Understanding choice, control and risk in community responses to the Covid-19 epidemic across the health divide to inform public health strategies in Malawi
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Date
2021-05-21
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Kamuzu University of Health Sciences
Abstract
The type of research study: This study will employ a mixed method, cross-sectional study design to explore the capacity of vulnerable
groups in urban and peri-urban areas to respond to the risk of COVID-19. We propose to conduct a
household survey, key informant interviews and photo voice.
The problem: Despite WHO guidance to prevent spread of COVID-19, the extent to which governments have accorded
populations freedom to choose how to respond to the risk of infection on one hand or enforced stringent
control measures on the other has varied dramatically. In an international pandemic, the decisions and
actions of individuals, the capacity of populations to protect their health and adhere to social distancing,
hygiene and self-isolation measures will have a bearing on the speed and spread of infection globally. This
mixed methods study seeks to explore the capacity of the most vulnerable population groups in Malawi to
respond to the risk of Covid-19, to inform national policy responses to protect the health of those most at
risk and to mitigate the adverse socioeconomic consequences of containment measures on population
health and wellbeing.
The objectives:
1. Explore with community groups the measures they are able to take to protect the health of community
members and those they support.
2. Explore with community groups their assessment of the government’s response to COVID-19 and its
impact on community health and wellbeing.
3. Explore what additional measures community groups believe are necessary and feasible in tackling
COVID-19.
4. Understand how vulnerable populations in lower socioeconomic groups resident in high density urban
and peri-urban settlements with little possibility of social distancing or self-isolation prioritize risk
within precarious settings.
5. Understand how vulnerable populations in lower socioeconomic groups protect their own health and
that of their household’s from covid-19.
Methodology:
We plan to conduct a household survey, photo voice and key informant interviews in order to respond to
the specific objectives above. We plan to build on the community of practice identified as local governing structures to identify and interview potential community support groups. We also plan to conduct a
householdtelephone survey as well as a digital photovoice study with follow-up telephone narrative
interviews.
Expected findings and their dissemination.
The findings will contribute to 1) understanding the health and social impacts of COVID-19 in urban and
peri-urban settings and amongst different vulnerable groups in Southern Malawi, 2) developing
community-driven strategies to mitigate the social, economic and health impacts of COVID-19 and 3)
inform the MoH and COVID-19 planning committee of community perspectives and responses to COVID-
19 (through the Department of Risk Communication and Community Engagement) to target future
communication messages. A copy of the report will also be shared with COMREC, College of Medicine and
other local institutions who may be interested with the findings.