{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:28:25Z","timestamp":1793824105961,"version":"4.6.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Oromia regional state experiencing cholera outbreaks in a protracted pattern despite various interventions at local and regional levels. This study aimed to examine the implementation of Risk Communication and Community Engagement (RCCE) activities for cholera outbreak control in the region.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a quantitative and qualitative mixed-method study. The study included 422 respondents for quantitative, 22 key informant interviews (KII), and 4 Focus Group Discussions (FGDs) for the qualitative methods. Risk Communication and Community Engagement (RCCE) activities were assessed using standard questionnaires adapted from national cholera guideline later categorized as poor, satisfactory and good. The findings have also been derived qualitatively from three distinct themes or pillars, specifically (coordination and logistics, RCCE, and the Oral Cholera Vaccine). The quantitative data were analyzed using Stata, version 14.0, and ATLAS.ti9 software was used for qualitative data analysis. An ordinal logistic regression model was applied to identify factors associated with the RCCE status, and a thematic content analysis was performed for the qualitative study. Odds Ratios with 95% confidence intervals (CI) were used to present the findings from the quantitative analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Only 53% (223) of participants had received health information on cholera of whom 22.8% (96) had material for Social Behaviour Change (SBC) in the local language (Afan Oromo). The overall RCCE implementation status was rated as poor by 73% of the respondents, satisfactory by 23%, and only 4% rated it as good. Level of education and occupation of the house are among the factors affecting the implementation of RCCE. The qualitative findings revealed a lack of regular community dialogues, and community engagements were notably minimal during the early phase of the outbreak. Overall, the RCCE implementation activities were characterized by inconsistency, a lack of comprehensiveness, and uniformity across all levels.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The RCCE-related intervention activities were found to be minimal, inconsistent and less focused. The RCCE interventions and awareness creation need to begin with the small units of the community structures, including individuals and families and have to happen continuously with the community, and health workers' involvement at all level. Preliminary evaluation of Social and Behaviour Change (SBC) materials before their distribution should be made, and adopting diverse communication modalities to control the outbreak.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s41182-024-00679-0","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T02:14:01Z","timestamp":1736734441000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk Communication and Community Engagement (RCCE) implementations to control cholera outbreak in Oromia region, Ethiopia"],"prefix":"10.1186","volume":"53","author":[{"given":"Dabesa","family":"Gobena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esayas Kebede","family":"Gudina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Getahun","family":"Fetensa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tizta Tilahun","family":"Degfie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessema","family":"Debela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afework","family":"Tamiru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenebu Begna","family":"Bayissa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dereje","family":"Diriba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarekegn","family":"Sarbessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bekele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natinel","family":"Teferi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achalu","family":"Layesa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abate","family":"Zewdie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawit Worku","family":"Ayele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meron Debebe","family":"Mersha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chala","family":"Bafikadu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senahara Korsa","family":"Wake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lemi","family":"Abebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tesfaye","family":"Kebebew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tefera","family":"Goshu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birhanu","family":"Kenate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadeta","family":"Dessie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeleke","family":"Mekonnen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"issue":"2","key":"679_CR1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.3390\/tropicalmed6020064","volume":"6","author":"J Holmgren","year":"2021","unstructured":"Holmgren J. An update on cholera immunity and current and future cholera vaccines. Trop Med Infect Dis. 2021;6(2):64.","journal-title":"Trop Med Infect Dis"},{"key":"679_CR2","unstructured":"Weekly epidemiological record Relev\u00e9 \u00e9pid\u00e9miologique hebdomadaire. 2017."},{"issue":"4","key":"679_CR3","doi-asserted-by":"publisher","first-page":"766","DOI":"10.4269\/ajtmh.21-0597","volume":"107","author":"SR Chae","year":"2022","unstructured":"Chae SR, Lukupulo H, Kim S, Walker T, Hardy C, Abade A, et al. An assessment of household knowledge and practices during a cholera Epidemic\u2014Dar es Salaam, Tanzania, 2016. Am J Trop Med Hyg. 2022;107(4):766\u201372.","journal-title":"Am J Trop Med Hyg"},{"key":"679_CR4","unstructured":"Act R. of Cholera in Africa. 2009;1060\u20133."},{"key":"679_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(24)00010-4","author":"The Lancet, Gastroenterology, & , Hepatology","year":"2024","unstructured":"The Lancet, Gastroenterology, & , Hepatology. The cholera emergency. Lancet Gastroenterol Hepatol. 2024. https:\/\/doi.org\/10.1016\/s2468-1253(24)00010-4.