Health knowledge and non-pharmaceutical interventions during the Covid-19 pandemic in Africa

Anne Fitzpatrick, Sabrin Beg, Laura Derksen, Anne Karing, Jason Kerwin, Adrienne M. Lucas, Natalia Ordaz Reynoso, Munir Squires

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Providing health information is a non-pharmaceutical intervention designed to reduce disease transmission and infection risk by encouraging behavior change. But does knowledge change behavior? We test whether coronavirus health knowledge promotes protective risk mitigation behaviors early in the Covid-19 pandemic in samples from four African countries (Ghana, Malawi, Sierra Leone, and Tanzania). Despite reputations for weak health sectors and low average levels of education, health knowledge of the symptoms and transmission mechanisms was high in all countries in the two months after the virus entered the country. Higher knowledge was associated with increased protective measures that would likely lower disease risk with one exception–knowledge was inversely correlated with social distancing. Respondents largely adhered to mask mandates and lockdowns, but continued coming into contact with others at small, informal gatherings, gatherings not affected by mandates. Knowledge alone did not reduce all risky activities, especially gatherings within other people's homes. Even early in the pandemic, income loss or stress were commonly reported. Our results suggest that early and consistent government provision of health information likely reduced the initial severity of the pandemic in Africa but was not a panacea.

Original languageEnglish (US)
Pages (from-to)33-53
Number of pages21
JournalJournal of Economic Behavior and Organization
StatePublished - Oct 1 2021

Bibliographical note

Funding Information:
We gratefully acknowledge generous funding from the Sandra Rotman Centre for Health Sector Strategy, the Joseph P. Healey Research Grant, the Canada Excellence Research Chairs program awarded to Dr. Erik Snowberg in Data-Intensive Methods in Economics, Co-Impact through a Jameel Poverty Action Lab (J-PAL) sub-award. For excellent research management and assistance we thank Henry Atimone, Charlotte Burlingame, and Heather Wong. We thank the entire field team in each country for their efforts in completing these surveys. We thank Marcella Alsan, Emily Beam, Janet Currie, Alan de Brauw, David Molitor, Kosali Simon, and Laura Wherry for helpful comments. All errors are our own.

Publisher Copyright:
© 2021 Elsevier B.V.


  • Coronavirus
  • Health behaviors
  • Lockdowns
  • Non-pharmaceutical interventions
  • Pandemics
  • Risk mitigation


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