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Nine months after the start of the Ebola outbreak in Sierra Leone in May 2014, communities in Port Loko continued to engage in high-risk practices; many remained unwilling to seek treatment. In the face of such behaviors, Oxfam Community Outreach teams conducted qualitative research using in-depth interviews, focus groups, and questionnaires to better understand the barriers and enablers affecting treatment-seeking behavior. Analysis of their results highlights 3 primary barriers to treatment seeking: fear and limited information, concern about unknown outsiders, and the often prohibitive distance and limited accessibility of treatment. Communities were asked to provide suggestions on how to address these barriers. Their recommendations fell into 4 main categories: providing information and better communication, including community members in decisions, providing closer treatment facilities with opportunities to learn how they operate, and using survivors to inspire hope for other sufferers. This research highlights the need for social mobilization programs to invest early in understanding the underlying causes of risky behaviors in order to develop programs that address them.

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Engaging communities in humanitarian programming is key to ensuring their participation in decision-making that affects them as outlined by commitment 4 of the Core Humanitarian Standards. Based on learning from the West-African Ebola response (2014–2016), Oxfam’s WASH (water, sanitation, and hygiene) team is undertaking a paradigm shift toward greater community engagement (hereafter referred to as CE) in WASH, with a strong focus on measuring community participation—a crucial step toward understanding how we can better involve communities in reducing the risks of WASH-related diseases. This article presents key findings from Oxfam’s recent responses in Bangladesh and the Democratic Republic of Congo (DRC), describing the process of building trust and identifying barriers and enablers to meaningful CE in emergencies.

The COVID-19 pandemic has exposed long-standing social inequalities and vulnerabilities, with the most disadvantaged and marginalised groups bearing the greatest health, social, and economic burdens. Beyond documenting these vulnerabilities, there is a need to mitigate them and support the resilience of marginalised communities. ‘Community resilience’ can bolster community capacity to cope with the pressures of various shocks; this brief explores how its concepts can be applied to epidemics. It reviews the grey and academic literature on different approaches to community resilience. It covers 1) terminology, 2) lessons from practice, 3) the context of community resilience, 4) a systems approach, and 5) key human and social capacities. Social justice, inequality, equity, and fairness are highlighted as themes in need of further development for resilience as it relates to epidemic preparedness and response. This brief was developed for SSHAP by IDS (led by Megan Schmidt-Sane with Tabitha Hrynick) with Anthrologica (Eva Niederberger).