A population survey on behavioural insights on COVID-19 in Sri Lanka: A quantitative analysis on perceptions, behaviours, opinions, trust and affect to inform pandemic outbreak response

Abstract

Background The COVID-19 pandemic outbreak is placing insurmountable challenges and burden on health systems and authorities demanding responses with effective and appropriate policies and interventions. Wrong decision making, lack of foresightedness and preparation in the acute and transition phases can threaten the gains collectively achieved. Understanding the behaviours, perceptions and feelings of the population is imperative in management decisions. Not much evidence is available on such behavioural insights to inform the COVID-19 response in countries. This study is expected to contribute to the evidence-informed understanding on effective management of the outbreak.Methods This was a cross sectional observational study with entirely voluntary online participation. The study protocol and the questionnaire, originally prepared by a WHO collaboration, were adjusted to match the local setting and resource availability. The study explored 14 variables including perceptions, trust and behaviours in relation to COVID-19. Data was collected during the first wave of COVID-19 in early May 2020 and statistically analysed to see the associations and comparisons between chosen variables.Results N = 1001 with 65.63% from the age range 18–29 years and 65% from the non -health care worker category. Basic or postgraduate degree holders were 64.7%. Participants were from 23 out of the 25 districts in SL with 34.07% from high-risk districts. They were in general, knowledgeable (e.g., > 95% correctly identified common symptoms of COVID19) and majority (99.5%) reported conforming to the health recommendations. They trusted government health bodies including hospitals (90.8%) but majority (63.8%) had poor confidence in media in the ability to manage the outbreak. Stigma around COVID-19 was not a concern for the majority of 78.9%. Participants less than 30 years believed in conspiracies around COVID-19 more than older counterparts.Conclusion The perceptions, affect and behaviour of the study population gives insights on information dissemination, gaps in health message delivery, alternative approaches in responding and policy making helping to improve the pandemic response.