BACKGROUND
Emergencies test health systems, and they also test who is told what, when and in which language. AHOA holds that health information is a public good and part of universal health coverage (UHC), health security and human rights. Income, geography, literacy, gender, disability, age or connectivity should not decide who receives it. The current gaps are large. The International Telecommunications Union (ITU) estimates that only 36% of people in Africa use the Internet.
INEQUALITIES THAT DECIDE WHO IS INFORMED
Africa has the widest urban-rural gap in Internet use of any region: 55% of urban residents are online against 21% of rural residents. Women trail men, at 31% against 40%. In low-income countries only 14% of rural residents are online. A warning issued only through apps, websites or SMS therefore misses most of the people at greatest risk.
REACHING THOSE MOST EASILY LEFT OUT
Women, children, adolescents, older persons, persons with disabilities and displaced populations each need a channel that suits them. In practice that means sign-language interpretation, audio and large-print formats, and easy-read leaflets. It also means messages carried through schools, women's groups, health facilities and camp structures, because a single national broadcast will not reach everyone.
LANGUAGE AND CULTURE
Guinea's response to Ebola in 2014-16 shows what local-language communication can do. The main campaign was aired on community radio by local hosts in local languages. Stations invited survivors and traditional and religious leaders to address rumours about burial practices. A peer-reviewed-style analysis by González-Torres found that cases fell earlier, and by more, in areas with a local station than in areas that received the same campaign through a non-local station.
TRUSTED LOCAL CHANNELS
Sierra Leone's Ose to Ose Ebola Tok ("house-to-house talk") campaign in September 2014 used more than 28,500 trained mobilisers, youths and volunteers to reach 1.5 million households. WHO's own team there noted that radio was not enough, since not everyone owns a set. Traditional leaders and community members whom people already trusted carried messages in person. Community health workers, CSOs and local radio stations can do the same work, provided they receive accurate, timely and translated material from health authorities.
CONCLUSION
Trust in health information is built locally, before an emergency, through familiar voices and languages. The evidence from Guinea and Sierra Leone points to community radio, community health workers and CSOs as part of the information system itself. Health authorities should pay for them, equip them and consult them accordingly. Disaggregated data on who is actually being reached, by sex, age, disability, location and displacement status, would show where messages are failing.
BIBLIOGRAPHY
International Telecommunication Union. Measuring Digital Development: Facts and Figures 2025. Geneva: ITU; 2025. https://www.itu.int/itu-d/reports/statistics/2025/10/15/internet-use-in-...
González-Torres A. Local Media and the Shaping of Social Norms: Evidence from the Ebola Outbreak. arXiv:2210.15946; 2023. https://arxiv.org/abs/2210.15946
WHO Regional Office for Africa. Sierra Leone: Increasing community engagement for Ebola on-air. https://afro.who.int/news/sierra-leone-increasing-community-engagement-e...
UNICEF, "Ose to Ose Ebola Tok" campaign, as reproduced by Social Science in Action (SSHAP). https://www.socialscienceinaction.org/resources/sierra-leone-increasing-...
“Technological tools, including computers, search engines, statistical software, AI, and other digital applications routinely employed in contemporary scholarship, assisted in the preparation of this work. However, the conceptualization, analysis, interpretation, verification of information, conclusions, and responsibility for the content remain solely those of the author.” - Dr. Uzodinma Adirieje; CEO/Programmes Director, Afrihealth Optonet Association (AHOA), and President, African Refugees Council (ARC).
HIFA profile: Dr. Uzodinma Adirieje is a leading voice in health education, community health, and advocacy, with decades of experience advancing people-centered development across Africa and beyond. His approach to health education emphasizes participatory learning, knowledge transfer, and behavior change communication, ensuring that individuals and communities gain the skills and awareness to make informed decisions about their health. He develops and delivers innovative health promotion strategies tailored to local realities, particularly in resource-limited settings. In community health, Dr. Adirieje has championed integrated primary health care, preventive medicine, and grassroots health initiatives. Through Afrihealth Optonet Association (AHOA), which he leads, he connects civil society, community groups, and health institutions to strengthen healthcare delivery, tackle health inequities, and improve access to essential services for vulnerable populations. His work addresses infectious diseases, maternal and child health, nutrition, climate and health, environmental health, and emerging public health challenges. As a passionate advocate, Dr. Adirieje works with governments, NGOs, and international organizations to influence health policy, mobilize resources, and promote sustainable development goals (SDGs). He amplifies community voices, ensuring that health systems are inclusive, accountable, and responsive. His advocacy extends beyond health to governance, environment, and social justice, positioning him as a multidisciplinary leader shaping healthier and more equitable societies. afrepton AT gmail.com