Community Leader Introduction Letter - English

Attachment 3

Information Collection Instrument- Community Leader Introduction

Assessment on Public Knowledge, Attitudes, and Practices Relating to Ebola Virus Disease (EVD) Prevention and Medical Care in Guinea

Statement regarding Assessment Participation

Hello. My name is _______________________________.

I am working with Santé Plus Guinea to gather information on how people feel about the work that has been done around the country to fight Ebola disease. Sante Plus Guinea is a non-governmental organization led by Guinea professionals who are working on public health issues. Many villages across the country will have the opportunity to voice their thoughts about Ebola and to help us to better understand what people know, think, and do to protect themselves from Ebola. Your village was one of the villages chosen by chance selection to provide feedback on the Ebola response.

To do this work, when a village has the opportunity to participate, we talk with the village leaders to ask their permission to speak with people in the village on their knowledge, beliefs and practices. Participation will be strictly voluntary. This information will help us, civil society organizations, health partners, and even Guinea government health professionals to do a great job by providing people information on to help stop Ebola and protect the residents of your community.

The opinions of leaders like yourself are very important in addition to the opinion of people in the village. We would like to ask you a few questions about your thoughts regarding the risk of Ebola faced by your community, what information your community has received about Ebola, and any concerns you have about Ebola activities in your area. Then we would like to answer questions you may have about Ebola and get your advice about how to better protect your community from this disease. Our questions will take about 15 minutes, leaving about 15 minutes for your questions and further discussion.

Sante Plus will keep all the information you share with us confidential – meaning that we will not link your name in any reports or identify you as the respondent in any other way. You participation in this assessment is voluntary, and you will not be paid. You may choose to stop answering questions at any point or refuse to answer questions you do not feel comfortable responding to. There are no right or wrong responses. Therefore we encourage you to be honest and truthful in your responses so that we can accurately understand the on-the-ground situation.

ASK TO RESPONDENT:

• Do you have any questions?

• Do I have your permission to continue with the questions?

• Do I have your permission to interview members of this community about their knowledge, attitudes, and practices regarding Ebola?

1. YES I AGREE  Continue with interview

2. NO I DECLINE  END interview; respectfully thank participant for their time

By signing below, I attest that I have read the above statement to the participant and he/she has agreed to continue with the interview. I have also addressed all of his/her questions and/or concerns.

SIGNATURE OF INTERVIEWER: ………………………………………………..

DATE (Day, Month, Year): /____/____/____/

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