Using the Community Perception Tracker to inform COVID-19 response in Lebanon and Zimbabwe: A qualitative methods evaluation

Abstract

Background Despite the recognized importance of community engagement during disease outbreaks, methods describing how to operationalise engagement are lacking. The Community Perception Tracker (CPT) was designed by Oxfam to systematically record real-time information on disease perceptions and outbreak response actions in order to adapt programmes.

Methods We conducted a phased, qualitative methods, process evaluation in Zimbabwe and Lebanon to understand whether the CPT approach was a feasible way to incorporate community perceptions into COVID-19 response programming and whether this resulted in more relevant programming. We conducted 3 rounds of interviews with 15 staff using the CPT, analysed programmatic data, and conducted multiple rounds of phone-based interviews with outbreak-affected populations (50 participants per country). Qualitative data were thematically analysed and quantitative data descriptively summarized.

Results Initially CPT implementing staff struggled to differentiate how the CPT differed from other monitoring tools that they were familiar with and felt that the training did not convey the full process and its value. However, with practise, collaboration and iterative improvements to the recommended CPT steps, staff found the process to be feasible and a significant value-add to their programming. Staff initially focused more on quantitively summarizing perceptions but eventually developed processes for maximizing the qualitative data on perceptions too. Trends emerging from the CPT led to frequent programmatic tweaks to COVID-19 messaging and product distributions. Emergent trends in perceptions also led staff to work cross-sectorally and advocate to other actors on behalf of populations. Outbreak-affected populations exposed to the programmes reported high levels of knowledge about COVID-19 and reported they practiced preventative behaviours, although this waned with time. Most population members also felt the COVID-19 programmes were relevant to their needs and said that non-government organisations were a trusted source of information.

Conclusions The CPT appears to be a promising approach for ensuring that community engagement is undertaken systematically and that community perspectives are actively incorporated to improve programming. While crisis-affected populations generally found the programmes to be useful and relevant and to have influenced their knowledge and behaviours, it is not possible to attribute this to the CPT approach due to the study design.