After the onset of the COVID-19 pandemic, statistical agencies around the world canceled ongoing surveys due to restrictions on the movement of their workers and safety measures. But this was a time when up-to-date information on fast-changing health and economic conditions was more important than ever. So, how could they keep the information flowing without jeopardizing the health of interviewers and respondents? Many statistical agencies had to grapple with this question. One obvious alternative was phone surveys, thanks to their successful implementation in similar contexts, notably during the Ebola outbreak in West Africa (Etang and Himelein, 2020).
This was part of our work in Zimbabwe and to meet this need, the World Bank Poverty and Equity Team, in partnership with UNICEF, provided technical and financial assistance to the Zimbabwe Statistics Office (ZIMSTAT) to start a high-frequency phone survey. The survey would monitor the socioeconomic impact of the pandemic and its effects on people’s behavior and perceptions. ZIMSTAT completed a total of nine rounds of phone surveys between July 2020 and January 2023. We summarize the main findings of the surveys in this note.
In this blog, I share some interesting and unexpected findings from the survey related to public health management.
We found that Zimbabwe achieved quick and equitable vaccination due to timely procurement and distribution of vaccines. Zimbabwe launched its COVID-19 vaccination campaign in February 2021, but vaccines became widely available only in the summer. Initially, there was an urban-rural coverage gap, with urban residents about four times more likely to get a shot than rural residents. But, with the expansion of coverage, the gap closed rapidly. By early 2022, when about 80% of the population had received at least one shot, the urban-rural gap had been all but erased.
We also observed that, because of the swift and equitable distribution of vaccines, most people perceived the vaccine distribution to be fair. In October 2021, when the rural-urban gap was about 10%, two-thirds (67%) of the population believed vaccines were distributed fairly. By February 2022, more than 76% thought so.
Data sources in this blog: Sharma et al., 2024
We noticed that “social proof” is a powerful determinant of public health behavior. Before or soon after the vaccine rollout, a sizable proportion of the population hesitated to get the shot. The hesitators were either “rejecters” – those who would not get vaccinated – or “fence-sitters” – those who were unsure. But we were encouraged to see that once vaccine distribution picked up pace and more people got the shot, the rank of hesitators declined rapidly. From 37% of the population in March 2021, only 6% in August 2022 would still not get the vaccine or were unsure about it.
We were surprised that the preventive health practices that people adopted in emergency did not persist when the crisis subsided. Immediately after the declaration of the pandemic, most people (59%) washed their hands after being in public. However, this behavior declined steadily, with only 7% regularly washing their hands in January 2023, when most people had been vaccinated, and the concerns about COVID-19 had largely subsided. The “backsliding” occurred sooner and faster in rural areas.
ZIMSTAT adopted an innovative approach to data collection due to the requirements during the pandemic. But the exercise demonstrated the importance of a continuous household data collection mechanism to monitor economic trends, the impact of economic shocks, government policies, and public response. Countries as diverse as Uzbekistan and Malawi have instituted frequent surveys to monitor the impact of economic and social reforms, and climate shocks. The establishment of a continuous monitoring system is taking root in other countries in the region such as Kenya and Tanzania as well. With creative and innovative thinking, there is an opportunity to integrate continuous household welfare monitoring in Zimbabwe’s national statistical system for a steady flow of timely, relevant, and credible data to support evidence-based decision making.
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