Knowledge And Perception Of Non-Pharmaceutical Preventive Measures Of Covid 19
Providing health information is a non-pharmaceutical intervention designed to reduce disease transmission and infection risk by encouraging behavior change. But does knowledge change behavior? This study test whether coronavirus health knowledge promotes protective risk mitigation behaviors early in the COVID-19 pandemic. Specifically, the study seeks to assess the knowledge and perception of non-pharmaceutical preventive measures of Covid 19 in Nigeria. Despite reputations for weak health sectors and low average levels of education, health knowledge of the symptoms and transmission mechanisms was high. Higher knowledge is associated with increased protective measures that would likely lower disease risk with one exception– knowledge is inversely correlated with social distancing. Respondents largely adhered to mask mandates and lockdowns, but continued coming into contact with others at small, informal gatherings, gatherings not affected by mandates. Knowledge alone appears unlikely to reduce all risky activities, especially gatherings within other people’s homes. Even early in the pandemic income loss or stress were commonly reported. Our results suggest that early and consistent government provision of health information, likely reduced the severity of the pandemic in Africa but was not a panacea.
Table Of Content
- Title Page
- Table Of Content
- 1.1 Background To The Study
- 1.2 Statement Of Problem
- 1.3 Research Objectives
- 1.4 Research Question
- 1.5 Research Hypotheses
- 1.6 Significance Of The Study
2.0 Literature Review
- 2.1 Conceptual Review
- 2.2 The Health Sector Amid Covid
- 2.3 Non-Pharmaceutical Preventive Measures Of Covid 19
- 2.4 Safety Measures Against Covid 19
- 2.5 Theoretical Review
3.0 Research Methodology
- 3.1 Research Design
- 3.2 Research Setting
- 3.3 Target Population
- 3.4 Sampling
- 3.5 Instruments For Data Collection
- 3.6 Method Of Data Analysis
4.0 Results And Discussion
- 4.1 Results
- 4.2 Discussion
5.0 Conclusion And Recommendation
- 5.1 Conclusion
- 5.2 Recommendations
1.1 Background Of The Study
As the coronavirus pandemic emerged, policy makers were concerned that the health impacts of the pandemic may be disproportionately borne by lower income countries because of their weak health sectors and their populations’ inability to socially isolate (United Nations 2020). This concern was particularly acute in Africa where despite younger populations, many residents have co-morbidities that would result in more severe symptoms, pushing weak health infrastructures past their limits (Lone and Ahmad 2020). Absent a vaccine, countries relied on information campaigns to encourage individual non-pharmaceutical interventions (NPIs)–social distancing, hand washing, and mask wearing– and imposing community NPIs– closures of schools, businesses, and/or houses of worship. These NPIs do not rely on the sophistication or capacity of the health sector but instead depend on voluntary behavior change. Whether NPIs can be successful in lower income countries is an empirical question– do people understand and trust the information, adhere to mandates, and have the capacity and ability to change their risky behaviors?
We analyse the level of health knowledge and whether health knowledge increased the adoption of Nonpharmaceutical Interventions (NPIs)such as mask-wearing and social distancing using detailed survey data from four African countries collected early in the pandemic, early April through mid-June, less than 2 months after the virus was first reported in each country. Our countries represent varied geography–West, East, and South-eastern–and income–lower-middle and low income. We asked people in Nigeria about their knowledge of coronavirus symptoms and transmission mechanisms, and their household’s experience with social distancing, and how their households were affected by the pandemic. With unified measures across four countries, we compare the knowledge, risk mitigation practices, and consequences of the pandemic (including associated lockdowns).
