The role of participatory radio talk shows in strengthening health systems and fostering community engagement in Sierra Leone

<ns3:p>Background Preserving health outcomes in vulnerable and crisis-prone environments remains a significant challenge due to systemic weaknesses, limited resources, and recurrent emergencies. This study evaluates the ReBUILD for Resilience program in Sierra Leone, an intervention aimed at strengthening health systems and fostering community engagement through co-created radio discussions. Methods The intervention was implemented in the Moyamba and Kailahun districts, focusing on improving health literacy, empowering communities, and addressing local health priorities. Stakeholders, including community members, health workers, and local authorities, collaboratively developed and disseminated culturally relevant radio content. Data were collected through qualitative methods, including interviews and focus group discussions, and analysed to identify key themes related to stakeholder involvement, implementation processes, and perceived impacts. Results Four main themes were identified: stakeholder motivations, perceived objectives, planning and implementation processes, and program impacts. Stakeholders were driven by a sense of community responsibility and the need to bridge health knowledge gaps. The radio discussions were perceived as effective in raising awareness and facilitating communication between communities and health authorities. Successful implementation was attributed to collaborative planning and the use of local languages. While stakeholders noted perceived benefits such as improved health literacy and behaviour changes, these outcomes were not directly assessed in the study. Challenges included logistical and financial constraints, highlighting the need for sustainable funding strategies. Conclusions The ReBUILD for Resilience program demonstrates the transformative potential of co-produced health interventions in fragile and shock-prone settings. Community ownership, cultural relevance, and stakeholder participation were critical to its success. This study contributes to the growing evidence on participatory approaches to strengthening health systems and underscores the need for innovative strategies to ensure the sustainability of such interventions in resource-constrained environments.</ns3:p>