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.