While existing literature has focused on the role of demographics (Goldberg and Reed 2020; Castex et al. 2020a; Castex et al. 2020b), government policies (Rannan-Eliya et al. 2021), or political economy (Chiplunker and Das 2020; Alsan et al. 2020 ), less work has used micro- data on what role, if any, individual risk mitigation practices play at explaining COVID-19 prevalence worldwide (Rannan-Eliya et al. 2021). In the US, Alsan et al. (2020) showed the relationship between sociodemographic characteristics and reported knowledge and behavior in the US. We show that individual knowledge increases mitigation measures, but does not curtail all risky behaviors, across four countries. We show that mandates help individuals adopt risk mitigation strategies. Together, both of these findings suggest that both individ- ual risk mitigation strategies and high rates of compliance with mandated, community NPIs may also contribute to the relatively low rates of COVID-19 cases in Africa as compared to richer countries.
Despite the lack of a direct health e↵ect, we also add to the growing evidence that the social and economic consequences of the pandemic were severe, with projections of continued negative e↵ects for some time to come (Erokhin and Gao 2020; Amare et al. 2020; Jain et al. 2020; Mahmud and Riley 2020; Josephson et al. 2020).
Finally, we contribute to the literature on the elements of a successful public health campaign. Vaccinations have been successful at reducing the burden of disease and increasing life expectancy, in part because once an individual achieves immunity through vaccination no additional action is necessary by them (Karing 2020). In contrast, attempts to reduce malaria transmission through regular bed net use and reduce HIV/AIDS transmission with adherence to pharmaceutical regimes and eliminating risky behaviors have been more complicated (e.g. Lucas 2010, Lucas and Wilson 2018). Our contradiction between knowledge and some forms of action are similar to the understanding that developed during the behavior change-communication messaging campaigns during the HIV epidemics in the early 2000s (Lo et al. 2016 ). While abstinence-only education was ine↵ective at reducing transmission, encouraging a suite of other risk mitigation strategies such as using condoms was more
effective, particularly for high risk groups (Okafor et al., 2017). However, continued use of condoms was difficult to individuals to maintain when faced with typical levels of risk (Foss et al. 2007). In the same way, individuals adopted risk mitigation measures in response to the coronavirus threat, but were unable to voluntarily adhere to extreme measures such as reducing all extraneous contacts. While early in the pandemic our results indicate households were engaging in relatively lower-cost protective measures, we caution that such protective measures may wane as individuals find ongoing e↵orts burdensome as they wait for a vaccine. We show that despite the important role of information as a non-pharmaceutical intervention, even knowledgable households perform constrained optimization that might not allow them to fully realize the benefits of risk-mitigation.
1.2 Statement Of Problem
Health ministers across Africa acted early in response to the pandemic. Approximately one month after the January 22, 2020 consensus that COVID-19 transmitted between humans and in recognition of the potential impact of the pandemic, African health ministers es- tablished a coronavirus task force to create a continent-wide strategy (Osseni 2020). This action was earlier than strategies and plans announced by richer countries.2 On March 11, the WHO declared the coronavirus a pandemic, and on June 5 the WHO updated its guidance on mask-wearing.
Governments, international bodies, and nonprofits enacted public health messaging campaigns, often in local languages, across the continent starting in early March. In addition to any programs by specific countries, UNICEF began large-scale public health messaging campaigns to improve awareness about the coronavirus. To combat misinformation, start- ing in April the WHO partnered with Twitter, Facebook, Tencent and TikTok to ensure the content on their platforms was accurate, set up websites to disseminate accurate infor- mation in local languages, and engaged Google to allow for targeted search of coronavirus information in local languages. In addition to private sector mobilization, the World Bank also issued $14 billion in grants to a↵ected countries, with an intention to deploy up to an additional $16 billion over the next year and half to help countries cope with containing the public health threat. Other major NGOs, including Catholic Relief Services, Living Water International, Sightsavers, the Red Cross, Save the Children, repurposed their campaigns from other diseases and ailments to focus on the coronavirus, including messaging targeted to increasing awareness and induce risk mitigation measures, such as hand washing. Individual philanthropists also contributed to the disaster preparedness. Chinese billionaire Jack Ma, for example, shipped a cargo flight containing 6 million medical items in late March to be distributed across the continent.
