Africa continues to face complex humanitarian emergencies driven by armed conflict, forced displacement, climate shocks, disease outbreaks, and fragile health and WASH systems. In such environments, refugees, internally displaced persons (IDPs), and host communities are disproportionately exposed to preventable illnesses, while disrupted services and institutional mistrust can undermine otherwise effective public-health interventions. Risk-Information Communication and Community Engagement (RCCE) has therefore become a critical component of humanitarian preparedness and response. Beyond disseminating health information, effective RCCE enables communities to participate in identifying risks, shaping solutions, addressing misinformation, and building confidence in health interventions. Its importance is particularly evident during cholera and other outbreaks, where timely information, trusted community leadership, culturally appropriate communication, and functional feedback mechanisms can influence prevention, early care-seeking, vaccination uptake, and outbreak control. RCCE must consequently be embedded within resilient, accountable, and community-centred health systems.
THE TRUST DEFICIT IN DISPLACEMENT SETTINGS
In displacement and conflict-affected settings, health outcomes hinge less on the availability of interventions than on whether affected populations trust the institutions delivering them. Refugees, IDPs, and host communities frequently encounter health systems already strained by scarcity, and any miscommunication compounds pre-existing suspicion born of displacement trauma. In eastern DRC, Sudan, and South Sudan - among four countries WHO currently classifies as in "acute crisis" for cholera, outbreaks have repeatedly outpaced supply-side interventions precisely where community trust and engagement lagged behind case management. Globally, over 287,000 cholera cases and 3,100 deaths were reported across 28 countries by mid-2025, a burden concentrated in conflict and displacement contexts where flooding, overcrowding, and disrupted WASH systems converge.
COMMUNITY PARTICIPATION AS THE OPERATIVE VARIABLE
Evidence from Oromia, Ethiopia, where RCCE performance was assessed across 422 households alongside key informant interviews, found that RCCE quality - not vaccine or logistics availability alone, was independently associated with outbreak containment. This affirms a lesson practitioners have long observed: two-way, culturally embedded dialogue, not one-way messaging, determines uptake. In Cox's Bazar, WHO's 2025 cholera preparedness simulation with Rohingya refugee communities identified that even robust clinical readiness failed where community engagement and cross-sector WASH-health coordination were weak, underscoring that RCCE cannot be a standalone communications add-on but must be structurally integrated into preparedness architecture.
VACCINE CONFIDENCE CONSTRAINED BY STRUCTURAL SCARCITY
Communication cannot substitute for supply. In 2023, African countries requested 70.7 million oral cholera vaccine doses but received only 26.1 million; in 2024, 26.3 million of 43.2 million requested doses arrived. When RCCE builds demand that supply chains cannot meet, trust erodes further at the next engagement cycle - a pattern our teams have observed in Borno State IDP camps, where anticipatory messaging without matched allocation fuelled scepticism toward subsequent immunisation rounds.
COUNTERING MISINFORMATION THROUGH SYSTEMS, NOT SLOGANS
Misinformation in these settings rarely originates from ignorance; it fills vacuums left by inconsistent or delayed official communication. Effective countering requires trained community health volunteers, local-language feedback loops, and religious and traditional leaders positioned as co-communicators rather than message conduits.
GROUNDING ‘RCCE’ IN HEALTH SYSTEMS STRENGTHENING
RCCE investments deliver sustained value only when routed through strengthened community health worker cadres, functioning surveillance systems, and durable WASH infrastructure, and not parallel, project-bound structures that dissolve when humanitarian funding cycles end.
CONCLUSION
Effective RCCE in Africa’s humanitarian and conflict settings is fundamentally about building trust, strengthening relationships, and enabling communities to become active partners in health protection. Communication strategies cannot succeed when they are disconnected from reliable services, adequate supplies, functioning WASH systems, and responsive health institutions. Equally, communities should not be treated merely as recipients of messages but as essential actors in preparedness, surveillance, misinformation management, and outbreak response. Governments, humanitarian agencies, civil society, health workers, traditional and religious leaders, and affected populations must therefore jointly design and implement RCCE approaches that are inclusive, culturally grounded, locally led, and responsive to community feedback. Investing in RCCE as part of health-systems strengthening can transform crisis communication from a short-term emergency function into a durable foundation for public trust, resilience, health equity, and improved outcomes across Africa.
Gobena, D., Gudina, E. K., Fetensa, G., Degfie, T. T., Debela, T., & [other authors as listed]. (2025). Risk communication and community engagement (RCCE) implementations to control cholera outbreak in Oromia region, Ethiopia. Tropical Medicine and Health, 53(4), Article 4. https://doi.org/10.1186/s41182-024-00679-0
World Health Organization. (2025, May 20). WHO leads cholera preparedness simulation to strengthen outbreak response in Rohingya camps ahead of monsoon [News release]. https://www.who.int/bangladesh/news/detail/20-05-2025-who-leads-cholera-...
World Health Organization. (2025, September 10). WHO EPI-WIN webinar: Community protection for cholera – Risk communication and community engagement (RCCE) [Webinar]. https://www.who.int/news-room/events/detail/2025/09/10/default-calendar/...
N. Dereje, M. Aragaw, K. Mercy, et al., “Addressing the recurrent and protracted cholera outbreaks in Africa: Challenges and the way forward,” Nature Communications, vol. 16, Art. no. 9792, 2025, doi: 10.1038/s41467-025-64789-x.
C. E. Halder et al., “Understanding the challenges and gaps in community engagement interventions for COVID-19 prevention strategies in Rohingya refugees: A qualitative study with frontline workers and community representatives,” *Here are the same two references formatted in IEEE style
“Technological tools, including computers, search engines, statistical software, AI, and other digital applications routinely employed in contemporary scholarship, assisted in the preparation of this work. However, the conceptualization, analysis, interpretation, verification of information, conclusions, and responsibility for the content remain solely those of the author.” - Dr. Uzodinma Adirieje; CEO/Programmes Director, Afrihealth Optonet Association (AHOA), and President, African Refugees Council (ARC).
HIFA profile: Dr. Uzodinma Adirieje is a leading voice in health education, community health, and advocacy, with decades of experience advancing people-centered development across Africa and beyond. His approach to health education emphasizes participatory learning, knowledge transfer, and behavior change communication, ensuring that individuals and communities gain the skills and awareness to make informed decisions about their health. He develops and delivers innovative health promotion strategies tailored to local realities, particularly in resource-limited settings. In community health, Dr. Adirieje has championed integrated primary health care, preventive medicine, and grassroots health initiatives. Through Afrihealth Optonet Association (AHOA), which he leads, he connects civil society, community groups, and health institutions to strengthen healthcare delivery, tackle health inequities, and improve access to essential services for vulnerable populations. His work addresses infectious diseases, maternal and child health, nutrition, climate and health, environmental health, and emerging public health challenges. As a passionate advocate, Dr. Adirieje works with governments, NGOs, and international organizations to influence health policy, mobilize resources, and promote sustainable development goals (SDGs). He amplifies community voices, ensuring that health systems are inclusive, accountable, and responsive. His advocacy extends beyond health to governance, environment, and social justice, positioning him as a multidisciplinary leader shaping healthier and more equitable societies. afrepton AT gmail.com