Health Development Initiative (HDI) and the International Organization for Migration (IOM), in partnership with the Rwanda Biomedical Centre (RBC), have launched a project aimed at strengthening cross-border community preparedness for Mpox and other high-risk epidemic-prone diseases.

The initiative will use the Community-Centred Risk Communication and Community Engagement (RCCE) model, a public health approach that actively engages communities during health risks and emergencies.

Built on a participatory and rights-based design, the model involves communities in planning and response. It leverages integrated communication channels to reach diverse groups, strengthens local capacity, and links with existing health systems. Innovation is incorporated through a digital feedback dashboard that tracks and responds to community needs. Mobile tents and edutainment activities are used to share messages in engaging ways, while adaptive learning and cross-border coordination ensure flexibility and responsiveness.

Dr. Boyiga Bodinga, Migration and Health Programme Officer at IOM, said RCCE empowers communities to prevent, detect, and respond to diseases.

"What’s key is that for any disease of concern, the community is aware, knows how to prevent it, and knows how to seek care. We are working together to shape the RCCE strategy and support efforts at points of entry,” he said.

He added that IOM prioritizes safe and dignified movement, addresses health risks associated with forced migration, and supports regular migration in Africa using tools such as health border mobility mapping to guide targeted RCCE interventions.

The RCCE project will directly and indirectly benefit border-community residents within 10 km of points of entry (PoEs) at Rubavu, Rusizi, Rusumo, Kagitumbu, Galuna, and Cyanika, including cross-border travelers and key populations. Secondary beneficiaries include district health authorities, surveillance officers, and national institutions, who will gain improved coordination capacity through harmonized communication tools and feedback mechanisms.

Project teams will travel to cross-border areas to implement activities that address critical gaps in community preparedness and coordination for Mpox and other epidemic-prone diseases. Activities include information sessions, Knowledge, Attitudes, and Practices (KAP) surveys, and other community support initiatives.

The project will collaborate closely with government institutions, Community Health Workers (CHWs), border screening teams, moto drivers, bus representatives, traders, and key population groups. Together, they will disseminate health messages through IEC materials such as flyers and posters, as well as by conducting KAP surveys.

Why RCCE is needed

As of March 2025, Rwanda had reported 114 laboratory-confirmed Mpox cases. A 2024 country readiness assessment found that while 95% of respondents had heard of Mpox, only 44 percent had discussed preventive measures within households.

Nearly two in five women face barriers to accessing outbreak information and care. These gaps reflect behavioral and structural challenges, low risk perception, misinformation, language barriers, and limited linkage between community and PoE surveillance systems. They highlight the need for timely health-seeking, rumor management, and stigma reduction at both community and PoE levels.

Enhancing cross-border community preparedness is critical, as Rwanda remains highly vulnerable to transboundary and emerging infectious diseases due to dense populations, high mobility, and its role as a regional trade hub. Border districts act as mobility corridors, facilitating potential disease spread.

Dr. Dan Lutasingwa, HDI’s Health Technical Advisor, said the project aligns with Rwanda’s Health Sector Strategic Plan (2024/25–2028/29), which prioritizes community resilience and risk communication.

"Focusing on high-mobility border districts with points of entry, the project aims to enhance early detection and response mechanisms through community-centered approaches. This is essential for mitigating cross-border disease spread and strengthening overall public health resilience in Rwanda,” he said.

HDI’s approach begins by understanding what border communities already know and do not know before creating or refining health messages.

"The plan was to consult experts first, then engage border communities, conduct assessments, identify knowledge gaps, and co-create messages with stakeholders at points of entry,” Lutasingwa noted.

Robust feedback and reporting system are central to the project. Communities can share concerns and alerts through hotlines, WhatsApp groups, and reporting platforms. Weekly aggregation of feedback will determine the validity of reported issues, improving reporting, referrals, and effective feedback mechanisms.

One innovation is testing longer-term community education. Instead of brief interactions, HDIplans to assess whether week-long sessions led by trained youth and CHWs improve behavior change and cost-effectiveness.

RBC’s role

Jean-Bosco Ntirenganya, Division Manager of the Rwanda Health Communication Centre (RHCC) at RBC, emphasized the importance of RCCE outside of emergencies.

"It’s a great opportunity to discuss Risk Communication and Community Engagement when there’s no outbreak. This allows partners to plan strategically and focus on long-term system strengthening rather than reactive measures,” he said.

He noted that the stakeholders’ meeting offered an opportunity to evaluate what works and enhance border-based engagement. RHCC is currently working on a revised RCCE strategy for the next five years.

Olivier Nsekuye, Acting Director of the Surveillance Unit at RBC, said RCCE at PoEs is essential not only for detecting and preventing disease spread but also for informing and empowering communities to act promptly to protect themselves and travelers.

Mpox (Monkeypox) is the primary focus, given its high transmission risk at cross-border points, making enhanced surveillance and community awareness critical. Viral hemorrhagic fevers and zoonotic diseases, including Marburg, Ebola, and Rift Valley Fever, are also prioritized due to high mortality rates, requiring rapid isolation and reporting. Vaccine preventable diseases such as measles and polio are emphasized for their high contagion potential.

Other monitoring priorities include waterborne diseases like cholera and respiratory diseases such as influenza and COVID-19, which remain important for ongoing public health preparedness.

"Effective RCCE ensures not only disease prevention but also orderly and safe migration, benefiting both travellers and host communities,” Nsekuye emphasized.

Focus areas for monitoring these diseases include key border points and provinces: Rubavu and Gatuna in the Northern Province, Rusizi in the Western Province, Kagitumba, Rusumo, Buziba, Nemba in the Eastern Province, Akanyaru Bas and Akanyaru Haut in the Southern Province, and Kigali International Airport.