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U-Report utilized in Ebola response in 2012

Ebola Outbreaks in Uganda: Key Points for Media on U-report/UNICEF Uganda Strategy

From 2nd August 2012 through to the 4th August 2012, one of the major challenges faced by the Ebola Task force (as highlighted in the situation reports provided by the Ministry of Health and WHO) was obtaining the funding and resources to mobilize and sensitize communities on the key facts of Ebola (symptoms, spread and prevention) and being able to respond to and verify alerts.

After the confirmation of the Ebola virus outbreak, and given the demand for information in the system U-report implemented a communication plan as part of a larger UNICEF multimedia strategy with three objectives:

1. Share information on Symptoms, Spread and Prevention Methods

The following SMS alerts were careful drafted and sent to Kibaale, and the surrounding districts Hoima, Kiboga, Mubende, Ntoroko, Bundibugyo, Kabarole Kyenjojo, Kyegegwa, Kyankwanzi, and  Ibanda.

SMS Alert 1: Ebola Outbreak Awareness (Date Sent: 31st July 2012)

There is an Ebola outbreak in Kibaale. Today and tomorrow I am going to send u some SMSs to give u more info about how to recognise ebola & how to prevent it.

Auto Response: Tomorrow between 4pm and 6pm we will conduct a question and answer session about Ebola. SMS between 4pm and 6pm tomorrow.

SMS  Alert 2: Ebola Outbreak Symptoms(Date Sent: 1st August 2012 )  

Ebola SYMPTOMS include fever, stomach pain, diarrhoea and vomiting. There may also be body rash, blood in eyes, blood in the vomit, bleeding from nose/ears/eyes.

SMS Alert 3: Ebola Outbreak Spread (Date Sent: 1st August 2012)

Ebola spreads thu contact with saliva, blood, urine, faeces & sweat from infected people. Also avoid contact with dead from ebola . Be SAFE - avoid all contact.

SMS Alert 4: Ebola Outbreak Prevention (Date Sent: 2nd August 2012)

To PREVENT Ebola: report suspects to health centre, no people contact, no contact with animals, wash hands a lot. Pour JIK & water on vomit or stool of those infected

2. Real-Time Conversations with U-Reporters

The real-time page on the U-Report interface allowed the U-report team in Kampala to respond to questions about the Ebola virus and find out what was occurring in their communities.  The page has a number of features which allow the team to work effectively and respond to queries in a short amount of time (within 24hours). For example, in the ratings category, the messages can be rated in order of urgency. Between 1st and the 2nd August 2012, 72 U-reporter SMS text messages were rated and 16 of those were replied to by the U-report team. Any questions or information that required further action (such as the reporting of symptoms) was referred to the Ministry of Health.

From these real time conversations, U-report was able to provide U-Reporters with the correct information from the Ministry of Health and WHO which helped to relieve the panic caused by mixed messages (from various sources often informal) and the communities’  limited knowledge. In the event of any further emergency health situations in Uganda, U-report can be used to help gather information and to inform communities.

3. Obtaining Community Feedback

The final stages of the communication plan were to investigate whether the SMS alerts containing information on Ebola symptoms, spread and prevention and the real time conversations, provided useful information to U-Reporters. U-report received 760 Responses out of 4,817(15 %)  U-reporters in Kibaale and surrounding districts for the following poll question sent out on the 3rd August 2012:  

“Did u find the Ebola information from Ministry of Health and World Health Organisation useful? Answer YES or NO with any message u have for them.”

67% of U-reporters say they found the SMS alerts very useful some felt empowered now that they had more knowledge but wanted more information on government plans or interventions for the outbreak. Others requested U-report to continue to provide information for other viruses or diseases.  Other U-reporters stated they had already heard this information through the radio and newspapers, which demonstrates that U-report was aligned in the wider communications plan. They wanted to know more about the government’s actions namely, the training of health workers, provisions for infected patients and suspected cases.

The responses of U-Reporters to the Ebola SMS Alerts from 31st July 2012 through to 15th August 2012 closely match what the media reported about the fears and frustrations faced within communities. Over a 1000 SMS text messages were received.  47% of the messages received were those of gratitude for the SMS alerts provided by U-report from the Ministry of Health. Some felt empowered to share that information with their families or other members of their community. 17% continued to ask for more information on how to go about their daily lives and activities, and they also requested updates on the progress of the government response plan. Others sought clarification on rumours and myths they had heard about the number of deaths, and the causes of the Ebola virus. Even though only 3% provided us with information about what was happening in their communities, those that did, texted valuable information. For example, one SMS contained information about an Ebola information seminar which had taken place in their village. 12% of the SMSs were U-reporters providing their opinions on the outbreak and their thoughts on what the government should be doing.
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