Organisational learning from community feedbacks on COVID-19 restrictive measures and health management self-reliance perspectives: a socio-anthropological case study in Bukavu, DRCongo

Background Central African countries face global health problems caused by emerging diseases that have significant social and economic impacts such as Ebola, COVID-19, HIV/AIDS, Chikungunya, Rift Valley Fever, Avian Influenza, Newcastle Disease, etc. The efficient management of emerging diseases often involves restrictive and constraining responses to fundamental rights, which require long-lasting social and health security schemes. The governments have not yet been able to establish these schemes in Central African countries. In this difficult conjuncture, it is important to question the integration of the situations of poor communities as well as the responsibilities in view of the self-reliance of health management strategies. Particularly, the COVID-19 pandemic has led governments to apply restrictive control measures that have required a sudden behavioral change in the population. For organizational learning, it is necessary to analyze situations of resistance to COVID-19 response measures. Using a socio-anthropological survey this study provides a retrospective community feedback and discusses organizational perspectives from the experience of first wave COVID-19 restrictive measures in Bukavu city, South Kivu, Democratic Republic of the Congo. Methods A qualitative study was conducted between April and July 2020 in Bukavu town, South Kivu, DR Congo. We used a socio-anthropological survey and a literature documentation for discussion. A total of 86 individual semi-structured interviews lasting a maximum of one hour and 5 focus groups discussions were conducted in the three communes (Ibanda, Bagira and Kadutu) of the city of Bukavu. Various stakeholders have participated to the survey such as unformal drug seller, students, shopkeeper, household responsible, state health agencies workers, unemployed youth, clinical healthcare providers, housewives, adult without schooling, a lawyer and clinical healthcare providers in the COVID-19 treatment center. These interviewed actors were selected through convenience sampling. First, they were selected based on their availability and willingness to participate in the study. Also, the informants were targeted according to the information we aimed to collect from them. The theme explored during the individual interview and focus group discussion was the community perception on restrictive COVID-19 measures and behaviors risks; and the factors that represent obstacles to the adoption of the response measure. The interview recordings were translated and transcribed. We used the thematic analysis method to progressively present and discuss the survey results by identifying recurring themes from the data. Results: The study revealed cases of the community members understanding of the scientific characteristics of COVID-19, their perceptions about the geographical emerging of the COVID-19 pandemic, their business opinions on the emergence of COVID-19 and the cultural and religious labeling of the pandemic. Also, community feedback on restrictive COVID-19 measures is enhanced and explicitly puts forward the expectations and suggestions, constraints to implement these measures. Moreover, it’s raised from the stakeholder’s opinions, the perspective for self-reliance in the strategies and resources in health risk management. In this regard, the analyze emphasis on the key role of stakeholders from the south in the dialog for change aiming at self-reliance in the health risk communities’ perceptions, strategies and resources. Conclusion: The dynamics in attitudes observed within the community brings out the challenges of community engagement in the context of COVID-19. The response to COVID-19 has resulted in the need to apply restrictive measures that have required a behavioral change in the population. Therefore, investigating the perceptions and determinants of implementation of restrictive measures is a good approach. However, to ensure these elements bring added value to the implementation of the health risks response, they should be integrated on the basis of a participatory consultation considering the resources available in the management program.