Socio-Cultural and Behavioural Contexts of 2014 Ebola Virus Disease Outbreak in Nigeria: Community Perspectives and Nurses' Preparedness

Abstract

The 2014 Ebola Virus Disease (EVD) outbreak in two states of Nigeria created social challenges because of the socio-cultural and behavioural implications of the disease. The outbreak lasted for three months, had twenty cases, eight deaths, and a case fatality of 40%. Ebola control guidelines suggest consideration of the socio-cultural responses to the outbreak. Therefore this study sought to identify the socio-cultural responses that influenced Ebola control, and determined nurses' preparedness to provide relevant socio-cultural care during the Ebola outbreak. Quantitative and qualitative methods were used to explore the socio-cultural and behavioural perspectives of Ebola in different communities for 3 weeks during the epidemic. Qualitative data were collected from 178 conveniently selected adults living in four communities in two South-South states of Nigeria; transcribed and analysed using NVivo 7.0. Quantitative data were collected from 85 nurses randomly selected from 6 community health centres, and data were analysed using descriptive statistics on SPSS 20.0. Approval for the study was obtained from the Ministry of Health of both states. Results revealed five themes: "naming the disease", "beliefs that impede Ebola control", "socio-cultural practices that impede control", "behavioural responses that enhance control" and "social concerns about the epidemic". Only 41% nurses were able to identify the Ebola-related socio-cultural factors; over 55% did not see socio-cultural factors as playing any important role in Ebola care; and only 36.5% agreed that they need training to provide such care. This study sheds light on the rarely considered issue of socio-cultural influence on Ebola control, and the results reveal low level of nurses" preparedness to deal with socio-cultural issues and provide relevant socio-cultural care during the epidemic. Although certain sociocultural beliefs and practices influencing EVD control existed in Nigeria during the epidemic, nurses working in the community had inadequate knowledge of these.

Community acceptance of COVID-19 and demystifying stigma in a severely affected population in Ghana

“…This is because there is a general notion that being isolated or under quarantine in our cultural context is strange and usually associated with witchcraft or punishment by the gods and thus leads to stigmatisation. 19 The situation is even worse with branded COVID-19 vehicles and security personnel in households of victims.…”