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"679_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(23)02244-4","author":"Z Memish","year":"2023","unstructured":"Memish Z, Blumberg L, Al-Maani AS, Baru R, Dube E, Gao GF, Jernigan DB, Leo Y-S, Peiris JSM, Masud JHB, McVernon J, Nonvignon J, Ogunsola F, Reese H, Safdar RM, Ungchusak K, Wieler LH, Heymann D. 2. Moving cholera vaccines ahead of the epidemic curve. Lancet. 2023. https:\/\/doi.org\/10.1016\/s0140-6736(23)02244-4.","journal-title":"Lancet"},{"issue":"23","key":"679_CR7","doi-asserted-by":"publisher","first-page":"16243","DOI":"10.3390\/ijerph192316243","volume":"19","author":"D Malaeb","year":"2022","unstructured":"Malaeb D, Sallam M, Younes S, Mourad N, El-Dine AS, Obeid S, et al. Knowledge, attitude, and practice in a sample of the Lebanese population regarding cholera. Int J Environ Res Public Health. 2022;19(23):16243.","journal-title":"Int J Environ Res Public Health"},{"issue":"10133","key":"679_CR8","doi-asserted-by":"publisher","first-page":"1908","DOI":"10.1016\/S0140-6736(17)33050-7","volume":"391","author":"J Lessler","year":"2018","unstructured":"Lessler J, Moore SM, Luquero FJ, Mckay HS, Grais R, Henkens M, et al. Mapping the burden of cholera in sub-Saharan Africa and implications for control: an analysis of data across geographical scales. Lancet. 2018;391(10133):1908\u201315.","journal-title":"Lancet"},{"key":"679_CR9","unstructured":"Preprint not peerrev Preprint not peered. 2021."},{"key":"679_CR10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae200","author":"M Hussen","year":"2024","unstructured":"Hussen M, Demlie YW, Edosa M, Kebede M, Wossen M, Chane AM, Abate G, Asfaw WH, Hailu D, Teferi M, Jeon Y, Gedefaw A, Park SE. Ethiopia National Cholera Elimination Plan 2022\u20132028: experiences, challenges, and the way forward. Clin Infect Dis. 2024. https:\/\/doi.org\/10.1093\/cid\/ciae200.","journal-title":"Clin Infect Dis"},{"key":"679_CR11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae236","author":"YW Demlie","year":"2024","unstructured":"Demlie YW, Gedefaw A, Jeon Y, Hailu D, Getahun T, Mogeni OD, Mukasa D, Jang GH, Pak GD, Kim DR, Getachew EM, Yeshitela B, Abebe SA, Edosa M, Wossen M, Teferi M, Park SE. Retrospective analysis of cholera\/acute watery diarrhea outbreaks in Ethiopia from 2001 to 2023: incidence, case fatality rate, and seasonal and multiyear epidemic patterns. Clin Infect Dis. 2024. https:\/\/doi.org\/10.1093\/cid\/ciae236.","journal-title":"Clin Infect Dis"},{"key":"679_CR12","volume-title":"Cholera\u2014StatPearls\u2014NCBI bookshelf","author":"M Fanous","year":"2022","unstructured":"Fanous M, King KC. Cholera\u2014StatPearls\u2014NCBI bookshelf. St. Petersburg: StatPearls; 2022."},{"key":"679_CR13","unstructured":"WHO. WHO Outbreak Communication Guidelines. WHO Outbreak Communication Guidelines. 2005; 1\u201313."},{"key":"679_CR14","unstructured":"central statistical agency Addis Abeba E. Section O- Health. 2008."},{"key":"679_CR15","volume-title":"Research design: qualitative, quantitative, and mixed methods approaches","author":"JW Creswell","year":"2003","unstructured":"Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches. Second: Sage Publications; 2003."},{"key":"679_CR16","volume-title":"Research design: quantitative, qualitative, mixed methods, arts-based, and community-based participatory research approaches","author":"P Leavy","year":"2017","unstructured":"Leavy P. Research design: quantitative, qualitative, mixed methods, arts-based, and community-based participatory research approaches. 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Cholera in the WHO African Region Cholera in the WHO African Region. 2023; 0\u201322."},{"key":"679_CR20","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1097\/JS9.0000000000000196","volume":"109","author":"MN Asumah","year":"2022","unstructured":"Asumah MN, Padhi BK, Sinha A. Rising cases of cholera in Ethiopia\u202f: a need for sustainable wash practices\u202f? Int J Surg. 2022;109:608\u20139.","journal-title":"Int J Surg"},{"key":"679_CR21","unstructured":"Crescent R, Societies N, Engagement C, Engagement C. CHOLERA OUTBREAK\u202f: 2023."},{"key":"679_CR22","unstructured":"World Health Organization. Global strategic preparedness, readiness and response plan for cholera. Vol. 4, Journal of Cement Based Composites. 2023."},{"key":"679_CR23","unstructured":"Federal Democratic Republic of Ethiopia Ministry of Health. Multi-Sectorial Cholera Elimination Plan Ethiopia 2021\u20132028. 2021."},{"key":"679_CR24","unstructured":"Unicef. Evaluation of COVID-19 Risk Communication and Community Engagement in Jordan Country Office Acknowledgments. 2023."},{"key":"679_CR25","unstructured":"World health organization TGF. Communicating risk in public health emergencies. 2017."},{"key":"679_CR26","unstructured":"Emergencies PH, Region WHOSA. Communication Strategy. 2023."},{"key":"679_CR27","unstructured":"Welfare F. Social and Behavior Change Communication (SBCC) Training for Information , Education , and Communication ( IEC ) Officers. 2013."}],"container-title":["Tropical Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-024-00679-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41182-024-00679-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-024-00679-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T02:14:13Z","timestamp":1736734453000},"score":1,"resource":{"primary":{"URL":"https:\/\/tropmedhealth.biomedcentral.com\/articles\/10.1186\/s41182-024-00679-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,13]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["679"],"URL":"https:\/\/doi.org\/10.1186\/s41182-024-00679-0","relation":{},"ISSN":["1349-4147"],"issn-type":[{"value":"1349-4147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,13]]},"assertion":[{"value":"20 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Oromia Health Bureau Research Ethics Review committee before the actual commencement of the study on July 10,2023, with Ref.no BFO\/WBTFH\/146\/586. An ethical clearance letter was obtained. Informed consent, as well as written and verbal consent, was obtained from all subjects. A support letter was written from the regional health bureau to zones and woreda for facilitation during the study period. All methods were carried out according to relevant guidelines and regulations. To ensure confidentiality, participants' names and other identifiers were not recorded in the data abstraction format.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4"}}