Ebola is a virus that causes severe and fatal haemorrhagic disease in human. On 8th of May 2018, the Ministry of Health of the Democratic Republic of the Congo (DRC) declared outbreak of Ebola Virus Disease (EVD) in the Equateur Province. The current risk of spread of EVD in Australia is low unless there has been direct exposure of the body fluids with the infected person or animal. The Government of Australia, Department of Health is however monitoring the outbreak situation, conducting risk assessments and responding to requests for information or assistance for proper control of EVD (Government of Australia Department of Health, 2018). The following assignment aims highlight emergency response plan for EVD with a bottom-up approach.
Public health emergency (PHE) mainly plans to involve little consultation with the public and thus mainly follows the guidelines of the top-down approach. Top-down approach is mainly guided by government and public health agencies along with the active participation of the scientific experts. However, top-down approach creates gap between the evidence and practice in the domain of synergies between the communities and institutions and the how the institutions can engage with the communities. Thus the overall approach adversely affects the ability of the communities and institutions to be prepared and effectively respond the emergencies (Ramsbottom et al., 2018). Here comes the importance of the bottom-up approach. Bottom-up approach involves the drafting of the emergency response plan based on the perspective and requirement of the community members. The strategic bottom-up approaches at the local and the regional level helps in public health promotion. Bottom-up approach promotes proper community mobilization (Krajnc Nikoli?, & Belovi?, B, 2015). Community mobilization helps in reaching out to different sectors of a community and then creating partnership to address specific public health issue. This helps in fostering co-operation across different sectors and community and thereby helping to reduce health inequalities and effective promotion of public health (Huberman, Klaus, & Davis, 2014).
Community engagement is crucial in the bottom-up approach. In EVD control community engagement can be done via partnering with the community member in the health surveillance campaign of EVD. In this community surveillance program education about the spread of the disease, early signs and symptoms can be given. This in turn will help to increase the disease awareness from the grass-root level along with the increase in the reported cases of the EVD. In the community engagement program, education will be provided in the domain of social mobilization techniques and ways to identify the suspected cases of EVD. This will encourage the families to come together, highlight the number of suspected cases of EVD. This in turn will help the government to draft a effective prevention program via taking into consideration of the number of reported cases of EVD and level of disease education among the community (World Health Organization, 2018). Community engagement helps to create advocacy in health. The Ottawa Charter of Health promotion indicated that advocacy in health enable a community to take active initiatives in managing their health (World Health Organization, 2000).
In order to increase in the level of engagement among the community members for the proper bottom-up approach, consultation of the members of the community ho will be or are the prime victims of the diseases is mandatory. Consultation will be two way communications with community members or through feedback sharing. However, fewer people are likely to involve at this stage of bottom-up approach. Only the people who are the representatives of the whole community must be selected in the consultation process. In the consultation process, the gaps which they are facing in successfully preventing the disease must get highlighted. This will help in framing the policies with special insight of the gaps in the community in disease control. However, linguistically isolated communities may not be aware of the need of the disease control. In such cases, word-of mouth can be used as an effective means of consultation. Friends of those culturally and linguistically diverse (CALD) community members who share bilingual communication skills must be used to as an important source of information for the consultation process (Ramsbottom et al., 2018).
Community participation in the health helps in the development of the emergency response plan in the domain of effective problem solving and thereby making them to take proper responsibility for their health and welfare. This community level participation of the members of the community is an effective bottom-up approach. This is because; it promotes active participation of the community members in the development of the awareness plan against EVD. Since EBV spreads rapidly via contact, the community level participation will help in the development of effective skills and methods in the domain of avoiding contact with the infected individuals while not hampering the provision for care. The community level participation in EVD control will also highlight the other areas like consumption of improperly cooked food, hand hygiene, taking precautions while travelling and avoiding contact with the reservoir species. This basic precaution starting from the community level will help to control the spread of the disease (Shrivastava, Shrivastava & Ramasamy, 2015).
It is elementary that actions in health promotion arena are guided by key organizations who aid in resource allocation and funding. The agenda is to direct the consequences health preparedness plan can bring in. A number of key organizations are to be brought into the limelight for preparing a plan for action. The government of Australia, especially the Department of health, would have the prime role in this regard. The concerned health bodies of the different communities are also to be involved. Further, not-for profit organizations would have an active involvement in fulfillment of objectives of the preparedness plan. The bodies mentioned above would collaboratively work for empowering the community and setting up the preparedness plan. Joint action would bring about major changes in the beliefs of individuals of the community and foster greater health equity.
