Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR

Background Community engagement has been recognized as a key tool for supporting national health agendas, and experiences from the COVID-19 pandemic can offer important lessons for tackling future global health challenges such as antimicrobial resistance. This paper provides much-needed evaluation k...

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Main Authors: Marco J. Haenssgen, Elizabeth M. Elliott, Sandra Bode, Ounkham Souksavanh, Thongkhoon Xayyahong, Hironori Okabayashi, Shogo Kubota
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Global Health Action
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Online Access:http://dx.doi.org/10.1080/16549716.2025.2485523
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author Marco J. Haenssgen
Elizabeth M. Elliott
Sandra Bode
Ounkham Souksavanh
Thongkhoon Xayyahong
Hironori Okabayashi
Shogo Kubota
author_facet Marco J. Haenssgen
Elizabeth M. Elliott
Sandra Bode
Ounkham Souksavanh
Thongkhoon Xayyahong
Hironori Okabayashi
Shogo Kubota
author_sort Marco J. Haenssgen
collection DOAJ
description Background Community engagement has been recognized as a key tool for supporting national health agendas, and experiences from the COVID-19 pandemic can offer important lessons for tackling future global health challenges such as antimicrobial resistance. This paper provides much-needed evaluation knowledge on relational community engagement initiatives and their impact on COVID-19-related attitudes and practices. Methods A two-round mixed-method evaluative study to examine outcome indicators related to COVID-19-prevention and health-seeking behavior was implemented from October 2022 to December 2023 among 14 diverse case study communities in four Lao provinces. Data involved 50 semi-structured interviews with villagers, 50 key informant interviews, and two rounds of complete census surveys (3,161 survey observations incl. matched panel data from 618 individuals) to discern outcomes among villagers with different levels of activity participation in a difference-in-difference analysis. Results Relative to non-participating villagers, villagers participating in the activities had higher COVID-19 vaccine uptake (+0.13 doses), higher public healthcare utilization for presentations consistent with COVID-19 (e.g. fever and neurological and/or respiratory symptoms; +69.4% points), and less antibiotic use per illness episode (−0.2 antibiotic use episodes). However, the activity raised worries to disclose a COVID-19-positive status and was often interpreted as a health education campaign. Conclusions Relational community engagement offers a respectful way of addressing persistent healthcare challenges and supporting vulnerable populations – and thus holds key for ongoing global health priorities such as emerging infectious disease responses and antimicrobial resistance. We recommend that community engagement initiatives become a standard component of national health policy portfolios beyond the scope of COVID-19.
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spelling doaj-art-0d9dd5f9ffbc4be8be26708bfa2091e32025-08-20T03:52:57ZengTaylor & Francis GroupGlobal Health Action1654-98802025-12-0118110.1080/16549716.2025.24855232485523Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDRMarco J. Haenssgen0Elizabeth M. Elliott1Sandra Bode2Ounkham Souksavanh3Thongkhoon Xayyahong4Hironori Okabayashi5Shogo Kubota6Chiang Mai UniversityWorld Health Organization Regional Office for the Western PacificCountry Office for Lao People’s Democratic RepublicCountry Office for Lao People’s Democratic RepublicCountry Office for Lao People’s Democratic RepublicCountry Office for Lao People’s Democratic RepublicWorld Health Organization Regional Office for the Western PacificBackground Community engagement has been recognized as a key tool for supporting national health agendas, and experiences from the COVID-19 pandemic can offer important lessons for tackling future global health challenges such as antimicrobial resistance. This paper provides much-needed evaluation knowledge on relational community engagement initiatives and their impact on COVID-19-related attitudes and practices. Methods A two-round mixed-method evaluative study to examine outcome indicators related to COVID-19-prevention and health-seeking behavior was implemented from October 2022 to December 2023 among 14 diverse case study communities in four Lao provinces. Data involved 50 semi-structured interviews with villagers, 50 key informant interviews, and two rounds of complete census surveys (3,161 survey observations incl. matched panel data from 618 individuals) to discern outcomes among villagers with different levels of activity participation in a difference-in-difference analysis. Results Relative to non-participating villagers, villagers participating in the activities had higher COVID-19 vaccine uptake (+0.13 doses), higher public healthcare utilization for presentations consistent with COVID-19 (e.g. fever and neurological and/or respiratory symptoms; +69.4% points), and less antibiotic use per illness episode (−0.2 antibiotic use episodes). However, the activity raised worries to disclose a COVID-19-positive status and was often interpreted as a health education campaign. Conclusions Relational community engagement offers a respectful way of addressing persistent healthcare challenges and supporting vulnerable populations – and thus holds key for ongoing global health priorities such as emerging infectious disease responses and antimicrobial resistance. We recommend that community engagement initiatives become a standard component of national health policy portfolios beyond the scope of COVID-19.http://dx.doi.org/10.1080/16549716.2025.2485523community engagementevaluationcovidantimicrobial resistancerural areaslao pdr
spellingShingle Marco J. Haenssgen
Elizabeth M. Elliott
Sandra Bode
Ounkham Souksavanh
Thongkhoon Xayyahong
Hironori Okabayashi
Shogo Kubota
Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR
Global Health Action
community engagement
evaluation
covid
antimicrobial resistance
rural areas
lao pdr
title Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR
title_full Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR
title_fullStr Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR
title_full_unstemmed Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR
title_short Community engagement to support public health: mixed-method evaluation evidence on COVID-19 attitudes and practices in Lao PDR
title_sort community engagement to support public health mixed method evaluation evidence on covid 19 attitudes and practices in lao pdr
topic community engagement
evaluation
covid
antimicrobial resistance
rural areas
lao pdr
url http://dx.doi.org/10.1080/16549716.2025.2485523
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