1.3 Research Objectives
The main aim of this study is to assess the knowledge and perception of non-pharmaceutical preventive measures of Covid 19 in Nigeria.
The specific objectives are as follows;
- To determine the level of knowledge of COVID-19 among community residents in Enugu metropolis
- To assess the perception of community residents towards non-pharmaceutical preventive measures of COVID-19 in Enugu metropolis
- To identify the perceived barriers to the practice of non-pharmaceutical preventive measures of COVID-19 in Enugu metropolis
1.4 Research Question
- What is the level of knowledge of COVID-19 among community residents in Enugu metropolis?
- What is the perception of community residents towards non-pharmaceutical preventive measures of COVID-19 in Enugu metropolis?
- What are the perceived barriers to the practice of non-pharmaceutical preventive measures of COVID-19 in Enugu metropolis?
1.5 Research Hypotheses
HO: There is no relationship between knowledge and perception of non-pharmaceutical preventive measures of COVID-19 among community residents in Enugu metropolis
1.6 Significance Of The Study
Our study contributes to three related literatures. First, we contribute to the growing literature on how to manage and mitigate the effects of pandemics through Nonpharmaceutical Interventions (NPIs). We show that information is an effective NPI as it increases protective health behaviors and encourages behavior that mitigates risk similar to the existing literature on information and in particular can be useful during this pandemic. In particular, this study finds a correlation between health knowledge and hand washing, mask-wearing, and other risk mitigation measures. However, the effectiveness of information can depend upon other factors, including the costs of following the information, household bargaining power, a respondent’s beliefs regarding their eventual likelihood of contracting the disease. Protective measures are wearing a mask, washing hands, using hand sanitizer, and reducing social contacts, their life expectancy, or who issues the directives. In lower income countries with relatively expensive risk coping strategies, individuals may not be able to reduce their risk to desired levels despite their level of knowledge. Consistent with that intuition, we show that health knowledge is positively correlated with the number of times in the past week an individual was in close contact with those outside of their household (i.e., knowledge is negatively correlated with social distancing).
Second, our results contribute to a broader understanding of the combined effects of a pandemic and related lockdown. Early in the pandemic the direct health effects of the disease were a focus, and we show that only 4 percent of households were directly infected bythe virus, while, about half reported income loss with a similar amount reporting increased stress. Notably, the stress consequences were not concentrated among those who had lost income, but rather appear to be a more general phenomenon. Parents, in particular, report additional stress, a potentially worrisome situation in a context where rates of child abuse are high.
Third, our results contribute to the literature on the differential experience of the pandemic across countries. We are the first to use harmonized microdata across lower income countries on behavior change in response to the pandemic. The majority of the existing literature consists of descriptive statistics and does not discuss correlates of NPI use, nor seeks to explain the role of policy in contributing to differential NPI use across countries.
5.0 Conclusion And Recommendation
Findings providing confidence as community residents have good knowledge, positive perception and good practice regarding COVID-19 prevention using non-pharmaceutical preventive measures. The study also able to highlight gaps in specific aspects of knowledge, and practice that should be focused in future awareness and educational campaigns. Findings also demonstrated that community residents were using less authentic sources, this aspect should immediately be addressed as it ultimately affects knowledge and reflected in perception and practice. The study recommends the ministry of health authorities to promote all precautionary and preventive measures of COVID-19 including social distance with a comprehensive training program consisting better structured targeting all health professionals in order to have equilibrium clinical knowledge about COVID-19.
The following recommendations were made based on the findings of the study;
- Additional education intervention and campaigns are required for community residents and health professionals to avail them with the knowledge of the social distancing, mode of transmission, the isolation period and treatment strategies, as well as the risk of personal and family infection with COVID-19.
- The ministry of health and health authorities should encourage all precautionary and preventive measures of COVID-19 including social distance with a comprehensive training program consisting better structured targeting all health professionals.
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