Table 1

Comparison between health awareness and CLEA approaches

Health education approachesCLEA approaches
Unit of analysis
  • Individuals

  • Communities

Core activities
  • Educating households

  • Sharing information and key messages

  • Listening to communities

  • Inspiring self-realisation and self-motivated action

Communications approach
  • One-way information sharing

  • Health educators as experts

  • Facilitating dialogue

  • Community members as experts

  • Top-down

  • Sharing biomedical facts, correcting erroneous beliefs

  • Bottom-up

  • Appreciative of other ways of understanding illness

  • Allow multiple framings for disease at the same time

Facilitation style
  • Teaching and preaching

  • House-to-house

  • Listening and learning

  • Community-wide

Methods and tools
  • Information, education and communication materials

  • Lists of ‘Do’s’ and ‘Don’ts’

  • Participatory rural appraisal tools for communities

  • Data collection that feeds back into approach

Typical assumptions
  • Traditional beliefs are the problem to be solved

  • Communities must be convinced to use health services

  • Community responses can lower or enhance health

  • Services must adapt to meet community needs

Key motivations for change
  • Awareness of biomedical facts

  • Rational understanding of transmission routes

  • Self-preservation

  • Urgency to protect each other, build on solidarity

  • Build hope with early treatment

  • Build trust in health authorities

Desired outcomes
  • Individuals seek external health services and follow the rules.

  • Communities feel empowered to protect themselves using local resources.

  • Two-way dialogue results in better use of health services that respond to community needs.

  • Source: SMAC (2014), Community-led Ebola Action.20

  • CLEA, Community Led Ebola Action; SMAC, Social Mobilization Action Consortium.