improving coordination among health agencies is also another goal of the public health campaign. This goal stems from past news and health articles, which showed that poor coordination among health agencies undermined the Ebola fight in Sierra Leone (Fox, 2015). This challenge has led to delayed health care services and unavailability of drugs in some locations. The public health campaign should show areas of weakness that local authorities may eliminate, thereby improving the overall effectiveness of the program. Another goal of the proposed public health program is to improve the community’s preparedness against pandemics. The campaign aims to meet this goal through several ways, including promoting health equity in health programs and policies, linking public health and care systems to realise positive health outcomes, and developing strategic partnerships for improving community health outcomes. Other strategies that may support the same goals include developing a culture of continuous improvement, investing in up-to-date systems and expertise for public health planning, and developing a competent, skilled and diverse workforce. These goals could only suffice when the public health program highlights areas of weakness that have undermined relief efforts. This way, concerned health officials would easily understand areas of weaknesses that need attention from public health care givers. Similarly, since the public health campaign would borrow community health knowledge from other jurisdictions, public health workers would have a wealth of knowledge (from other parts of the world) that they could use to formulate relevant health interventions to contain Ebola. This strategy would help to improve community resilience when managing similar disasters (Pittman, 2010). In the same breadth of analysis, it intends to minimize people’s exposure to harmful environmental hazards that may cause the further spread of Ebola, or lead to increased rates of infections, in the West African nation. Health workers could only reap the benefits of this strategy through effective leadership about the natural and built environment (Pittman, 2010).
Health research is an important communication tool for developing the health promotion campaign (Dearing, 2009). This tool could provide important information for formulating the health campaign. For example, it could show the impediments to health promotion campaigns and the potential opportunities for increasing the success of such programs (Dearing, 2009). The law will also be another tool for communicating the aims of the public health campaign by making it mandatory for health care stakeholders to adopt health-promoting behaviours. Lastly, the community assessment tool (CAT) will also be instrumental in communicating the public health goals of the campaign by providing the framework for adopting and monitoring health interventions.
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This paper proposes the use of radios and televisions as proper communication tools for the proposed health campaign because they are the most common media platforms in Sierra Leone. Particularly, more than 90% of Sierra Leone households have a radio. Therefore, using this communication tool would enable the campaign to reach a large population of people. Health research would also be an important communication tool for the proposed public health campaign because it provides direction to health researchers when executing the public health campaign (Vaughan & Tinker, 2009). For example, by knowing different types of information about different aspects of the Sierra Leone community (through health research), public health workers would know where to focus their health campaigns and how to design them in the first place (Pittman, 2010).
Shaping a public health campaign to suit different types of audiences is important in communicating a public health message. The first reason is variations in cultural practices across different community settings. Some public health challenges reported in Sierra Leone only applied to selected communities (Fox, 2015). For example, people living in rural communities eat bush meat, while people living in urban areas do not. Therefore, it would be wrong to assume that the entire country should receive messages that warn against eating bush meat. Public health messages should also vary across demographic characteristics because of associated legal issues surrounding informed consent (Glanz, Rimer, & Viswanath, 2008). While adults may make sound decisions regarding their welfare, minors do not have this authority. Therefore, they have to rely on their parents, or guardians, to make sound health decisions. Consequently, it would be incorrect to assume that a public health message should target people of all ages, equally. Lastly, it is important to adjust public health messaging structures because of people’s varied levels of comprehension. Particularly, public health practitioners should consider the effects of varied literacy levels within a country when formulating a public health campaign because variations of literacy levels determine the complexity that such public health messages should have (Pittman, 2010). Similarly, literacy levels would determine the proposed types of health interventions in a public health campaign.
Marketing a public health campaign should include different channels (Vaughan & Tinker, 2009). The proposed marketing health campaign would include media marketing and small media marketing. As highlighted in this paper, media marketing would include communications through televisions and radios. Small media marketing would include designing, producing and distributing brochures and posters. This two-pronged strategy should reach a wide audience because it includes technological tools and interpersonal communications when communicating the core health messages (Vaughan & Tinker, 2009).
Dearing, J. W. (2009). Applying diffusion of innovation theory to intervention development. Research on Social Work Practice, 19(5), 503-518.
Eytan, T., Benabio, J., Golla, V., Parikh, R., & Stein, S. (2011). Social media and the health system. The Permanente Journal, 15(1), 71-74.
Fox, M. (2015). Sierra Leone: How Ebola Fools Even the Experts. Web.
Glanz, K., & Bishop, D. B. (2010). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399–418.
Glanz, K., Rimer, B. K., &Viswanath, K. (Eds). (2008). Health behavior and health education: Theory, research, and practice (4th ed.). San Francisco, CA: John Wiley & Sons.
Pittman, M. A. (2010). Multisectoral Lessons from Healthy Communities. Preventing Chronic Disease, 7(6), A117.
Vaughan, E., & Tinker, T. (2009). Effective health risk communication about pandemic influenza for vulnerable populations. American Journal of Public Health, 99, 324-32.