COVID-19 Pandemic: Ten Things We Need To Do Better In Health Promotion
By Glenn Laverack, PhD
Here are ten things we need to improve when it comes to health promotion during the COVID-19 outbreak:
1. We need to better protect frontline workers.
Front-line workers, including clinical and community health professionals, home and residential caregivers, and those whose work brings them into regular contact with the public should be instructed in the use and provision of sufficient and appropriate personal protective equipment (PPE).
2. We need to better protect vulnerable people in society.
Protecting vulnerable people in society against COVID-19 must be a priority and includes older people especially in residences, refugees and migrants, socially isolated people, the homeless, the mentally ill and women and children at risk of domestic violence. Shielding includes social distancing and seclusion, the use of PPE, hygiene facilities, and social support services.
3. We need to make better use of the social sciences to understand the complexity of societies.
Changing individual and collective behavior involves complex social processes and requires knowledge that takes into account local perspectives. Anthropological studies require in-depth, long-term contributions producing “thick and dense” accounts that are difficult to translate into practical recommendations. In an epidemic, new information is needed quickly, and it is the application of social science techniques that can best meet the demands of rapidly changing circumstances.
4. We must better respect the culture and the needs of the communities.
Culturally competent practice works with communities in a meaningful way that pays attention to common needs and perceptions of health. This mutual understanding lays the foundation for empathy and respect for the culture, ethnic diversity and self-determination of communities so that their needs are identified and placed at the center of health promotion programs.
5. We need to work better with the communities in the slums.
Slum conditions include poor sanitation and high population density that prevent good hygiene and social distancing. Local government, law enforcement authorities, health agencies and communities need to work together, but small gains have been made without a clear strategy on how best to cooperate. The sense of community solidarity in some poor urban communities provides an opportunity for better engagement and communication in health promotion programs.
6. We need to better strengthen social networks to support communities.
The usual social support network of friends and family was severed during COVID19 and urban and rural communities had to help each other better. However, altruism was not universal, some localities being better organized and more united than others. Advance planning and systematic social media support are essential to ensure a link between those affected and the delivery of health and social services.
7. We need to better support the mobilization of volunteers to help others.
The mobilization of volunteers by non-governmental agencies provided much needed support to provide essential services. Volunteers can form a valuable network of local contacts, and many community organizations depend on the efforts of volunteers who carry out useful daily activities. Recognition of this work is crucial to continuing to provide services that government organizations cannot do during an epidemic, including supporting the most vulnerable and for the distribution of essential items.
8. We need to use our common sense better and not rely on weak âevidenceâ.
The âevidenceâ for what works in health promotion is often weak, conflicting, or nonexistent. We need to use our common sense and our experience as a guide to what will and will not work during the COVID19 outbreak. The best scientific advice must be a combination of the most reliable evidence and professional consensus on what works. Trust your professional instincts.
9. We need to better support non-COVID19 health promotion issues.
Health promotion activities should be maintained during lockdown to support a healthy physical, mental and spiritual lifestyle. These activities include messages about healthy eating and activity levels, stress reduction, and the safe use of alcohol and tobacco at home. Ongoing prevention programs such as immunization and testing and services to deal with stress and domestic violence should also be maintained. There is a real risk that morbidity and mortality from non-pandemic health problems will be significantly higher than those directly related to COVID19.
10. We need to better involve communities in the response to the COVID19 epidemic.
Communities must be an integral part of the response to the COVID19 epidemic, including during any exit strategies and in order to reduce resistance to government-imposed changes and maintain preventive measures. Failure to involve communities is debatable and the reasons for not doing so need to be analyzed, including any assumptions about weak local skills, lack of trust between government and civil society, and restriction of human rights.
Glenn Laverack, Visiting Professor, Department of Sociology and Social Research, University of Trento, Italy