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Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions : evidence from a mixed methods observational study in Busia and Mandera counties
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Kaduka, Lydia, Olale, Joanna, Karamanos, Alexis, Mutai, Joseph, Coultas, Clare, Ahmed, Ismail, L'Esperance, Veline, Read, Ursula M., Dazzan, Paola, Cruickshank, John Kennedy, Muniu, Erastus and Harding, Seeromanie (2023) Contextually appropriate communication strategies for COVID-19 prevention in Kenya border regions : evidence from a mixed methods observational study in Busia and Mandera counties. BMJ Open, 13 (5). e062686. doi:10.1136/bmjopen-2022-062686 ISSN 2044-6055.
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Official URL: https://doi.org/10.1136/bmjopen-2022-062686
Abstract
Kenya has long and porous borders with its neighbouring countries. These regions, predominantly inhabited by highly mobile rural communities with strong cross-border cultural ties, present major challenges in managing movement of people and COVID-19 preventive measures. Our study sought to assess knowledge of COVID-19 prevention behaviours, how these varied by socioeconomic (SEC) factors and the challenges of engagement and implementation, in two border counties of Kenya. We conducted a mixed methods study using a household e-survey (Busia, N=294; Mandera, N=288; 57% females, 43% males), and qualitative telephone interviews (N=73: Busia 55; Mandera 18) with policy actors, healthcare workers, truckers and traders, and community members. Interviews were transcribed, English translated and analysed using the framework method. Associations between SEC (wealth quintiles, educational level) and knowledge of COVID-19 preventive behaviours were explored using Poisson regression. Participants were mostly educated to primary school level (54.4% Busia, 61.6% Mandera). Knowledge of COVID-19 prevention varied by behaviour: hand washing-86.5%, use of hand sanitiser-74.8%, wearing a face mask-63.1%, covering the mouth when sneezing or coughing-56.3% and social distancing-40.1%. Differences in knowledge by area, educational level and the wealth index were marked, greatest for Mandera, the less educated and the poor. Interviews with stakeholders revealed challenges in health messaging, psychosocial and socioeconomic factors, lack of preparedness for truck border crossings, language barrier, denial and livelihood insecurity as key challenges to engagement with and implementation of COVID-19 prevention behaviours in the border regions. The influence of SEC disparities and border dynamics on knowledge and engagement with COVID-19 prevention behaviours calls for contextually appropriate risk communication strategies that are cognisant of community needs and local patterns of information flow. Coordinating response measures across border points is crucial in winning communities' trust and maintaining essential economic and social activities. [Abstract copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.]
Item Type: | Journal Article | ||||||||||||||||||||||||
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Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||||||||||||||||||
SWORD Depositor: | Library Publications Router | ||||||||||||||||||||||||
Library of Congress Subject Headings (LCSH): | Communication in medicine -- Kenya, COVID-19 (Disease) -- Kenya, COVID-19 (Disease) -- Prevention, COVID-19 (Disease) -- Transmission -- Kenya, COVID-19 (Disease) -- Social aspects -- Kenya, COVID-19 (Disease) -- Economic aspects -- Kenya | ||||||||||||||||||||||||
Journal or Publication Title: | BMJ Open | ||||||||||||||||||||||||
Publisher: | BMJ | ||||||||||||||||||||||||
ISSN: | 2044-6055 | ||||||||||||||||||||||||
Official Date: | May 2023 | ||||||||||||||||||||||||
Dates: |
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Volume: | 13 | ||||||||||||||||||||||||
Number: | 5 | ||||||||||||||||||||||||
Article Number: | e062686 | ||||||||||||||||||||||||
DOI: | 10.1136/bmjopen-2022-062686 | ||||||||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||||||||||||||
Date of first compliant deposit: | 31 May 2023 | ||||||||||||||||||||||||
Date of first compliant Open Access: | 31 May 2023 | ||||||||||||||||||||||||
RIOXX Funder/Project Grant: |
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