STUDY ON PUBLIC KNOWLEDGE, ATTITUDES, AND

PRACTICES RELATED TO EVD PREVENTION AND MEDICAL CARE IN

SIERRA LEONE

Conducted: August 20th – 25th 2014

Objectives

Examine the public’s knowledge, attitudes, and practices related to Ebola Virus Disease (EVD) in Sierra Leone

Identify bottlenecks to preventing the spread of EVD

Use the study to inform evidence-based strategies in preventing the transmission of EVD and caring for those already infected and affected by the epidemic

Methodology

Administered a household survey to a random sample of 1413 people in Sierra Leone: West Area: Rural and Urban East: Kenema and Kailahun North: Kambia, Port Loko, and Koinadugu South: Moyama and Bo

Conducted in-depth interview and focus groups with traditional/religious leaders, health workers and teachers, local councils, law enforcement personnel

High awareness, low denial

Aware of Ebola

Believe it exists in SL

Heard of a survivor

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

100% 97%

76% • “Ebola is Real” has resonated with the public

• Need to go beyond awareness raising

“Virus” less frequently mentioned/ perceived as cause of Ebola

Mentioned witchcraft as cause

Mentioned curse as cause

Mentioned God as cause of EVD

Mentioned virus as cause

Mentioned bats/monkeys/animal as cause

0% 10% 20% 30% 40% 50% 60% 70% 80%

1%

1%

2%

41%

74%

Low comprehensive knowledge on EVD

0%

20%

40%

60%

80%

100%79%

50%39%

Positive perceptions/attitudes on means of EVD prevention and care

AGREE - avoid contact with blood and body fluids

AGREE- avoid funeral or burial rituals that require handling the body of someone who died of Ebola

AGREE - person with Ebola has higher chance of survival if s/he immediately goes to a health facility

0% 20% 40% 60% 80% 100%

87%

85%

91%

Serious misconceptions

Believe that bathing with salt and hot water can prevent Ebola

Believe Ebola is airborne

Believe one can get Ebola from Mosquito bites

Believe that spiritual healers can treat Ebola

Believe that traditional healers can treat Ebola

-10% 0% 10% 20% 30% 40% 50% 60%

42%

30%

29%

19%

6%

Risk perceptions are mixed

No Risk “I do not get in contact with people who have Ebola”

“God is protecting me”

“I don’t eat bush meat”Great Risk“Ebola is everywhere”

No Risk

Small r

isk

Mod

erat

e ...

Great

risk

Not sur

e

No re

spon

se

36%

14%

10%

34%

5%

1%

Current channels for receiving EVD information

• RADIO, RADIO, RADIO

• Churches and Mosques have an even wider reach in the Epicenters – Kailahun, Kenema, P. Loko (65-75%)

• Television is also a wide-reaching channel in urban parts of the country such as Western Area and Bo

Mobile phone/ Text messages

Newspaper/ flyers/ Brochures/ other print media

Community meetings

Television

Megaphone announcements

Religious venues

Radio

0% 20% 40% 60% 80% 100%

1%

8%

12%

21%

22%

41%

88%

Preferred channels for receiving EVD info

Newspaper/ flyers/ Brochures/ other print media

Community meetings

Mobile phone/ Text messages

Megaphone announcements

Religious venues

Television

House visits by health professionals

Radio

0% 20% 40% 60% 80% 100%

9%

10%

10%

13%

18%

21%

28%

85%

• Again: RADIO, RADIO, RADIO

• House visits by health professional especially preferred in Epicenters – Kailahun, Kenema, Port Loko (54-63%)

Trusted sources of EVD information

• Health

professionals are

the most trusted

source - especially

in epicenters (67 –

86%)

•

Government/MoH

S is the second

most trusted source

of EVD related

information

Traditional leaders

Relatives and Friends

Religious leaders (Pastor, Imam)

The Media

Government/ MoHS

Health / medical professionals

0.0% 20.0% 40.0% 60.0%

0%

8%

8%

36%

48%

60%

Nearly everyone is reporting some change in behavior (95%)

Avoid physical contact with people I suspect may have Ebola

Clean hands with other disinfectants

Wash hands with soap and water

0% 20% 40% 60% 80%

36%

37%

66% Hand washing with soap and water

HighestBo (84%) Koinadugu (82%)

LowestWestern Rural (40%) Port Loko (55%)

Very high level of stigma and discrimination towards Ebola victims

Would keep the information secret if a family member contracts Ebola

Believes pupil fully recovered from Ebola puts other pupils in their class at risk of Ebola

Would not welcome back neighbor into their community after recovering from Ebola

Some discriminatory attitude towards people suspected or having (had) Ebola

0% 20% 40% 60% 80% 100%

9%

32%

76%

96%

Very high acceptance levels towards use of holding centers & quarantining suspected Ebola cases

AGREE - person diagnosed with Ebola must be admitted into Treatment Center

AGREE - people in direct contact with someone diagnosed with Ebola must be

quarantined for 3 weeks

0% 20% 40% 60% 80% 100%

95%

89%

Ebola epidemic is having some negative effects on other essential health services Nearly 4 in 10 interviewed parents with an

Under-Five child who missed a scheduled vaccination cited Ebola epidemic as the reason

10% of pregnant women who missed a scheduled ANC cited the Ebola epidemic as the reason

Moving Forward Targeted and tailored messaging on Ebola preventionMessaging

Go beyond awareness raising; address

misconceptions

Clearly spell out modes of transmission using local

lang.

Develop simple/clear messages on protective

practices Reach high risk groups with targeted messages

Develop special messages around community

acceptance of Ebola affected persons and families

Moving forward more effective use of preferred and trusted sources of information Radio, Radio, Radio – must be maximally

used

Inter-personal engagement at

grassroots level

Effective use of television to tell survival

stories

Strategic engagement with churches and

mosques

Information should come from health

professionals and MoHS because they

are the most trusted source