Consultant to support in addressing Misinformation on Cholera in Nampula Province

BACKGROUND

Mozambique has been plagued by diarrheal epidemics, including cholera, which affect thousands of people and cause fatalities. Since cholera is a diarrheal disease directly linked to hygiene habits, environmental sanitation, and the quality of water and food, we must continuously implement actions aimed at improving environmental sanitation, individual and collective hygiene, water, and food quality, as well as promoting behavior change.

In Mozambique, cholera is highly seasonal, with a marked concentration of cases during the hot and rainy season, especially in the provinces of Cabo Delgado, Nampula, Tete and Sofala. Its occurrence can be defined as endemic with occasional epidemic peaks. The annual incidence varies from 0 to 211 per 100,000 inhabitants, with a lethality rate of between 0.2 per cent and 4.3 per cent.

Cholera epidemics are long-standing in the country, and some have argued that its appearance dates to 1859, on Ilha de Mozambique (Nampula), the first capital of the country. In 1973, Mozambique was affected by the seventh cholera pandemic with an epidemic phase which ended in 1975 followed by an endemic phase until 1985. Cholera re-emerged in 1989 in Tete province and reached Maputo city in 1991 with more than 3,600 cases reported in the following two years. The 1990s saw the biggest epidemics in the country. According to the literature, endemicity paired with a fast expansion of cases took place in 1991-1992. The literature explains the factors for this expansion: uncontrolled urban growth because of the war, worsening hygienic and sanitary conditions, the commercialization of food without proper sanitary control and the draught (Serra, 2003). All these factors affecting a population living in extreme poverty conditions. (UNICEF, 2023).

In 1998 was the year of the first autarkic elections in the country resulting in political. This same year saw a cholera epidemic in the country with more than 43,000 cases reported in all the country´s provinces. People from the government repeatedly mentioned politics as a direct cause of the violence related to cholera.

The "rumor" about cholera in the country first emerged in 1998 and may, in some way, be associated with the political-party tensions during the 1998 municipal elections, which heightened political friction. The population feared a return to war due to this political friction. (SERRA, 2003: 25-26)

The victims of the attacks resulting from misinformation about cholera include administrative officials, traditional leaders, midwives, NGO extension workers, and anyone perceived as suddenly distant, unfamiliar, unreachable, corrupt, unapproachable, or insensitive to local needs. These individuals become targets of blame and attack, especially in communities where people bitterly complain about being deprived of many goods and services and are grappling with dramatic challenges. (SERRA, 2003).

This time, on November 29, 2024, the offices of the non-governmental organization Médecins Sans Frontières (MSF) in the Mogovolas district, Nampula province, were attacked, and the following week the CTC was destroyed, followed by the referral health unit. Last week of December teams of the National Institute for Disaster Risk Management and Reduction (INGD), were attacked by the communities of Mogovolas, accused in distributing cholera while they were distributing kits to respond Chido Cyclone. From 6 January MoH and partners were forbitten to vaccinate against cholera, accused to distribute cholera.

Mozambique is a cosmopolitan country with important cultural and religious diversity. Each province has its own social realitieshowever, preliminary data shows a certain refusal to talk about cholera in public. This refusal may be linked to the stigmatization of the disease. This requires deconstruction to carry out effective interventions with communication that does not offend local cultures and beliefs.

MoH requested WHO support to contract three national anthropologists to conduct rapid socio-anthropological studies on cholera to underpinlocalised interventions adapted to particular social contexts, in Cabo Delgado province, Nampula and Zambezia provinces.

PURPOSE OF THE ASSIGNMENT

Conduct rapid socio-anthropological studiesin the most affected areas to understand perceptions, attitudes, behaviors, and practices around cholera. The selected candidate will also provide the necessary operational support to the operation in terms of key risk communication and communication engagement actions. Additionally, the selected expert will make operational recommendations to engage communities in increasing the ownership of the response against cholera.

MAIN ACTIVITIES

• Review of the literature on existing socio-anthropological studies on cholera in the country
• Conduct two action research studies in the main areas affected by cholera
• Analyse the knowledge, attitudes, perceptions and socio-cultural risk behaviours associated with cholera,
• Analyse the socio-cultural beliefs associated with the spread of cholera,
• Provide operational support and recommendations for engaging communities in the fight against cholera
• Write reports on each action research
• Manage relevant communities of social scientists to increase local WHO expertise pool

Qualifications

·At least 5 years of proven experience in socio-anthropological research.

·Previous experience supporting disease outbreak preparedness and/or response (desirable)

·Excellent planning and coordination skills, with proven ability to work with various stakeholders.

·Experience supporting capacity assessments and capacity building.

·Expertise of RCCE concepts and guidance; how to strengthen trust between, and amongst communities, understand how communities are responding (who and what they listen to), creating two-way dialogue, etc.

·Ability to contextualize and provide guidance to different populations and support development and dissemination of relevant RCCE strategies.

·Master level university degree in social anthropology

·Three free course provided by OPEN WHO (https://openwho.org)

oCólera: Introdução

oSocialNet: Empowering communities before, during, and after an infectious disease outbreak

oSocialNet: Social and behavioural insights COVID-19 data collection tool

LANGUAGE REQUIREMENTS:

Speak local languages and leave in the concerned provinces

Core Values:

·Care

·Respect

·Integrity

·Accountability

·Trust

Core Competencies

• Builds and Maintains Partnerships
• Demonstrates self-awareness and ethical awareness
• Drive to achieve results for impact
• Innovates and embraces change
• Manages ambiguity and complexity
• Thinks and acts strategically
• Works collaboratively with others

Functional Competencies

• Applying technical expertise
• Analysing
• Relating and networking
• Analysing
• Relating and networking

Duration of the consultancy

· 2,5 months