|Subject Code and Title||PUBH6006: Community Health and Disease Prevention|
|Assessment||Assessment 3: Emergency Response Plan – Non-communicable Disease Prevention|
|Learning Outcomes||This assessment addresses the following learning outcome:|
5. Apply theoretical frameworks to develop effective health promotion interventions
Prepare a community engagement and mobilization strategy for an emergency response plan for an outbreak of the Ebola virus. Your strategy should clearly state a step-by-step approach that ensures that communities are engaged to have an active role alongside authorities and health agencies in the plan to rapidly respond to the threat of the spread of the disease. The strategy should use headings for each stage of engagement, consultation, participation, organisation, capacity building, action and possibly empowerment. Explain your decision to use either a top-down and/or bottom-up approach.
Emergency Prevention Plan- Ebola Virus Disease
An emergency response plan is directed to achieve public health and plays a critical role in the management of community within a particular region. The local jurisdiction, health facilities and community volunteers, are affected by the public health consequences. During the initial response, the people within a community are reliant on the services of the local community resources. It is the duty of the local, state, territorial and national stakeholders to need to be prepared for the emergency response coordinate, cooperate, collaborate and cross-sector partnerships with international organisations to mitigate the emergency. In this report, the emergency response plan would be directed towards the outbreak of the Ebola virus. The discussion of the approach towards the Ebola virus emergency response is discussed. In addition to this, a comparison between the advantages of using a bottom-up approach versus a top-down approach is also presented.
Understanding the Importance of Ebola Outbreak
One of the rare pathogens capable of developing fatal epidemics is the Ebola Virus causing Ebola disease. The viral infection is said to have transmitted from animals into humans and then infiltrated the human population. The rate of fatality for the Ebola disease is 50% on an average as determined from the studies depicting past outbreaks. The highest percentage of death was 90% within a population. According to the World Health Organization (WHO), the control of the outbreaks can be obtained with community engagement practices (Ebola virus disease, 2019). The intervention within the outbreak location, case management, prevention infection, controlling the practices, surveillance and tracing contact as well as social mobilisation can help in the initiation of an emergency response. The Democratic Republic of the Congo and Guinea islands were freed from the Ebola disease fatality with vaccination. The largest Ebola outbreak was observed in West Africa between 2014-2016 after its discovery in 1976. It was assumed that the start of the epidemic started in Guinea, which transmitted to the borders of Sierra Leone first and them Liberia. Currently, another outbreak is on the radar, in the Democratic Republic of the Congo that started in 2018 (Ebola virus disease, 2019). The public response activities are being affected by this outbreak, as the situation is complex along with the rise of public insecurities. Australian Health Protection Principal Committee led the internal response within Australia (Gilbert, 2016). The initiation of the emergency response included the screening of incoming passengers in the airports. In addition to this the testing protocols, public health development effort were being reviewed by experts in the health committees. The states were notified with the outbreak to warn the healthcare facilities and treatment initiation for people who were affected. There were no reports of the Ebola disease outbreak in Australia, but the investigation was ongoing.
Advantages of using a bottom-up approach versus a top-down approach to health emergency preparedness and response
In public health, both top-down and bottom-up approaches are used for the benefit of the community. The top-down approach is generally utilised by the large intergovernmental organisations to eradicate issue-specific or disease-specific control (Bloch et al., 2014). The control of HIV and Smallpox were done with the help of the top-down approach. Many smaller non-governmental organisations set up community-level control to facilitate the accessibility of healthcare in a particular region. Many of the disease-specific control is gained with the implementation of both these approaches to obtain public health outcome (McDermott et al., 2015). The top-down approach requires stakeholders to design a step-wise strategy in the breakdown of an incident to determine the causal agent (Gregorich & Ge, 2014). This approach is evolved from the engineering scrutiny approach to determine the sub-parts of the actual problem. The bottom-up approach, on the other hand, is the category of information processing technique, which utilises the current data relevant to an issue. The environment in which the individual dwells determines the data originated from the perceptive abilities.
