Knowing Versus Doing: Protective Health Behaviour Against COVID-19 in Aceh, Indonesia

Abstract

The COVID-19 pandemic shapes the lives of people around the globe – at the same time, people themselves have the power to shape the pandemic. By employing protective health behaviour, the population can alleviate the severity of an outbreak. This may be of particular importance whenever health systems or populations are vulnerable to shocks, as is frequently the case in low- and middle-income settings. Therefore, understanding the underlying drivers of protective action against COVID-19 is urgently needed for policy responses. We investigate the individual-level determinants of disease knowledge and behaviour in the context of the COVID-19 pandemic in Aceh, Indonesia. We use data from a representative sample of 40–70-year-olds, mainly obtained from telephone interviews between March and May 2020. We employ linear probability models that account for a comprehensive set of factors that were previously found to influence knowledge and practice during pandemics. We find that both knowledge and uptake of protective health behaviour are relatively high. Knowledge is the largest explanatory driver of protective health behaviour, while socioeconomics and economic preferences are minor determinants. However, knowledge itself is strongly shaped by socioeconomic gradients. On this basis, we show that policies need to disseminate information in an equitable way.

Acknowledgements

We thank the participants of the development economics seminar at the University of Goettingen and the Aceh International Nursing Conference at the Syiah Kuala University for fruitful discussions and comments on the project. We thank in particular the dedicated enumerators from Syiah Kuala University as well as student research assistants from University of Goettingen.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics statement

The study received ethical clearance from the ethics commission at the University of Goettingen and Syiah Kuala University.

Data availability

The data that support the findings of this study are available in Goettingen Research Online at DOI 10.25625/SKTLZV.

Supplementary Materials

Supplementary Materials are available for this article which can be accessed via the online version of this journal available at https://doi.org/10.1080/00220388.2021.1898594.

Notes

1. For willingness to take risks, this is assuming that the protective behaviour is perceived as the ‘safer’ lottery.

2. Exact inclusion criteria: no previous diabetes or hypertension diagnosis, no diabetes screening during the previous year, and not in regular care for another disease at the time of the baseline interview.

3. The components consist of 10 assets that were found to be most influential when determining the same asset index in SUSENAS 2017 for the two sample districts: ownership of a gas cylinder, refrigerator, PC, TV, jewellery, AC, car, improved latrine, motorbike, and improved drinking water.

4. Even though the question was deemed appropriate during pre-testing, four days into the data collection, enumerators reported that this question caused distress in some respondents, who had just lost their livelihood. Hence, we excluded it immediately thereafter.

Additional information

Funding

This work was supported by the DFG German Research Foundation under Grant RTG 1723: Globalization and Development.