Science - April 2, 2020

‘Confidence in health care essential in fighting the coronavirus’

Text:
Albert Sikkema

According to a study on the control of the Ebola outbreak in Sierra Leone in 2014, fighting a contagious disease is more successful if the population has confidence in the healthcare system. A valuable lesson for the fight against corona.

Community Care Centre in Sierra Leone, ©Maarten Voors

Wageningen development economist Maarten Voors and American colleagues researched the influence of Community Care Centres (CCC) in Sierra Leone during the epidemic. These CCC’s were essentially small field hospitals with a maximum of eight beds, staffed by local health workers providing information and education on preventing and controlling the ebola virus.

Trust
The rural population trusted these centres more than the larger treatment centres, where over 100 Ebola patients were treated under a much stricter safety regime. A large portion of the population was wary of these ‘western’ centres. This resulted in people infected by the disease hiding in villages and not seeking medical attention. The efforts to curb the spread of the epidemic stagnated as a result. In villages that had a community care centre, residents were more willing to get tested, which made fighting the virus more successful.

Births
In a second paper on the ebola crisis, Voors and his colleagues reach a similar conclusion. In the years leading up to the outbreak, the Sierra Leone government launched a World Bank-funded project to involve local villagers in local clinics. The villages involved showed an increased number of births at the clinics and a higher rate of vaccination, as well as lower infant mortality. During the Ebola epidemic, more people visited the clinics to get tested. On average, 60 per cent more people sought help from these clinics than similar clinics that had failed to establish ties with the local community.

Quarantine
The higher number of tests led to better quarantine measures for Ebola patients, causing the epidemic to level off sooner in these villages. Wageningen researcher Harro Maat, of the chair group Knowledge, Technology and Innovation, did a quantitative study of the ebola outbreak. He confirms that faith in the health care system played an essential part in decreasing the epidemic.

Corona
The lessons from the Sierra Leone situation are relevant to the current corona crisis, Voors states. ‘In this situation, confidence in health institutes is also essential in controlling the outbreak. Especially in countries where the population’s trust in the government is low, such as is the case in many African nations. First of all, countries need to have a sufficient supply of test kits and face masks. Still, the communication from the government, involving citizens in the relief efforts and increasing their faith in the health care system, is equally important. Without that trust, the sick will go in hiding, making it impossible to get a grip on the outbreak and respond with adequate measures.’


Re:act