Health Communication Strategies in Emergencies: A Case Study from Eastern Sierra Leone

Abstract Background: Effective health communication is critical during public health emergencies, particularly in low-resource settings like Eastern Sierra Leone. During the Ebola and COVID-19 outbreaks, timely dissemination of accurate information was essential to promote preventive behaviors and reduce misinformation. This study examines the effectiveness of both digital and traditional health communication strategies in reaching diverse populations across Kenema, Kailahun, and Kono districts. Methodology: A mixed-methods case study design was used, combining qualitative interviews (n = 30), focus group discussions (n = 90), and surveys (n = 500) to gather data from a total of 620 participants. Purposive sampling was applied to select key informants for qualitative data, while stratified random sampling ensured representation across demographic groups for the quantitative component. Data were analyzed using thematic analysis and descriptive and inferential statistics. Results: Findings indicate that community-based strategies—especially those led by local health workers and local radio—were the most trusted and effective channels, with 78% expressing trust in health workers and 60% preferring them as information sources. Digital tools such as social media were less effective due to limited access and digital literacy. Awareness was highest in Kenema (90%) and lowest in Kailahun (60%). Health messages had the most impact on hygiene practices (45%) and preventive behavior (35%), with limited influence on healthcare-seeking (20%). Conclusion: Community engagement, cultural relevance, and trust are central to effective health communication. Integrating digital tools into established community systems and expanding multilingual outreach can enhance emergency response effectiveness in similar contexts.