Risk communication during COVID-19: a comparative analysis of four countries

Abstract Background Risk communication (RC) is fundamental to ensuring public engagement in public health emergencies. Existing studies describe the mechanisms that integrate RC into emergency responses, but knowledge about which governing structures and policies are needed to ensure effective RC in public health emergencies is lacking. We compare RC across four epidemiological, socio-political, and geo-economic settings and identify key structural factors that can lead to effective RC in public health emergencies. Methods A multisite international study was implemented using qualitative research methods in Germany, Guinea, Nigeria, and Singapore. We mapped and assessed RC governing structures, drawing on a document review and semi-structured key informant interviews with 155 stakeholders involved in the design and implementation of RC strategies at national and sub-national levels. Results A comparative analysis of the content, process, actors, and context of the distinct RC structures in the four countries as well as related strengths and weaknesses are presented. Early integration of RC into preparedness and response plans alongside the use of previous experiences and structures are key to effective implementation of RC during public health emergencies. A lack of coordination increases the risk of parallel structures, missed opportunities, duplication of resources, and public confusion due to a cacophony of messages. Building on previous experiences of outbreaks and on existing structures and relationships can help governments to more quickly mobilise effective RC strategies during pandemics. Conclusions RC is key to effective pandemic responses and can help to reduce infection and transmission. Yet, considerable potential exists for countries to improve RC in public health emergencies. Learning from mistakes and successes during COVID-19 can help improve RC strategies and governing structures and prepare for future pandemics. Key messages Strengthening RC preparedness and response enables governments to more effectively implement the International Health Regulations. COVID-19 provides ample learning opportunities to improve communication in public health emergencies.