Responding to the information and prevention needs of sub-Saharan African communities in Antwerp at the beginning of the COVID-19 pandemic.

Abstract

Pre-existing racial and ethnic disparities in health, sustained by complex and intersecting socio-economic and structural inequities have exacerbated during the COVID-19 pandemic. There is limited evidence about how communities have experience the COVID-19 epidemic, and their perception of the causes and effects of COVID-19 related burden. This hinders true engagement with communities and co-creation of comprehensive prevention strategies including structural prevention that can address health disparities. We conducted this study to explore local needs, perceptions, and experiences of the COVID-19 pandemic and its control measures among Sub-Saharan African (SSA) communities in the Antwerp metropolitan area (Belgium) in 2020. Findings from this study may inform future responses to pandemic outbreaks while considering input from ethnic and racialised minorities in order to understand the intersecting factors causing their vulnerabilities.
 This study was part of a qualitative rapid assessment of information and prevention needs among ethnic and racial minorities living in Antwerp during the first COVID-19 wave in 2020. We used an interpretative and participatory ethnographic approach, conducting semi-structured interviews to explore personal experiences and a focus group discussion to capture community perceptions and attitudes. Data were collected online or by phone between April and September 2020. A community advisory board was set-up to advised on recruitment of participants, data collection and interpretation of findings. Data were transcribed and analysed using a thematic analytical approach.
 A total of 27 participants were included. Results showed that study participants and people in their social networks received information mostly through social media, and struggled with misinformation about the new virus and prevention measures. The combination of intersecting social and economic disadvantages made coping with control measures difficult for those living in precarious circumstances. Structural disparities combined with a lack of information made it particularly challenging to adhere to COVID-19 prevention guidelines, leading to vicious cycles. Despite those COVID-19-related challenges, the pandemic also provided important lessons about social resilience and coping strategies of SSA communities in Antwerp. Communities developed a number of community-based initiatives. Community and religious leaders improvised ad hoc solutions to challenges, from filling-in knowledge and information gaps among their members to developing creative solutions to mitigate the multi-layered impact of the lockdown measures: translating prevention messages, fighting misinformation, providing food packages for those in need, helping with administration, etc.
 To better design support and control strategies targeted to specific groups, such as racialised and ethnic minorities, we need not only to involve communities in developing an adequate response by addressing their specific needs and concerns, but also build on their strengths and resilience. This will remain important in the context of widening disparities and future epidemics.
 This presentation targets people with prevention and care needs and healthcare policy makers. The lessons from our research will be discussed with the view on co-design of prevention strategies for future crises.