In the case of the Ebola, sustainable development goals require a readiness plan for the control of an outbreak. It is essential to address three critical elements in the mitigation of public health issues. It is necessary to obtain financial support to complete the desired public health goal, the establishment of health systems, the addition of newer skills and the team building to achieve the public health response. In 2014, the Ebola outbreak caused an era-defining humanitarian crisis in Oxfam, West Africa (Gilbert, 2016). The medical emergency was initiated by a local health facility, but constructive solutions were not provided within that time. Community-wide volunteer efforts, international partnerships and the involvement of different medical agencies were put forward to construct facilities for the Ebola disease. Social mobilisation is one of the important advantages of the Bottom-up approach (Bloch et al., 2014). This was primarily responsible for the control, prevention and management of Ebola. The transmission of the disease needs to be controlled within the community with increased trust, competency and confidence among the stakeholders. Early referrals can be obtained with the set-up of the Ebola management centres to engagement community involvement in the response. WHO showed, (WHO Ebola Response Team, 2014) that mutual communication between the response team as well as the affected community needs to be initiated to understand their needs, adaptation to the intervention and the services respectively.
The procedure of Community engagement
Community engagement against a disease-specific response within a targeted community takes place on behalf of the elected council of the government. It is essential that for the community engagement, the community’s views be considered for reaching a solution, decision and planning (Community Engagement Procedure, 2017). The existing levels of services will be affected by community engagement practices. The nature of complexities within the specific disease requires complex decision-making. Therefore, the government, in order to avoid controversies, makes the response decision. The issue that has a long-term effect on the wellbeing of the community requires the engagement response.
This is the initial step of the response management as it provides the workforce with a clear direction to achieve the outcome (Community Engagement Procedure, 2017). The engagement requires the workforce to determine the need for community engagement and the extent of the participation. This provides the response team with the ability to assess the levels of services, complexity and long-term effect on the community.
In the case of the Ebola outbreak, it would be useful if the rapid detection and identification are possible for the prevention of disease transmission. The consultation between various response groups can be initiated to obtain a more specific response (Community Engagement Procedure, 2017). For example, the epidemiologists and contact tracers can consult with each other in establishing the root cause of the outbreak. In order to monitor the situation and tracking of the epidemic, a team of epidemiologists is necessary to be incorporated in the workforce.
Participation of the community and the affected people is essential to initiate the response within the region. The volunteers within the local region need to be incorporated as well as collaboration with the healthcare facilities would increase the response of the strategy (George et al., 2015). The engagement of the community can also be increased with the promotion of health campaigns to educate the community. This would enhance the participation of the community towards achieving increasing public health.
The mobilisation of the community needs to be organised with useful insights to mobilise the community for health promotion. The objective of the response plans needs to be organising the social activities throughout the community but not restricted within the neighbourhood (George et al., 2015). Shared interest would help the emergency response plan be in motion faster. The organisation between the workforce would, in turn, provide better health outcome for the community.
The purpose of the strategy is to strengthen the response time towards the building capacity in the Ebola disease outbreak. In order to build capacity within the response team, rapid diagnosis and vaccination program needs to be initiated (George et al., 2015). This would prevent the spread of the disease and manage the situation without becoming a national emergency. The capacity of the health professionals would also need to be increased for the integration into the response team (WHO Ebola Response Team, 2014). The experienced health professional, epidemiologists and infection prevention experts need to be added. Training the non-experts within the facilities is a necessity to be initiated.
The prompt actions, regarding detection and treatment, need to be initiated by the government to eradicate the communicable disease. Interventions within the region by healthcare professionals need to be initiated to facilitate the emergency response plan. The documentation of the time of the outbreak and the number of fatalities need to be done to facilitate the public health data (WHO Ebola Response Team, 2014). Evaluation of the situation would be possible with such effective actions. Neighbouring countries need to be informed to initiate surveillance. This would prevent the transmission of the communicable disease.
The objective of public participation is to empower the community. Hence, the decision of the intervention and health concerns needs to be provided to the community (Community Engagement Procedure, 2017). Council needs to assess the needs of the community and implement those strategies to achieve increased public health (WHO Ebola Response Team, 2014). The empowerment of the community would be reflected in the financial support being provided to the community to eradicate the outbreak within a particular location.
The fatality and of the communicable diseases like Ebola has made it important to give rise to emergency response plans. Countries like Australia need to be prepared for eradicating the disease in a controlled and organised manner. The efficiency of the government would be reflected in the management of the disease in the quickest way possible.