In this step, Hana Rohan (LSHTM & UK-PHRST) explains the role of a social scientist during an outbreak. She explains how this role has evolved over time and gives examples from outbreaks where social scientists have been involved.
What is the role of a social scientist during a disease outbreak?
In the current Ebola outbreak in North Kivu, Democratic Republic of the Congo (DRC), social scientists have deployed in a range of ways that include conducting rapid formative research to inform operational decisions and longer-term anthropological approaches that provide an opportunity to systematically listen to communities. Social scientists have also provided remote support through the provision of contextual briefs on subjects such as local political dynamics, migration patterns, local media content, and local burial practices (these are freely available at on the Social Science in Humanitarian Action website). These briefs have been widely taken up across the outbreak response and have facilitated the design of more targeted interventions.
While social scientists have been involved with disease outbreaks for many years, the 2014-2016 Ebola outbreak in West Africa was the first time that UN agencies directly commissioned social scientists to work across all stages of a health emergency response 1. The importance of social science in outbreak response is increasingly recognised by implementing and coordinating bodies, but given the relatively recent mainstreaming of social science in outbreaks, there is not yet consensus about its exact function. Many see social scientists’ role as primarily to inform risk communication activities, while others think that social scientists should be embedded within every outbreak response pillar.
Social science helps to identify the structural, social, and political factors that constrain and shape behaviour. In the context of infectious disease control, social science’s contribution can be split into two broad areas. It can help understand local explanations, interpretations, and concerns about disease and disease causation, and it can help ensure that those concerns are taken into account to ensure outbreak control interventions are locally appropriate 2.
In the 1990s, towards the beginning of the HIV/AIDS epidemic, much of the literature on the sub-Saharan epidemic contained “sweeping statements about a special ‘African sexuality,’ based on traditional marriage patterns different from those of Europe and Asia” 3. This characterisation of the epidemic as driven by somehow uniquely African sexual norms overplayed the role of individual agency in making decisions about sexual behaviour and implied that the epidemic was driven by multi-partner sexual relations. Social scientific research has shown that this reductionist approach ignored the ways that social or economic conditions emanating from 1980s Structural Adjustment Policies meant that in many communities women were reliant upon the exchange of sexual favours for financial support 3. Thus knowledge of the risk of HIV, which might be fatal years from now, could be offset against the need for economic survival in the present. These insights helped contribute to HIV/AIDS control strategies that recognised that knowledge does not necessarily translate into behaviour change, and that disease control strategies can rarely be applied in isolation from history, social structure, health systems, and politics.
© London School of Hygiene and Tropical Medicine 2019