Abstract

BackgroundSocial mobilisation is potentially a key tool in the prevention of non-communicable diseases (NCDs) in fragile settings. This formative study addressed existing and potential social mobilisation mechanisms seeking behaviour to tackle NCDs in El Salvador, with an emphasis on the implications in the context of the current COVID-19 pandemic.MethodsWe conducted 19 semi-structured interviews with health workers, government officials, NGO leaders, and community members. Interviews addressed mechanisms for social mobilisation which existed prior to COVID-19, the ways in which these mechanisms tackled NCDs, the impact of COVID-19 on social mobilisation activities and new, emerging mechanisms for social mobilisation in the wake of the COVID-19 pandemic.ResultsFindings indicate a growing awareness of NCDs within communities, with social mobilisation activities seen as valuable in tackling NCDs. However, major barriers to NCD prevention and treatment provision remain, with COVID-19 constraining many possible social mobilisation activities, leaving NCD patients with less support. Factors linked with effective social mobilisation of communities for NCD prevention included strong engagement of community health teams within community structures and the delivery of NCD prevention and management messages through community meetings with trusted health professionals or community members. There are gender differences in the experience of NCDs and women were generally more engaged with social mobilisation activities than men. In the context of COVID-19, traditional forms of social mobilisation were challenged, and new, virtual forms emerged. However, these new forms of engagement did not benefit all, especially those in hard-to-reach rural areas. In these contexts, specific traditional forms of mobilisation such as through radio (where possible) and trusted community leaders - became increasingly important.ConclusionsNew mechanisms of fostering social mobilisation include virtual connectors such as mobile phones, which enable mobilisation through platforms such as WhatsApp, Facebook and Twitter. However, traditional forms of social mobilisation hold value for those without access to such technology. Therefore, a combination of new and traditional mechanisms for social mobilisation hold potential for the future development of social mobilisation strategies in El Salvador and, as appropriate, in other fragile health contexts.

Highlights

  • Non-communicable diseases (NCDs) are a defining problem of the twenty-first century, hampering nations’ economic growth and sustainable development

  • Our inclusion criteria were for NGO/Government officials: a) working in an organisation which has involvement in decision-making regarding social mobilisation activities; b) working in an organisation which has been involved in social mobilisation activities before and since the COVID-19 pandemic

  • NGO Director NGO Director Ministry of Health official Ministry of Health official NGO Director NGO Director Government official Doctor Health promoter Doctor Doctor Doctor Health promoter Medical coordinator Health promoter Teacher Retired health promoter Businesswoman Laboratory worker has seen social mobilisation activities take place within or connected to it; b) be able to comment on changes in social mobilisation prior to and since the COVID-19 pandemic; and c) involved with treating or supporting individuals with non-communicable diseases (NCDs)

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Summary

Introduction

Non-communicable diseases (NCDs) are a defining problem of the twenty-first century, hampering nations’ economic growth and sustainable development. Cardiovascular diseases, diabetes, cancer and chronic respiratory diseases account for over three-quarters of all NCD associated deaths. They share key preventable risk factors, namely tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity [1]. Social mobilisation is potentially a key tool in the prevention of non-communicable diseases (NCDs) in fragile settings. This formative study addressed existing and potential social mobilisation mechanisms seeking behaviour to tackle NCDs in El Salvador, with an emphasis on the implications in the context of the current COVID-19 pandemic

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