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

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  • Kao, Kristen
  • Lust, Ellen
  • Dulani, Boniface
  • Ferree, Karen E.
  • Harris, Adam S.
  • Metheney, Erica

Abstract

A wide array of authorities—from religious leaders to government ministers—call upon citizens to take preventative measures against Covid-19. Which authorities can most effectively gain public compliance, and which measures will the public take up? Moreover, do people comply with authorities out of respect for their legitimacy, due to their expertise, or for fear of sanctioning? Answers to these questions are important for development practitioners, who need to understand how different partnerships might affect health behavior, and for scholars interested in understanding authority, legitimacy, and compliance. We explore these questions using a conjoint experiment embedded in a telephone survey of 4,641 Malawians. Individuals in our sample are more likely to say that they will comply with precautionary measures when the costs are low and expected benefits are high. Respondents view both traditional authorities and hospital heads as legitimately issuing directives and having the ability to monitor and sanction non-compliance, but appear to comply more with hospital heads and to do so out of respect for their expertise. These results emphasize how who issues directives affects whether individuals comply and provides insights as to why they do so. The findings also reflect individuals’ cost-benefit calculations when considering precautionary measures, highlighting the importance of steps that can reduce costs (e.g., food security or income measures) or accurately reflect risks (e.g., information signaling the prevalence of Covid-19). The study not only helps to address the Coronavirus crisis but also has important implications for broader questions of authority and compliance.

Suggested Citation

  • Kao, Kristen & Lust, Ellen & Dulani, Boniface & Ferree, Karen E. & Harris, Adam S. & Metheney, Erica, 2021. "The ABCs of Covid-19 prevention in Malawi: Authority, benefits, and costs of compliance," World Development, Elsevier, vol. 137(C).
  • Handle: RePEc:eee:wdevel:v:137:y:2021:i:c:s0305750x20302941
    DOI: 10.1016/j.worlddev.2020.105167
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    References listed on IDEAS

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    1. Blair, Robert A. & Morse, Benjamin S. & Tsai, Lily L., 2017. "Public health and public trust: Survey evidence from the Ebola Virus Disease epidemic in Liberia," Social Science & Medicine, Elsevier, vol. 172(C), pages 89-97.
    2. Naoki Egami & Kosuke Imai, 2019. "Causal Interaction in Factorial Experiments: Application to Conjoint Analysis," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 114(526), pages 529-540, April.
    3. Hainmueller, Jens & Hopkins, Daniel J. & Yamamoto, Teppei, 2014. "Causal Inference in Conjoint Analysis: Understanding Multidimensional Choices via Stated Preference Experiments," Political Analysis, Cambridge University Press, vol. 22(1), pages 1-30, January.
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    Cited by:

    1. Abayomi Samuel Oyekale & Thonaeng Charity Maselwa, 2021. "An Instrumental Variable Probit Modeling of COVID-19 Vaccination Compliance in Malawi," IJERPH, MDPI, vol. 18(24), pages 1-14, December.
    2. James Tengatenga & Susan M. Tengatenga Duley & Cecil J. Tengatenga, 2021. "Zimitsani Moto : Understanding the Malawi COVID-19 Response," Laws, MDPI, vol. 10(2), pages 1-14, March.
    3. Hausmann, Ricardo & Schetter, Ulrich, 2022. "Horrible trade-offs in a pandemic: Poverty, fiscal space, policy, and welfare," World Development, Elsevier, vol. 153(C).
    4. Blair, Robert A. & Curtice, Travis & Dow, David & Grossman, Guy, 2022. "Public trust, policing, and the COVID-19 pandemic: Evidence from an electoral authoritarian regime," Social Science & Medicine, Elsevier, vol. 305(C).
    5. Kohler, Iliana V. & Kämpfen, Fabrice & Ciancio, Alberto & Mwera, James & Mwapasa, Victor & Kohler, Hans-Peter, 2022. "Curtailing Covid-19 on a dollar-a-day in Malawi: Role of community leadership for shaping public health and economic responses to the pandemic," World Development, Elsevier, vol. 151(C).

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