'Vaccines are for children only'? Some institutional roots of popular scepticism about vaccines for COVID-19 in Sierra Leone.

Vaccines for COVID-19 began to be available in Africa from mid-2021. This paper reports on local reactions to the possibility of vaccination in one West African country, Sierra Leone. We show that the history of institutionalisation of vaccine is highly relevant to understanding these reactions.

Negotiating Intersecting Precarities: COVID-19, Pandemic Preparedness and Response in Africa.

This article shares findings on COVID-19 in Africa across 2020 to examine concepts and practices of epidemic preparedness and response. Amidst uncertainties about the trajectory of COVID-19, the stages of emergency response emerge in practice as interconnected. We illustrate how complex dynamics manifest as diverse actors interpret and modify approaches according to contexts and experiences.

How villagers in central Sierra Leone understand infection risks under threat of Covid-19.

Background: Concern has been expressed over how well Africa is prepared to cope with the pandemic of Covid-19. Will rural populations with low levels of education know how to apply community-based infection control? We undertook fieldwork in two villages in central Sierra Leone to gain insight into how rural people faced with Covid-19 assess epidemic infection risks.

Methods: Two communities were selected based on prior contrasted exposure to Ebola Virus Disease-one with substantial number of cases and the other having resisted infection through strong community sequestration measures.

Rural populations exposed to Ebola Virus Disease respond positively to localised case handling: Evidence from Sierra Leone.

At the height of the Ebola epidemic in Sierra Leone in November 2014, a new decentralized approach to ending infection chains was adopted. This approach was based on building local, small-scale Community Care Centres (CCC) intended to serve as triage units for safe handling of patients waiting for test results, with subsequent transfer to Ebola Treatment Centers (ETC) for those who tested positive for Ebola. This paper deals with local response to the CCC, and explains, through qualitative analysis of focus group data sets, why this development was seen in a positive light.

Towards an understanding of resilience: responding to health systems shocks.

The recent outbreak of Ebola Virus Disease (EVD) in West Africa has drawn attention to the role and responsiveness of health systems in the face of shock. It brought into sharp focus the idea that health systems need not only to be stronger but also more 'resilient'. In this article, we argue that responding to shocks is an important aspect of resilience, examining the health system behaviour in the face of four types of contemporary shocks: the financial crisis in Europe from 2008 onwards; climate change disasters; the EVD outbreak in West Africa 2013-16; and the recent refugee and migration crisis in Europe.