A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone-A food value-chain framework for improving future response strategies

Stephen R. Kodish, Frank Bio, Rachel Oemcke, James Conteh, Jean Max Beauliere, Solade Pyne-Bailey, Fabian Rohner, Ismael Ngnie-Teta, Mohammad B. Jalloh, James P. Wirth

Research output: Contribution to journalArticle

Abstract

Background This study sought understand how the 2014-2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude. Methodology This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a teambased coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures. Results The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food valuechain in Sierra Leone. System-wide impacts were similar to those typically seen in largescale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutritionsensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement. Conclusions Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.

Original languageEnglish (US)
Article numbere0007645
JournalPLoS neglected tropical diseases
Volume13
Issue number9
DOIs
StatePublished - Jan 1 2019

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Ebola Hemorrhagic Fever
Sierra Leone
Food Chain
Disease Outbreaks
Disasters
Health
Food Assistance
Food Storage
Interviews
Quarantine
Earthquakes
Food Handling
Food Supply
United Nations
Social Behavior
Virus Diseases
Hygiene
Communicable Diseases
Survivors
Software

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Kodish, Stephen R. ; Bio, Frank ; Oemcke, Rachel ; Conteh, James ; Beauliere, Jean Max ; Pyne-Bailey, Solade ; Rohner, Fabian ; Ngnie-Teta, Ismael ; Jalloh, Mohammad B. ; Wirth, James P. / A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone-A food value-chain framework for improving future response strategies. In: PLoS neglected tropical diseases. 2019 ; Vol. 13, No. 9.
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abstract = "Background This study sought understand how the 2014-2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude. Methodology This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a teambased coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures. Results The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food valuechain in Sierra Leone. System-wide impacts were similar to those typically seen in largescale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutritionsensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement. Conclusions Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.",
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A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone-A food value-chain framework for improving future response strategies. / Kodish, Stephen R.; Bio, Frank; Oemcke, Rachel; Conteh, James; Beauliere, Jean Max; Pyne-Bailey, Solade; Rohner, Fabian; Ngnie-Teta, Ismael; Jalloh, Mohammad B.; Wirth, James P.

In: PLoS neglected tropical diseases, Vol. 13, No. 9, e0007645, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Kodish, Stephen R.

AU - Bio, Frank

AU - Oemcke, Rachel

AU - Conteh, James

AU - Beauliere, Jean Max

AU - Pyne-Bailey, Solade

AU - Rohner, Fabian

AU - Ngnie-Teta, Ismael

AU - Jalloh, Mohammad B.

AU - Wirth, James P.

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N2 - Background This study sought understand how the 2014-2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude. Methodology This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a teambased coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures. Results The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food valuechain in Sierra Leone. System-wide impacts were similar to those typically seen in largescale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutritionsensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement. Conclusions Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.

AB - Background This study sought understand how the 2014-2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude. Methodology This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a teambased coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures. Results The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food valuechain in Sierra Leone. System-wide impacts were similar to those typically seen in largescale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutritionsensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement. Conclusions Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.

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