Self-reported vs Directly Observed Face Mask Use in Kenya

Jakubowski, Aleksandra; Egger, Dennis; Nekesa, Carolyne; Lowe, Layna; Walker, Michael; Miguel, Edward

doi:10.1001/jamanetworkopen.2021.18830

Cited by 20 publications

(17 citation statements)

References 4 publications

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“…After state‐wide mask mandates, self‐reported mask wearing did not increase significantly in the US, indicating a disconnect between rules, messaging and actions, and that socio‐behavioural research is needed to reinforce mask wearing (Clapham and Cook, 2021 ). A discrepancy between self‐reported and observed mask wearing was also observed in developing countries such as Bangladesh and Kenya (Abaluck et al ., 2021 ; Jakubowski et al ., 2021 ). Mask wearing became even more difficult to encourage when masks were associated with the expression of political opinions (Mello et al ., 2020 ) and led to refusal of masks by populist movements in several countries.…”

Section: Discussionmentioning

confidence: 99%

“…The observed small effects sometimes reflect a discrepancy between self‐reported and observed mask use. For example, a study assessing mask use in Kenya by phone survey versus direct observation revealed a vast gap between the two assessments (Jakubowski et al ., 2021 ). While only 12% of people admitted in phone interviews to not wearing a mask in public, 90% of people did not wear a mask when observed.…”

Section: The Benefits Of Wearing Face Masks – Interpretationmentioning

confidence: 99%

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Can a combination of vaccination and face mask wearing contain the COVID‐19 pandemic?

Brüssow

Zuber

2021

Microbial Biotechnology

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Summary The COVID‐19 pandemic is going into its third year with Europe again being the focus of major epidemic activity. The present review tries to answer the question whether one can come to grip with the pandemic by a combination of vaccinations and non‐pharmaceutical interventions (NPIs). Several COVID‐19 vaccines are of remarkable efficacy and achieve high protection rates against symptomatic disease, especially severe disease, but mathematical models suggest that the current vaccination coverage in many countries is insufficient to achieve pandemic control. NPIs are needed as complementary measures because recent research has also revealed the limits of vaccination alone. Here, we review the evidence for efficacy of face mask wearing in various settings. Overall pooled analysis showed significant reduction in COVID‐19 incidence with mask wearing, although heterogeneity between studies was substantial. Controlled trials of mask wearing are difficult to conduct, separating mask wearing effects in population studies from the impact of other NPIs is challenging and the efficacy of masks depend on mask material and mask fit. The combination of vaccination and mask wearing is potentially synergistic since vaccination protects so far well from disease development (the omicron variant is currently an unknown) but immunity from infection wanes over few months after vaccination. In comparison, masks interfere with the virus transmission process at a level of a physical barrier independent of coronavirus variant. Vaccination and masks are much less costly to apply than other NPI measures which are associated with high economic and social costs, but paradoxically both measures are the target of a vocal opposition by a sizable minority of the society. In parallel with biomedical research, we need more social science research into this opposition to guide political decisions on how to end the pandemic.

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Section: Discussionmentioning

confidence: 99%

Section: The Benefits Of Wearing Face Masks – Interpretationmentioning

confidence: 99%

Can a combination of vaccination and face mask wearing contain the COVID‐19 pandemic?

Brüssow

Zuber

2021

Microbial Biotechnology

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“…In Bangladesh, proper mask use remained very low, at around 10-20%, even after the government formally mandated mask use and threatened to fine those who did not comply (Abaluck and Mobarak 2020). An August 2020 phone survey in rural Kenya finds that while 88% of respondents claim to wear masks in public, direct observation in market centers revealed that only 10% actually did so (Jakubowski et al 2021).…”

Section: Mask-wearingmentioning

confidence: 99%

The Economics of the COVID-19 Pandemic in Poor Countries

Miguel

Mobarak

2022

Annu. Rev. Econ.

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The COVID-19 pandemic has upended health and living standards around the world. This article provides an interim overview of these effects, with a particular focus on low- and middle-income countries (LMICs). Economists have explained how the pandemic is likely to have different consequences for LMICs and demands distinct policy responses compared to those of rich countries. We survey the rapidly expanding body of empirical research that documents the pandemic's many adverse economic and noneconomic effects in terms of living standards, education, health, and gender equality, which appear to be unprecedented in scope and scale. We also review research on successful and failed policy responses, including the failure to ensure widespread vaccine coverage in many LMICs, which is needed to end the pandemic. We close with a discussion of implications for public policy in LMICs and for the institutions of international governance, given the likelihood of future pandemics and other major shocks (e.g., climate).

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“…Our main outcome measures are direct observations on a) whether a mask is visible and b) whether a mask is being worn properly (covering mouth and nose), as self-reports may overstate mask wearing [3]. Enumerators observed public spaces within villages from a safe distance and recorded the mask use, type and features of mask wearing by passer-by’s.…”

Section: Methodsmentioning

confidence: 99%

“…Although some recommendations are conflicting, evidence suggests that face masks may significantly reduce the spread of SARS-CoV-2 and numerous governments, including Kenya, have issued mask mandates for certain scenarios. However, questions remain on how to effectively promote mask adoption: Despite masks being mandatory, recent evidence shows less than 20% wear them at markets in Western Kenya [3].…”

Section: Introductionmentioning

confidence: 99%

Mask up! Testing strategies to increase mask usage in Kenya*

Egger

Jakubowski

Nekesa

et al. 2022

Preprint

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Background: COVID-19 continues to pose a major threat to countries around the world, and non-pharmaceutical interventions such as social distancing and face coverings remain important to reduce transmission, especially in settings with low vaccination rates. Despite a nationwide mask mandate in Kenya during the pandemic, proper masking remained low in Siaya County. We conducted a pilot study with the Siaya County Ministry of Health to improve mask adoption within Ugunja subcounty, and present initial findings on mask usage effects. Methods: The study took place across 72 villages in Ugunja subcounty, which were randomly assigned to receive: (i) free mask and education on mask usage; (ii) only education on mask usage; or (iii) no mask or education by community health workers. A role model intervention was also cross-randomized across half of the villages, along with SMS messages reinforcing a variety of messages around masking. The intervention was administered in January 2021. Data collection was done via phone survey and direct observation of mask usage. Findings: Preliminary analysis of the pilot study suggests providing free face masks may improve compliance, particularly in settings with higher COVID-19 risks. Two weeks to three months after the intervention, the free mask and education arm increased directly-observed correct mask usage by 3.1 percentage points (95% confidence interval 1.9, 6.0) on a control mean of 6.8 percent. Some treatment arms also improved COVID-19 knowledge and mask attitudes. Interpretation: Interventions designed to increase adoption of health measures can be successful, but behavioral change is challenging and may require frequent reinforcement.

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Self-reported vs Directly Observed Face Mask Use in Kenya

Abstract: Author Contributions: Drs Jakubowski and Egger had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 20 publications

References 4 publications

Can a combination of vaccination and face mask wearing contain the COVID‐19 pandemic?

Can a combination of vaccination and face mask wearing contain the COVID‐19 pandemic?

The Economics of the COVID-19 Pandemic in Poor Countries

Mask up! Testing strategies to increase mask usage in Kenya*

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