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

Figures & data

Figure 1. Map of “Zona Sur”, Cochabamba.

Figure 2. The ECO Project timeline and waves of COVID-19 infections in Cochabamba.

Figure 3. The steps of community engagement in the ECO project.

Figure 4. Images from co-creation sessions at the K’ara K’ara cultural Centre.

Table 1. The theory of change for community engagement in the ECO project.

Outcomes	Indicators	Means of verification	Assumptions
Generate information on the behavior of the population in relation to the diagnosis and treatment of COVID-19	Identify the health seeking routes with regard to COVID-19 diagnosis and treatment	KAP survey	The survey protocol is validated Valid informed consent Local authorities/leaders of social organizations have facilitated access to communities
	Perceptions about barriers to accessing COVID-19 diagnosis and treatment in health facilities
	Perceptions about facilitators to accessing COVID-19 diagnosis and treatment in health facilities
Strengthen the knowledge, attitudes and practices of the population to achieve early diagnosis and treatment of COVID-19 (within the first 5 days) particularly in populations with risk factors	Percentage of the population aware of the importance of early diagnosis and treatment (within 5 days)		Approval and support of local health authorities, health personnel and the leaders of social organizations to carry out the information campaign
	Percentage of the population with a positive attitude toward the early diagnosis and treatment of COVID-19
	Percentage of positive social media reactions to the information campaign	KAP survey Social media metrics Use of paper-based material in facilities
Assess the acceptability and feasibility of a diagnostic and treatment strategy from the perspective of the community and health personnel.	Users’ level of confidence in the health facility regarding timely diagnosis and treatment of COVID-19	KAP survey Community focus groups	Diagnosis and treatment strategy implemented
	Health personnel’s level of confidence in the health facility regarding timely diagnosis and treatment of COVID-19	Survey with health personnel Health personnel focus groups

Table 2. Summarizes the elements of the health information campaign developed by participants from the various health areas in the co-creation sessions.

Health areas	Format	Topic	Key messages
Alalay	One video	Trust in your health center and the infection control measures	Images of the infection control measures in the health center during patient care.
	Four videos		Diagnosis and treatment within 5 days of symptoms Diagnosis and treatment for at-risk groups COVID-19 has not disappeared Addressing circulating mis- information around COVID-19
	Two raps	Let’s learn to live with COVID	COVID-19 has not disappeared Timely diagnosis and treatment
Alto Pagador	A short video	Timely diagnosis to avoid COVID-19-related complications	Comparison between early diagnosis and treatment and late-diagnosis leading to critical care Importance of maintaining one’s health
España	Three YouTube videos	Prevention and risk	Prevention targeting at-risk groups COVID-19 has not left, continue with prevention measures COVID-19 exists
	Three YouTube videos	Trust in the health center	Promote community participation Encourage health personnel Build trust and continue to use face masks At-risk groups
	Video - animation	Post-COVID symptoms and at-risk groups	Post-COVID-19 health impacts on people’s everyday lives Prevention as key to prevent post-COVID Early treatment at health facilities to prevent post-COVID symptoms
	Printed comic strip	Post-COVID symptoms	Post-COVID-19 health impacts on people’s everyday lives
Gloria, K’ara K’ara and Pukarita	Three short videos	Diagnosis and treatment of COVID-19 in the health center	Motivation to seek care in the health center
K’ara k’ara	Three posters	COVID-19 has not left us and need for continued prevention	Promoting hand washing Importance of accessing health facilities
Mineros San Juan	Radio drama (Spanish and Quechua language)	The health center as key to overcoming COVID-19	Treatment seeking of a taxi-driver who is skeptical of COVID-19 but avoids complications when he becomes ill because his wife takes him to the health center
	Five radio advertisements		Key messages from the radio drama above
Sebastián Pagador	Video short story	Timely diagnosis	Story of an adolescent who recall his family’s experience of COVID-19
	Information leaflet	Basic COVID-19-related information	COVID-19 transmission and symptoms Importance of seeking care at the health facility
Villa Israel	One video	Biosecurity measures – use of alcohol	How did we prevent infectious disease transmission in the past? How do we do it now?
	One poster	Protecting persons at risk of COVID-19	The value value of early diagnosis of those at greatest risk of COVID-19 Importance of timely diagnosis to reduce complications

Figure 5. ECO project Co-created leaflets.

Figure 6. A banner displayed in participating health facilities with the key messages of the information and education campaign.