1. Building resilient communities for
better health and well-being in the
Eastern Mediterranean Region
Agenda item 3(c)
Maha El-Adawy
Director, Healthier Populations Department
Sixty-eighth session of the WHO Regional Committee for the Eastern Mediterranean
Cairo, Egypt, 11–14 October 2021

2. The COVID-19 response has presented
several examples that illustrate:
→ Initiating discussions with communities to
understand sociocultural contexts and
power dynamics, and mapping networks
and influencers in the community
→ Identifying what types of engagement
interventions are safe, feasible and
acceptable
Community engagement: A two-way
process
• People are more likely to take action if they are
involved in decision-making
• Engage communities early and work to involve,
collaborate with and empower them
• Leave no community behind

3. • Flattening the curve is important in every country as
there are limited numbers of hospitals, nurses and
doctors
• Public health and social measures are important to
flatten the curve
• Community fatigue and complacency continues to be a
challenge
• COVID-19 vaccine demand generation was not addressed
properly
• Late and insufficient involvement of communities
• Vaccine hesitancy of up to 50–60% in some countries initially
• Vaccine acceptance has increased lately: median of 85% in all
countries
Source: WHO/UNICEF regional survey
Many challenges remain

4. • Global conferences, SDGs, Global Action Plan, GPW 13, Vision 2023, Risk
communication and community engagement (RCCE) framework for COVID-
19 response.
• In Afghanistan: A basic package of health services was developed by the
Ministry of Public Health covering essential health services. The Ministry
supervised and engaged NGOs to deliver these through a community-
based approach.
• In Pakistan: The Marginalized Areas Reproductive Health and Family
Planning Viable Initiatives (MARVI) project used an integrated community-
based approach to improve access to quality family planning and
reproductive health services in remote areas. It helped to increase
contraceptive use from 9% in 2008 to 27% in 2013.
• In Egypt: A social mobilization approach was used in villages to increase
the perception of risk from avian influenza A(H5N1) virus and motivate
people to address the threat at the household level.
Community engagement is not new

5. • Landscape analysis of community engagement in the Region conducted December–May
2021.
• Many drivers, enablers, challenges and barriers identified were relevant to many different
contexts, but some were highly context-dependent.
Community engagement in health:
new positioning and strategic shift in WHO engagement
1 billion more
people
benefiting from
universal health
coverage
1 billion more
people better
protected
from health
emergencies
1 billion more
people
enjoying better
health and
well-being

6. • Better understanding of community needs and
concerns
• More trust
• Better informed decisions on public health issues
• Better organizational performance
• More community satisfaction and acceptance
• Greater sense of community ownership and
participation
• More uptake of services as they are tailored to
community needs
Community engagement
leads to improved health
outcomes and equity
Community engagement matters now
more than ever

7. Community system Health system
Primary health care system strengthening

8. Inform
• the public with balanced and objective information (RCCE activities)
• to obtain feedback (Societal dialogue in Tunisia)
Involve
• to work directly with the public throughout the process (Community health workers
in Egypt, Islamic Republic of Iran, Pakistan, Somalia and Sudan)
Collaborate
• with partners and the public on each aspect of a decision (Supreme Health Councils
in some countries of the Region)
Empower
• by placing final decision-making in their hands and enabling them to play an active
role (Weliyate Health Committees in Oman)
Consult
Spectrum of community engagement

9. Roadmap for enhancing community
engagement
Strategic
directions
Document
and
communicate
linkages
Advance
evidence-based
and innovative
interventions
Enhance
collaboration
and
coordination for
effective
interventions
Localize
community
engagement
approaches
Build the
capacity of
communities
and civil society
Streamline
listening and
community
feedback

10. • To be effective and meaningful, community engagement
needs “corporate” recognition
A culture of community engagement – not the
traditional hierarchical, compartmentalized UN
approach
• The canvas of community is too big – need to focus and
contextualize
Identify entry points, e.g. target community health
workers, youth, nongovernmental and civil society
organizations and faith leaders
• Community engagement is mainly conceptual – let us
make it operational
Budgets, dedicated staff, reporting
Optimizing community engagement

11. • Create a clear governance structure for community engagement
– a multisectoral approach
• Develop an effective community engagement strategy or plan
based on the proposed regional roadmap
• Identify the role of communities and civil society in national
strategies and plans
• Promote community-based participatory action
• Enhance social mobilization and social dialogue
Priority actions by Member States

12. Priority actions by WHO
• Provide technical support to Member States to develop national
strategies/plans to establish and enhance community engagement
• Deliver on WHO’s commitments under the Framework of Engagement
with Non-State Actors and ensure WHO’s accountability
• Support community-based participatory research approaches
• Establish a regional platform accessible to community representatives for
knowledge and practice-sharing
• Support documentation of best practices in community engagement at
regional and country levels

13. Thank You
Community engagement is the cornerstone for a
resilient, prepared and healthy population