The South African public’s perception of its government’s response to the Covid-19 pandemic was the third most favourable in an international survey of severely affected nations, behind China and South Korea and just ahead of India and Germany, reports MedicalBrief.
The Barcelona Institute for Global Health (ISGlobal), in coordination with the City University of New York Graduate School of Public Health (CUNY SPH) and other international institutions, has developed an easy and reliable tool to evaluate the public perception of governmental response to the COVID-19 pandemic. According to an analysis of the first results obtained across 19 countries, the COVID-SCORE questionnaire can help public health officials and other decision makers identify and correct weaknesses in key aspects of a country’s response, and track trends as the pandemic evolves.
Government response to the COVID-19 pandemic has varied considerably between countries. Although most governments have implemented a series of common measures such as mobility restrictions, closure of businesses, places of worship and schools, or shelter-at-home orders, the timing and approach have differed. One key element that determines the course of a pandemic is society’s compliance with such measures, which in turn depends on several factors such as trust in government or the clarity of the information that government sources provide.
“We need basic tools to help us assess the public perception of government responses in key aspects such as communication, or access to health services and social welfare,” says Jeffrey V Lazarus, researcher at ISGlobal. Together with international colleagues, Lazarus coordinated the development of COVID-SCORE with 10 items related to key aspects of the government response, to be rated by the interviewees.
The study Lazarus and his colleagues published validates the tool and presents the first results from a survey conducted in June 2020 with over 13,400 participants from 19 countries heavily affected by the pandemic. The average score varied considerably between countries – from 35.76 out of a maximum of 100 for Ecuador to 80.48 for China, the country whose response was rated most positively. Countries in Asia tended to have higher scores, while Latin-American and European countries were among those with lowest scores.
As expected, the average score for a country was strongly associated with the level of trust in government, as reported in this survey and measured independently by the Wellcome Global Monitor.
“We know that public compliance with preventive measures greatly depends on the trust in public health experts, health systems and science,” says Ayman El-Mohandes, dean of CUNY SPH. Higher COVID-19 mortality or a greater percentage of respondents directly affected by the disease correlated with a lower score for the country, the researchers found.
The average score for the US, with 773 respondents, was 50.57. Highest rated (3.16 out of 5) was the government’s assistance with income, food, and shelter during the pandemic: this finding corresponds with the timing of the survey, which took place soon after the initial emergency funds were distributed last spring. Notably, the US ranked seventeenth among the 19 countries surveyed with regard to government cooperation with other countries and international organisations such as the WHO (3.03 out of 5). Spain, with 748 respondents, obtained an average score of 44.68. The highest-rated item was relative to the government’s cooperation with other countries and international organisations such as the WHO (3.46 on a 1 to 5 scale), while the lowest-rated item was access to free and reliable COVID-19 testing in case of symptoms (2.09).
In all countries, questions about protection and assistance to vulnerable groups and help in meeting daily needs for income, food and shelter rated poorly, which underscores the need to give particular attention to the most vulnerable. Provision of mental health services was the lowest-rated item across all countries.
“This tool is easy to implement and can guide researchers and authorities in designing measures to better control the pandemic,” says El-Mohandes. In addition, it can be done at different moments to assess the response as the pandemic evolves.
Average Score by Country
South Korea 74.54
South Africa 64.62
United States 50.57
United Kingdom 48.66
Background: Understanding public perceptions of government responses to COVID-19 may foster improved public cooperation. Trust in government and population risk of exposure may influence public perception of the response. Other population-level characteristics, such as country socio-economic development, COVID-19 morbidity and mortality, and degree of democratic government, may influence perception.
Methods and findings: We developed a novel ten-item instrument that asks respondents to rate key aspects of their government’s response to the pandemic (COVID-SCORE). We examined whether the results varied by gender, age group, education level, and monthly income. We also examined the internal and external validity of the index using appropriate predefined variables. To test for dimensionality of the results, we used a principal component analysis (PCA) for the ten survey items. We found that Cronbach’s alpha was 0.92 and that the first component of the PCA explained 60% of variance with the remaining factors having eigenvalues below 1, strongly indicating that the tool is both reliable and unidimensional. Based on responses from 13,426 people randomly selected from the general population in 19 countries, the mean national scores ranged from 35.76 (Ecuador) to 80.48 (China) out of a maximum of 100 points. Heterogeneity in responses was observed across age, gender, education and income with the greatest amount of heterogeneity observed between countries. National scores correlated with respondents’ reported levels of trust in government and with country-level COVID-19 mortality rates.
Conclusions: The COVID-SCORE survey instrument demonstrated satisfactory validity. It may help governments more effectively engage constituents in current and future efforts to control COVID-19. Additional country-specific assessment should be undertaken to measure trends over time and the public perceptions of key aspects of government responses in other countries.
Jeffrey V Lazarus, Scott Ratzan, Adam Palayew, Francesco C Billari, Agnes Binagwaho, Spencer Kimball, Heidi J Larson, Alessia Melegaro, Kenneth Rabin, Trenton M White, Ayman El-Mohandes
IS Global material
PLOS ONE abstract