Lessons from community engagement to improve COVID-19 diagnosis and treatment in Cochabamba, Bolivia

ABSTRACT

Background

Community engagement is recognized as a vital component of health-related research and programs, particularly during infectious disease outbreaks and epidemics. Despite the importance of engaging communities in the response to COVID-19, relatively little research has examined how this was (or was not) achieved, and even less in low- and middle-income countries. This article describes the community engagement that accompanied efforts to strengthen COVID-19 diagnosis and treatment as part of the ECO Project in Cochabamba, Bolivia and highlights lessons for future pandemic response.

Methods

Community engagement involved formative assessment, co-creation to develop a health information campaign, ongoing community listening and evaluation. Qualitative data were collected during workshops, project meetings and focus groups. Questionnaire-based surveys were conducted to assess COVID-19-related attitudes, knowledge and practices.

Results

The collected data highlighted the value of working closely with well-established community health committees and involving community members with social media skills in the design of COVID-19-related messages to address on- and offline misinformation. Co-creation sessions enabled the adjustment of the information campaign in terms of content and approach based on the needs and preferences of community members and health staff. The continuous listening with community and health personnel facilitated the ongoing adaptation of project activities.

Conclusion

Through a stepped and multi-pronged approach, incorporating co-creation and community listening, the engagement could respond to emerging local challenges during the pandemic. The project created spaces for dialogue and opportunities for collaboration that strengthened links between the community and the health services.

Paper context

Main findings

Key elements of community engagement to improve COVID-19 diagnosis and treatment in Cochabamba, Bolivia, included working closely with well-established community health committees, involving community members with social media skills in the co-design of COVID-19-related messages, and continuous listening with community and health personnel facilitated the ongoing adaptation of project activities.

Added knowledge

With little research on community engagement for COVID-19 diagnosis and treatment in Latin America, this study reports the results of mixed methods research on the impact of a comprehensive approach to engagement that highlights lessons for future health emergencies.

Global health impact for policy and action

Lessons for engagement in health emergencies include the need for a multi-pronged approach, incorporating co-creation and community listening, to respond to emerging local challenges.

KEYWORDS:

• COVID-19
• community engagement
• Bolivia
• co-creation
• health promotion

Responsible Editor

Maria Emmelin

Responsible Editor

Maria Emmelin

Acknowledgments

The authors would like to thank the community members in the catchment areas of participating health facilities in Zona Sur of Cochabamba, particularly the co-creation participants, and survey enumerators. Also, particular thanks to the health personnel in the participating health facilities and the health system and community leaders who facilitated the community engagement activities in the ECO project.

Community leaders of the work areas include:Cochabamba Municipal Social Health Council Board of Directors; Presidente: Adalid Paiva Macias; Vicepresidente: María Rosario Cáceres; Secretaría de Hacienda: Ramiro Ticacolque Llanque; Secretaría de actas: Rosmery Alcocer Arispe; Secretaría de conflictos: Lorgia Villca Willcarani; Secretaría de Interculturalidad: Israel Escobar Terceros; Secretaría de Comunicación: Felicidad Ramos Flores; Secretaría de Coordinación con poblaciones en situación de vulnerabilidad: David Choque Escobar; Vocal 1: Hilda Huanaco Villca; Vocal 2: Víctor Hugo Huanca López; Presidenta del Tribunal de Ética: Margarita Rosmery Villarroel Colque, Vocal 1 del Tribunal de Ética: Mery Alicia Cadima Rodríguez. Local Health Committees management 2022-2023: 1. Alalay – Mario Gómez; 2. Alto Pagador – Lorgia Villca, 3. Sebastián Pagador – Elías Marca; 4. Gloria Alto Buena Vista – Esteban Fernández; 5. K’ara K’ara – Omar Ayma; 6. Villa Israel – María Luz Farfán 7. “1° de Mayo” - Ramiro Tikacolque; 8. Pucarita - Margarita Villarroel; 9. Mineros San Juan - David Choque; 10. España – Rosmery Alcocer

Author contributions

EP: study design; data collection; data analysis; writing the first draft. NM: data collection; data analysis; revising and contributing the manuscript; CA-V: data collection; data analysis, revising and contributing the manuscript; CB: data collection; data analysis, revising and contributing the manuscript; BMM: data collection; data analysis, revising and contributing the manuscript;, LT: data analysis; revising and contributing the manuscript; AP: supervision of data collection; revising and contributing the manuscript. LV^†:supervision of data collection; data analysis; RR: funding acquisition; study design; revising and contributing to the manuscript. All authors approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval

The ECO Project received approval from the ethics committee of CEADES (CE-ECO-17032023, Bolivia) and Hospital Clínic Barcelona (CEIm: HCB/2023/0139 Spain). Participants in data collection activities gave written informed consent. Confidentiality was assured and all data were managed according to data protection regimens (including General Data Protection Regulation [GDPR]).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2024.2358602

Additional information

Funding

The ECO Project was supported by a grant from UNITAID.