Influences of community engagement and health system strengthening for cholera control in cholera reporting countries

Abstract

The 2030 Global Task Force on Cholera Control Roadmap hinges on strengthening the implementation of multistranded cholera interventions, including community engagement and health system strengthening. However, a composite picture of specific facilitators and barriers for these interventions and any overlapping factors existing between the two, is lacking. Therefore, this study aims to address this shortcoming, focusing on cholera-reporting countries, which are disproportionately affected by cholera and may be cholera endemic. A scoping methodology was chosen to allow for iterative mapping, synthesis of the available research and to pinpoint research activity for global and local cholera policy-makers and shareholders. Using the Arksey and O’Malley framework for scoping reviews, we searched PubMed, Web of Science and CINAHL. Inclusion criteria included publication in English between 1990 and 2021 and cholera as the primary document focus in an epidemic or endemic setting. Data charting was completed through narrative descriptive and thematic analysis. Forty-four documents were included, with half relating to sub-Saharan African countries, 68% (30/44) to cholera endemic settings and 21% (9/44) to insecure settings. We identified four themes of facilitators and barriers to health systems strengthening: health system cooperation and agreement with external actors; maintaining functional capacity in the face of change; good governance, focused political will and sociopolitical influences on the cholera response and insecurity and targeted destruction. Community engagement had two themes: trust building in the health system and growing social cohesion. Insecurity and the community; cooperation and agreement; and sociopolitical influences on trust building were themes of factors acting at the interface between community engagement and health system. Given the decisive role of the community–health system interface for both sustained health system strengthening and community engagement, there is a need to advocate for conflict resolution, trust building and good governance for long-term cholera prevention and control in cholera reporting countries.

Attitude towards Cholera Vaccination and its Related Factors in Jordan amid the 2022 Middle East Outbreak

“…These items offered response options of "Yes", "No", and "I do not know". These cholera knowledge items included: (1) Cholera is caused by bacteria; (2) Watery diarrhea is a symptom of cholera; (3) Bloody diarrhea is a symptom of cholera*; (4) Vomiting is a symptom of cholera; (5) Fever is a symptom of cholera; (6) Dehydration is a symptom of cholera; (7) Anorexia is a symptom of cholera; (8) Cholera can be prevented by herbs*; (9) Cholera can be prevented by handwashing; (10) Cholera can be prevented by thorough food cooking; (11) Cholera can be prevented by boiling water; (12) Cholera can be prevented by thorough fruit and vegetables washing; (13) Cholera is treated by reducing uid intake*; (14)…”

“…These measures involve the improvement of public hygiene, water sanitation, and sewage systems to prevent outbreaks [11,12]. Additionally, the mitigation of cholera outbreaks necessitates coordinated efforts involving the international organizations and national authorities, non-governmental organizations (NGOs), healthcare o cials and professionals, and importantly, the community engagement [13][14][15]. Such efforts are critical to enhance the preparedness and to facilitate swift responses to cholera outbreaks [16,17].…”