Capacity building is known to be the process through which individuals obtain, develop and retain knowledge and skills required to become increasingly competent and have a greater capacity. Community capacity building would be a conceptual approach for behavior and social change. Capacity building for mitigating outbreak of EVD would need to be carried out through provision of information and education for health to be delivered to the community members. The rationale would be to enable the individuals to have more control over their health as well as the environment that pose a threat to outbreak of EVD. Since individuals make choice conducive to health, it is necessary that individuals learn about the modes of transmission of EVD and the related signs and symptoms. Education is to be imparted through EVD awareness programs targeting individuals from both rural and urban communities. This is a bottom-up approach that considers involvement of the individuals at grass-root level. It is to be remembered that capacity building through education must engage with the ways in which individuals from the community actually perceive health awareness programs. The idea would be to build a more person-centered health system after a nuanced understanding of how individuals navigate the education provided to them (securelivelihoods.org, 2015).
Health promotion and mitigation of diseases is known to work through effective and concrete community action in making decisions after setting priorities, and subsequently implementing the same. Community engagement and mobilization for mitigating EVD outbreak would draw on the material and human sources present within the community for enhancing self-help and social support. The idea is to develop flexible systems for public participation in health matters through a bottom-up approach (Moon et al., 2017). In this regard action is to be taken for ensuring that individuals have access to information available on EVD. Updated information of EVD is to be uploaded to the public database with the priority of curbing the outbreak. In this regard it is to be mentioned that funding from the concerned government would be crucial for carrying out regular research and gathering information of the concerned area.
Community empowerment can be denoted as the process of motivating and enabling communities so that individuals of the communities gain an increased control over their lives. It would be appropriate to define community in the present context as the group of people at risk of developing Ebola Virus Disease who are spatially connected in the society. A number of factors are known to influence community empowerment in a program context. These are leadership, participation, problem assessment, organizational structures, links to others, resource mobilization, ‘asking why’, and program management. The mentioned aspects of community empowerment would provide a suitable connection between inter-personal elements like community cohesiveness, trust, and individual control. These are the noted aspects of community empowerment. All these, enable groups and individuals to organize and mobilize themselves towards the objectives of social change (Laverack & Wallerstein, 2001). Based on this knowledge, it would be crucial to address these factors for empowering the individuals of the community through a bottom up approach. For example, leadership would be exercised at the community level for informing the stakeholders holding an authority position about the agenda of response plan. These stakeholders would then form a committee for arranging for multiple meetings in collaboration and consultation with external agencies as well as other members of the community. The process might take several months of interactions and socialization. However, it would be the cohesiveness and integrity of the individual members of the community that would allow a functional organizational structure within the community.
Conclusion
Thus from the discussion, it can be concluded that bottom-up approach is the best suited approach for drafting the emergency response plan towards the control and the prevention of the EVD. The bottom-up approach helps in the proper community mobilization and active community engagement in control of the disease. Active community mobilization will promote proper community engagement, consultation, and participation of the community members. This in turn will promote proper participation of the organisations, capacity building and community empowerment in drafting the emergency response planning. This bottom-up plan will help to control the disease from the grass-root level via formulating the disease control plan on the basis of the gaps in the understanding of the disease development in the community members will help in active prevention of the disease.
References
Government of Australia Department of Health. (2018). Information for the Public. Access date: 26th August 2018. Retrieved from: https://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-ebola-Information-for-the-Public
Huberman, B., Klaus, T., & Davis, L. (2014). Strategies guided by best practice for community mobilization. Advocates for Youth. August, 8-20.
Krajnc Nikoli?, T., & Belovi?, B. (2015). The transfer of the bottom-up approach to tackle health inequalities to seven EU countries: Tatjana Krajnc Nikoli?. The European Journal of Public Health, 25(suppl_3), ckv167-030.
Laverack, G., & Wallerstein, N. (2001). Measuring community empowerment: a fresh look at organizational domains. Health promotion international, 16(2), 179-185.
Moon, S., Leigh, J., Woskie, L., Checchi, F., Dzau, V., Fallah, M., … & Katz, R. (2017). Post-Ebola reforms: ample analysis, inadequate action. Bmj, 356, j280.
Ramsbottom, A., O’Brien, E., Ciotti, L., & Takacs, J. (2018). Enablers and Barriers to Community Engagement in Public Health Emergency Preparedness: A Literature Review. Journal of community health, 1-9.
Secure Livelihoods. (2015). After Ebola: towards a smarter model of capacity building. Retrieved from https://securelivelihoods.org/wp-content/uploads/After-Ebola-towards-a-smarter-model-of-capacity-building.pdf
Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2015). Public health strategies to ensure optimal community participation in the Ebola outbreak in West-Africa. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 20(3), 318.
World Health Organization. (2000). The Ottawa Charter for Health Promotion. Access date: 26th August 2018. Retrieved from: https://www.who.int/healthpromotion/conferences/previous/ottawa/en/
World Health Organization. (2018). Helping Guinean communities fight Ebola. Access date: 26th August 2018. Retrieved from: https://www.who.int/features/2015/guinea-communities-fight-ebola/en/
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