This paper summarises a project based in Sierra Leone during the 2014-15 Ebola outbreak that produced a set of culturally contextualised Ebola messages. The messages are based on findings from interviews and focus group discussions with community members from two Ebola ‘hot-spots’. In these areas, misinformation around Ebola and distrust of health workers was prevalent. This suggested that the top-down messaging implemented early in the outbreak had not been effective.

Findings from the formative research were analysed and split into a number of themes at a message development workshop attended by health workers, NGO workers and research assistants. Draft messages were then developed to address the key themes. Each message was accompanied with the following information:

  • Rationale behind the message

  • Intended audience of the message

  • Channels via which the message could be disseminated

  • Messengers who could be used to spread the message

  • Any operational issues associated with the message


Image: Kinsman, J., et al 2017

The 26 draft messages that came out of the workshop were then field-tested in the communities. A few problems were identified, but all were seen as broadly appropriate with adaptations, and so none were rejected. The adapted messages were then organised into 14 topic areas, which were formally presented to the Ministry of Health and Sanitation.

During the process, four key principles of message development in public health emergencies emerged:

  • The importance of using trusted messengers

    • People wanted to hear messages from people they trusted. Certain categories of people were considered generally trustworthy (Chiefs, religious leaders) and untrustworthy (doctors). These categories will vary in different communities.

  • The value of two-way communication

    • Community members felt that messages must be disseminated face-to-face, by going door-to-door or taking part in community meetings, rather than just in public campaigns such as radio jingles or billboards. This also allows messengers to feed back any community concerns to researchers.

  • The importance of strengthening parallel operational services

    • Messages to promote treatment-seeking behaviour, for example, must be matched by good services, or the credibility of the messages will be undermined.

  • The importance of understanding local factors

    • The researchers came across a number of locally sensitive issues, such as avoiding the colours of the major political parties in their campaign materials, and ensuring the messages were available in locally-spoken languages.

To see the full 14 message areas disseminated and more detailed information on the process and examples, read the full article here.


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