The ABCs of Covid-19 prevention in Malawi: Authority, benefits, and costs of compliance

Abstract

Highlights The type of authority ordering precautionary measures affects compliance. Citizens are more likely to comply with costly measures when health risks are high. Citizens are more likely to comply with authorities they view as having expertise. Policymakers should provide expert-backed advice to increase compliance. Policymakers should take measures to make compliance less costly.

Curtailing Covid-19 on a Dollar-a-Day in Malawi: Implications for the Ongoing Pandemic

“…As the experience of the United States, another country with a competitive election in 2020, has shown, the presence of distrust and lack of support for Covid-19 prevention measures shared by significant fractions of the population can be an impediment to an effective pandemic response (Ciancio et al 2020;Soveri et al 2020). Trust is related to cultural values, norms and beliefs that in Malawi are represented by the authority of the village heads (OECD 2013;Quinn et al 2013) and prior research in SSA has shown that local authorities are often seen as more trustful than national institutions and leaders (Kao et al 2021;Vinck et al 2019). This is consistent with our findings that local sources of information (coming from local health personnel, traditional healers, community leaders and/or religious leaders) are more important to implementing social distancing measures than national sources such as newspapers, radio, TV, etc (Supplemental Table S11).…”

“…Because of their eminent roles in all village-related matters, including monitoring compliance with public health measures and their authority to sanction dissent behavior (Kao et al 2021), the MLSFH 2020 Covid-19 Phone Survey elicited information on the pandemic-related activities of respondents' village heads (VHs). In this analysis, we define a VH as "socially active" if he/she had instructed village residents to implement social distancing measures (cancel village meetings, keep distance from other people during activities outside of the household (i.e., when fetching water), stop public works or recreational activities on common playgrounds).…”

“…Our study also affirms that meaningful involvement of local communities and local leadership can shape the population-wide response to Covid-19 and mitigate the secondary consequences of the pandemic. Specifically, supporting local leadership engaged in building social capital (i.e., disease knowledge, adoption of preventive health behavior), trust in governmental and health authorities and their health policies, can amplify public health messages (Chan 2014;Hargreaves et al 2020;Hopman et al 2020;Kao et al 2021;Nuwagira and Muzoora 2020) and foster appropriate individual behavioral, social and economic responses to the Covid-19 pandemic, and potentially alleviate its impacts on communities such the ones we study in rural Malawi.…”

“…2020; Hopman et al . 2020; Kao et al . 2021; Nuwagira and Muzoora 2020) and foster appropriate individual behavioral, social and economic responses to the Covid-19 pandemic, and potentially alleviate its impacts on communities such the ones we study in rural Malawi.…”

Health Knowledge and Non-Pharmaceutical Interventions During the COVID-19 Pandemic in Africa

“…However, the e↵ectiveness of information can depend upon other factors, including the costs of following the information (Kremer et al 2007), household bargaining power (Dupas 2011), a respondent's beliefs regarding their eventual likelihood of contracting the disease (Kerwin 2020 ), their life expectancy (Oster 2012), or who issues the directives (Kao et al 2020).…”