Abstract
Background
Cholera outbreaks remain a significant public health challenge in Ethiopia, influenced by a combination of environmental and socioeconomic vulnerabilities. Factors such as inadequate access to safe water, poor sanitation, and limited health infrastructure exacerbate the risk of cholera transmission. Effective cholera control measures depend on robust community participation, as local knowledge and engagement are crucial for successful interventions. However, community perspectives regarding cholera preparedness and response have largely been unexplored, creating a gap in understanding how best to mobilize local resources and foster community ownership of health initiatives.
Methods
This qualitative study employed semi-structured interviews with Health Development Army (HDA) members from the Sidama Region, conducted between June and August 2023. The interview guides aimed to explore participants’ knowledge, practices, challenges, and recommendations related to cholera preparedness. A thematic analysis approach was utilized to identify key insights on community engagement.
Results
Participants highlighted the vulnerability of local livelihoods and the essential role of social cohesion in health decision-making. Influential figures, such as elders and religious leaders, were pivotal in shaping community health responses. While there was general awareness of cholera symptoms, 18 out of 30 participants reported significant knowledge gaps regarding disease transmission and prevention. Existing interventions primarily focused on environmental sanitation but encountered considerable challenges. Although access to healthcare services improved through demand generation and community-based health insurance, 14 respondents still noted major barriers. The engagement of external actors was reported by only 9 participants and was largely limited to outreach efforts.
Conclusions
This study underscores the importance of integrating community perspectives into cholera control efforts. By emphasizing the roles of local leaders, identifying knowledge gaps in disease understanding, and addressing household vulnerabilities, it advocates for targeted education and enhanced coordination among health authorities and communities. These insights aim to promote sustainable, community-driven health interventions that improve cholera preparedness and response in the Sidama region and beyond.