The importance of listening to the community

IPERVAC is a perception social study on the COVID-19 vaccine and the impact it has on health-seeking behaviors in Sierra Leone, especially for infants. 

The study takes place in 2 districts – the Bombali district (more representative of an urban setting) and the Port Loko district (more representative of a rural setting).

Initially, we had a scoping workshop where we identified key traditional community leaders and district leaders as an entry point to the community, as well as to engage them in the research. We held 2 workshops (one in each district). There are key reasons as to why to engage these leaders in the community:

1. Seek their support, by formally informing them about the study and its purpose
2. Gather information from them on key actors for the study, in order to shape the research and give us some background context on the community.

We also engaged the District Health Management Team (DHM, which is the management body representing the ministry of health at district level) and the District COVID-19 Response Center from the 2 districts. They gave us their support and were really keen on having the study shared with them, as well as other stakeholders, once we have the results.

What comes after the scope phase of research?

We’ve been doing *focus group discussions and in-depth interviews with different groups from the community, identifying key targets from the local population – from health workers, to caretakers, taxi drivers, traditional healers, religious leaders,  midwives, pharmacists…They all have crucial, relevant perspectives on community health perceptions. We’ve also done observation research in outreach Covid vaccination points, local social gatherings, as well as other contexts that inform community perceptions around COVID-19.

* Focus group discussions are community discussions where a group talks about a specific topic, with the help of a researcher/moderator leading that discussion (see image below). Makeni District, Sierra Leona.

Why do you think it’s important to involve the community in the study?

I think involving the community is important because part of the responsibility and initiative of conducting this study is to see how we can support governments and the Ministry of Health and Sanitation, as well as other organizations and civil society, through helping them understand the perceptions of people and how they can use those ground level insights to develop various health strategies, and ensure there is a high level of compliance of vaccine optics of  COVID-19.

Who did you do the stakeholders workshops with?

Community leaders, to get compliance from the paramount chiefs. We invited the paramount chiefs, we invited local and area chiefs, mammy queens (female community leaders), youth leaders, councilors representing political regions, to make sure they are more involved in the process and that their input is recognized.

Overall, how  did the community take his research project?

They really supported it and appreciated it. For them, it is very important that their voices are heard, and they understood the reason why conducting this study is important.

According to the available data we have, the compliance of taking the COVID-19 vaccine was around 14% in April. They believe this intervention could help the country’s vaccination rates.

What is unique about this study?

Other studies are focused specifically on COVID-19 disease, but there is no study of this nature in Sierra Leone. The DHM team really appreciated it, which is why they want to be updated and have the results shared with them, because they are doing a lot of campaigns still around vaccine hesitancy, and this could help them.

What have been the biggest challenges you’ve encountered during the study?

We’ve encountered a few challenges, but all these have been addressed and were taken into account when designing and carrying out the study. An example is community expectations, given the current economic situation and high cost of living, people often divert their attention to politics in conversations.

What we do is sympathize with them, as well as outline the topic we’re most interested in hearing about by taking them through the purpose of the study.

Another challenge is that we’ve in a heavy rainy season, so commuting and hosting groups has sometimes been a challenge.This challenge, however, was managed until we finished the data collection and analysis.

This study was a qualitative study. Why do you think these studies are important?

1. It’s a social study. It gives community people the opportunity to give their input on a particular topic
2. Once the study finishes, this result will be shared which can later inform decision-making and policy-development by the government and the Ministry of Health and Sanitation.
3. Apart from IPERVAC, qualitative research has helped with all kinds of interventions: health interventions, educational interventions…it’s important to hear the voices and experiences of people and use those voices to develop a country and policies

What impact do you hope this study will have?

A great impact. Apart from increasing awareness around Covid vaccines, when the results are up and shared it also informs decision-makers about various issues that are identified at community level:

• It will help the Ministry of Health and Sanitation to ensure that they actually develop informed strategies around COVID 19 awareness and campaigns, with Sierra Leone having one of the lowest vaccine uptakes among African countries
• This can help them understand the issue at a community level, their perception, what are the fears of the people, and help them define their overall strategy