Jhabindra Bhandari

Around the globe, there are increasing evidences that communities are at risk of emergencies and disasters including those associated with infectious disease outbreaks, conflicts, and natural, technological and other hazards. New diseases, like COVID-19, are emerging at unprecedented rates disrupting people’s health and causing adverse social and economic impacts. In addition to increasing morbidity, mortality and disability, emergencies may result in severe disruptions of the health system.
According to WHO, risk communication is the real-time exchange of information, advice and opinions between experts, community leaders, officials and the people who are at risk and is core strategy in health emergency response. During the pandemics or natural disasters, effective risk communication allows people at risk to understand and adopt protective behaviours.

Meaningful engagement
For public health emergencies, risk communication includes a range of communication capacities required through the preparedness, response and recovery phases of a public health event to encourage informed decision making, positive behaviour change and trust. Therefore, meaningful community engagement is very important to enhance effectiveness and efficiency of risk communication strategies during public health emergencies.
Due to rapid advancement in information technologies, risk communication uses many communication techniques ranging from media and social media communications to mass communications. It requires the understanding of stakeholders’ perceptions, concerns and beliefs, as well as their knowledge and practices. Effective risk communication will help manage rumours, misinformation and other communications challenges.
In today’s digital media environment, people constantly receive information from many sources, ranging from print media to television to alerts and social media on mobile devices. Immediately after the news media about the outbreak of diseases, people usually want to know what is happening and who is affected. In addition, public health authorities are expected to provide the news media with timely and accurate information about the updated scenario of outbreak and its effects on public health.
During emergency health response, it is necessary to develop a comprehensive communication strategy with adequate resources that aims at reaching the affected populations and partners who might influence them. Therefore, risk communication for health protection should be an integral part of local health systems. In view of current and emerging risks to public health and the need for more effective risk communication strategies, it is high time to integrate emergency risk communication into health and emergency response systems.
There are several initiatives to respond the pandemic like COVID-19 and other disaster-induced health emergencies in the country. Considering the emerging needs of building resilient health systems for pandemic response at local level, capacity building initiative for front-line health workers and humanitarian organisations have been recently completed across provinces in coordination and partnership with Ministry of Health and Population (MoHP), Asian Disaster Preparedness Center (ADPC), National Disaster Risk Reduction Center (NDRC), Nabil Bank and Chaudhary Foundation.
"No country is immune to health emergency and disaster. Therefore, the capacity building of front-line health workers is crucial to update their knowledge on recent policies, guidelines, standard operating procedures, and risk communication strategies for effective preparedness and response of health emergencies at the local level." says Dr. Samir Kumar Adhikari, Chief of Health Emergency Operation Centre of MoHP.
Multi-sector approach is the key to health emergency and disaster response. "We now need a joint public-private partnership initiative for pandemic preparedness and response. For continuity and sustainability, health emergency and disaster risk management should be a high priority agenda of provincial and local governments in their policies and plans. Strengthening the capacity of local governments is critical for health emergency and disaster risk management incorporating measures for prevention, mitigation, preparedness, response and recovery." says Man Thapa, Country Representative of ADPC.
Additionally, health systems are resilient if they protect human life and produce good health outcomes for all during a crisis and in its aftermath. “Planning and management of COVID-19 response has been a new and challenging experience for us. And the capacity building of local governments in health emergency preparedness and risk communication is key priority to build resilient health system." says Deepak Tiwari, Chief of Health Office in Chitwan.
The International Health Regulations (2005) or IHR (2005) highlights the importance of risk communication as an important public health intervention. Towards this end, national governments need to assess their risk communication capacities in order to ensure effective emergency preparedness and response at all levels.

Capacity building
Despite significant progress in risk communication capacity in the country, there are emerging needs to provide training to health workers, journalists and media communities on how to report on health emergencies. While health emergencies become increasingly complex, as witnessed during COVID-19 and others, there are clear needs of enhancing the capacity of front-line health workers in planning risk communication interventions in health facilities and communities.
To sum up, the COVID-19 pandemic reminds the world of the gaps in health systems, as well as the vulnerabilities to the disproportionate impact of health emergencies of certain vulnerable populations and communities. Therefore, framing of pandemic and post-pandemic responses should be community-centered, rights-affirmative, and gender-transformative. And the role of civil society, private sector and media is to advocate on promotion of health equity and social justice for ensuring right to health. Let's join our hands in strengthening health systems and ensuring universal health coverage while protecting other essential health services.

(Bhandari is senior doctoral research fellow in global health)