Emergence and Development of Health Risk Communication Networks Among Street-Level Health Bureaucrats During the COVID-19 Pandemic Crisis in Myanmar

Street-level health bureaucrats have actively contributed to implementing the COVID-19 prevention, control, and treatment policies of the Myanmar government. However, the need for bureaucrats on the frontlines of policy implementation to maintain a safe distance from others to prevent the spread of COVID-19 has posed challenges for the sharing and exchange of information related to health risks. In this context, this study examined what health risk communication patterns have emerged and developed among street-level health bureaucrats during the COVID-19 pandemic, and how this risk communication has been affected by street-level health bureaucrats' perceptions of client meaningfulness and willingness to implement COVID-19 policies. The results reveal that street-level health bureaucrats in the health risk communication network are embedded in reciprocally or transitively connected discussion relationships that sustain their health risk communication over time. Moreover, when specific healthcare staff members perceive more benefits of COVID-19 policies for their patients and are more willing to care for patients, other healthcare staff avoid them to protect themselves from COVID-19 infection. Due to their higher level of understanding of the adopted measures, healthcare staff members who are highly willing to implement COVID-19 policies are frequently approached by other staff members to communicate about COVID-19 issues. This study empirically contributes to the literature on street-level bureaucrats in times of pandemic crisis by examining the formation of health risk communications in the context of street-level health bureaucrats' responses to and participation in public healthcare policy implementation processes.