WHAT IS RCCE?
Introduction
During the 2014-2016 West Africa Ebola epidemic, over 28,000 people were infected and 11,000 died. Medical interventions—vaccines, treatment, contact tracing—were critical. But one factor determined which communities survived and which didn’t: trust.
In Guinea, where health workers ignored community burial practices, families hid sick relatives and buried dead ones secretly. Ebola spread. In Sierra Leone, where health teams worked with traditional leaders to adapt burial practices respectfully, transmission slowed.
The difference wasn’t medicine. It was communication and community engagement—RCCE.
Defining RCCE
Risk Communication and Community Engagement (RCCE) is a systematic, two-way process of:
- Building trust between authorities, health workers, and communities
- Sharing accurate, timely information about health risks and protective actions
- Listening to community concerns, questions, rumors, and feedback
- Working together to co-create solutions that fit local contexts
- Taking collective action to prevent, detect, and respond to health emergencies
The Dual Function
RCCE has two interconnected parts:
RISK COMMUNICATION = One-to-many information flow
- Alerts and warnings
- Health advisories
- Media briefings
- Social media updates
- IEC materials (posters, radio spots)
COMMUNITY ENGAGEMENT = Two-way relationship building
- Community dialogues
- Focus group discussions
- Participatory planning
- Social listening
- Addressing concerns and rumors
- Empowering community-led action
Both are essential. Risk communication without engagement creates distrust. Engagement without clear communication leaves people uninformed.
RCCE vs. Health Promotion vs. Behavior Change Communication
Health Promotion = Long-term efforts to improve population health (e.g., nutrition campaigns, exercise programs)
Behavior Change Communication (BCC) = Persuasive messaging to change specific behaviors (e.g., condom use, vaccination uptake)
RCCE = Emergency-focused, trust-based, two-way communication during crises AND preparedness
RCCE includes BCC techniques but adds:
- Urgency and crisis context
- Two-way dialogue (not just persuasion)
- Rumor management
- Coordination across sectors
- Continuous adaptation based on community feedback
Why RCCE Matters: The Evidence
Ebola in DRC (2018-2020): Community resistance led to 400+ attacks on health workers. When RCCE teams involved traditional healers and addressed fear (rather than just correcting misinformation), attacks decreased 70%.
COVID-19 in Uganda (2020-2022): Districts with strong community health worker networks (pre-existing relationships) had 40% higher mask usage and faster case detection than districts relying only on media campaigns.
Cholera in Kampala (2017-2018): Rapid RCCE response in Kawempe (engaging market leaders, providing handwashing stations, rumor tracking) contained outbreak in 3 weeks. Delayed response in another division led to 2-month outbreak.
Return on investment: WHO estimates that $1 invested in RCCE saves $5-10 in response costs by preventing misinformation, building compliance, and enabling early detection.
RCCE in Kampala’s Context
Kampala presents unique RCCE challenges:
Urban density = Rapid disease transmission potential
Mobility = Regional hub—cases spread quickly across East Africa
Linguistic diversity = English, Luganda, Swahili, Somali, Arabic, French, Kinyarwanda, Acholi, Luo
Informality = 60% in settlements with limited WASH, health access
Digital divide = Some have smartphones; others lack electricity
Social fragmentation = Refugees, migrants, marginalized groups often disconnected from formal health systems
KCCA’s RCCE strategy must:
- Use multiple channels (radio, SMS, WhatsApp, community meetings, religious leaders, VHTs)
- Provide multilingual materials
- Engage trusted intermediaries (market leaders, LC leaders, imams, priests, transport leaders)
- Build systems BEFORE emergencies (relationships take time)
- Continuously adapt based on feedback
Core RCCE Principles
- Community-centered: Start with community perspectives, not institutional messages
- Evidence-based: Use behavioral science, local data, social listening
- Inclusive: Reach ALL populations, especially marginalized
- Transparent: Admit uncertainty, share what’s known and unknown
- Timely: Information arrives when people need it—not too late
- Two-way: Listen as much as you speak
- Coordinated: One voice across sectors (health, security, local government)
- Accountable: Follow through on commitments; explain changes
RCCE Actors in KCCA
KCCA Public Health Department = Technical lead, coordinates divisions
5 Division Medical Officers (DMOs) = Implement RCCE in each division
Village Health Teams (VHTs) = Frontline community engagement
Health Facility Staff = Clinical settings + community outreach
Task Forces = Multisectoral coordination (health, security, LC leaders, private sector)
Partners = UNICEF, WHO, Red Cross, S4P, NGOs
Media = Radio stations, newspapers, online platforms
Community Leaders = Religious, market, transport, cultural leaders
Everyone has a role. RCCE isn’t just for communication officers—it’s a whole-of-society approach.