Box 1: Community engagement in wearing and making face
coverings.
In South Africa, it is mandatory to wear a face covering when leaving
your home. Rural areas are hard to reach and have higher rates of
poverty and unemployment. George Hospital trust set up collaboration
with Non-Profit Organisation Azaria, and members of the community who
own sewing machines. Through this ongoing partnership they have
fundraised, made and distributed 18 000 face coverings to people who
would struggle to obtain them (Figure 1). This also creates job
opportunities for women in need through the purchase of face coverings
from Azaria and engages members of the public in making them as
volunteers.
Engaging with sociocultural narratives
Community perceptions and practices around the use of face coverings
differ widely and these sociocultural realities influence acceptability
of face coverings as a transmission prevention intervention for
COVID-19. Prior to the COVID-19 pandemic, face covers were seen as
appropriate to a specific setting (a healthcare visit), a particular
crisis period (during wildfires). In some countries, predominantly in
Asia, face coverings were widely worn in public, likely due to past
experience with respiratory virus epidemics and a strong cultural
emphasis on interdependence instead of independence.11In the current COVID-19 pandemic, face coverings are being rapidly
introduced as a public health intervention in countries where there is
no cultural tradition of doing so. For successful uptake, such
interventions need to be grounded in the social and cultural realities
of affected communities. One way to strengthen implementation strategies
is to understand the meanings and practices associated with face
covering.