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Abstract
Introduction The 2018–2020 Ebola outbreak in the Democratic Republic of the Congo (DRC) took place in the highly complex protracted crisis regions of North Kivu and Ituri. The Red Cross developed a community feedback (CF) data collection process through the work of hundreds of Red Cross personnel, who gathered unprompted feedback in order to inform the response coordination mechanism and decision-making.
Aim To understand how a new CF system was used to make operational and strategic decisions by Ebola response leadership.
Methods Qualitative data collection in November 2019 in Goma and Beni (DRC), including document review, observation of meetings and CF activities, key informant interviews and focus group discussions.
Findings The credibility and use of different evidence types was affected by the experiential and academic backgrounds of the consumers of that evidence. Ebola response decision-makers were often medics or epidemiologists who tended to view quantitative evidence as having more rigour than qualitative evidence. The process of taking in and using evidence in the Ebola response was affected by decision-makers’ bandwidth to parse large volumes of data coming from a range of different sources. The operationalisation of those data into decisions was hampered by the size of the response and an associated reduction in agility to new evidence.
Conclusion CF data collection has both instrumental and intrinsic value for outbreak response and should be normalised as a critical data stream; however, a failure to act on those data can further frustrate communities.
- health policy
- epidemiology
- viral haemorrhagic fevers
- qualitative study
Data availability statement
No data are available. Due to the sensitive nature of qualitative research and difficulty anonymising participants, these data are not publicly available.
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Data availability statement
No data are available. Due to the sensitive nature of qualitative research and difficulty anonymising participants, these data are not publicly available.
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Footnotes
Handling editor Seye Abimbola
Contributors FC, HR, GM, OB conceptualised and designed this study. Data collection and acquisition by GM, OB, CAC, EE, LR. GM and HR were responsible for data analysis and interpretation, and drafted the manuscript. All authors contributed critical revisions, approved the final draft and are accountable for the work. Funding was secured by FC, HR, GM, OB. GM is the overall guarantor for this work.
Funding This research was funded by the Elrha’s Research for Health In Humanitarian Crises (R2HC) Programme, which aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. R2HC is funded by the UK Foreign, Commonwealth & Development Office (FCDO), Wellcome, and the UK National Institute for Health Research (NIHR). GM receives doctoral funding from the Pierre Elliott Trudeau Foundation, Montreal, Canada. HR is a member of the UK Public Health Rapid Support Team which is funded by UK Aid from the Department of Health and Social Care and is jointly run by UK Health Security Agency and the London School of Hygiene & Tropical Medicine.
Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the Department of Health and Social Care.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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