The WHO Country Office in Zambia, in collaboration with Zambia's Ministry of Health, has piloted an innovative tabletop exercise to strengthen community preparedness, readiness and response to cholera. The initiative was coordinated with the WHO Regional Office for Africa and received technical support from the Community Protection and Resilience Unit in the WHO Health Emergencies Programme at headquarters.
Conducted in Lusaka from 22 to 24 July 2026, the Cholera Community Protection Tabletop Exercise brought together 51 frontline actors from three provinces of Zambia, supported by eight local facilitators. Six observers from Malawi and Zimbabwe also participated, creating opportunities for regional learning and future adaptation of the approach.
Cholera remains a major public health challenge, particularly where access to safe water, sanitation and timely health services is limited. Community health workers, volunteers and other frontline actors have an essential role in identifying risks, communicating preventive measures, detecting suspected cases and connecting affected communities with care. The exercise provided a safe and participatory environment in which these actors could practise community-level preparedness and response.
Strengthening coordination through shared learning
Participants included community health workers and volunteers, environmental health officers, health promotion officers, public health nurses, rapid response team members, and water, sanitation and hygiene professionals.
Working through a simulated cholera emergency, participants exchanged perspectives, clarified responsibilities and considered how community, health and WASH actors could coordinate decisions and actions before and during an outbreak.
Participants practice collective decision-making through an interactive exercise on community preparedness and response.
Learning from the Zambia pilot
Evaluation findings indicate that participants valued learning through collective decision-making, comparing professional perspectives and working through realistic challenges together.
Their feedback is informing the next iteration of the exercise. Priorities include simplifying technical language, supporting local languages, clarifying instructions and visual orientation, and allowing sufficient time for facilitated discussion and reflection. These findings will help ensure that the exercise focuses on preparedness knowledge, coordination and decision-making rather than familiarity with technical terminology.
“The gamification of the engagement made it very interesting and very engaging.”
Pilot participant, Zambia
“Participants are exposed to situations where they have to take decisions together, collaborate across sectors and take response actions.”
Facilitator, Zambia
The face-to-face format also enabled participants to share operational experience, collaborate across sectors and learn from one another throughout the exercise.
A video featuring the Zambia pilot and participant feedback is available on OpenWHO, together with a short introduction to playing the Cholera Tabletop Exercise.
Building on the in-person experience
The strong engagement generated by the physical board game is shaping the initiative’s next phase. WHO plans to preserve the facilitated, in-person experience while developing a complementary digital version that will make the exercise easier to translate, localize and adapt to different country contexts.
This work will also create a reusable foundation for adapting the same participatory simulation and gamification approach to other health topics. Each adaptation will require locally relevant and technically validated content, while drawing on an established learning model.
The Zambia pilot demonstrates how participatory learning can bring technical knowledge, local experience and multisectoral coordination together, strengthening the role of communities and frontline actors in preparing for cholera and other health emergencies.
Organizations interested in adapting or implementing the next iteration of the hybrid exercise can contact the Community Protection and Resilience Unit.