The commentary [https://www.ajol.info/index.php/mjz/article/view/205146] has brought out two key issues that I think have also affected compliance to measures right here in Zambia.
1) most information is restricted to media (coupled with misleading information) and most of the rural and peri urban have no access to it. They rely on health workers to share such information and in most cases this information is given at health facilities. The second wave especially has seen less of public awareness programs by institutions (leaving much room for misinformation and a sense that some parts are unaffected). Our approach has rather seemed to be Top bottom (we seem to prepare more for the clinical aspects of it and not preventing disease) instead of bottom top (pandemic is a public health issue and community engagement very much critical, intense prevention measures and awareness would have been used). Primary levels of care would have been more effective in getting communities to have access to scientific information, enhance compliance to measures and ultimately gain community support in the pandemic fight. This step will be even more important in the vaccination roll out with current vaccine skepticism being reported across the world.
2) access to clean water in most of these parts is still challenging. The need for improved access to water and sanitation can not be over emphasized and this should be championed in regions where we continue to lose lives due to oral fecal transmitted diseases. Culturally acceptable practices can only be developed if communities themselves design them. Therefore, our win against this is highly dependent on engaging the public at all levels in decision making process, be it prevention, treatment and vaccination.
HIFA-Zambia profile: Flata Mwale is a medical laboratory scientist at the Ministry of Health Zambia. She is currently also the Deputy lead and co-founder of Women in Global Health Zambia chapter, a part of the global movement championing gender equality in global health and local public health sector. She trained at the College of Medicine, University of Malawi. Professional interests: Health systems strengthening and health policy. Advocacy for equity and equality in access, utilization and distribution of health care. Email address: fltmwale AT gmail.com