Informing Covid-19 preparedness in Sierra Leone

As Covid-19 continues to spread, governments in West Africa have been working to meet the virus head-on. In Sierra Leone, the government took measures back in January to quarantine all travelers from countries reporting Covid-19 cases and travelers with high temperatures. With limited public health infrastructure, slowing the spread has been critical to protecting their population of nearly 8 million. In late March, Sierra Leone confirmed the first case in-country, put in place a temporary lockdown, and convened development partners for Covid-19 preparedness and response

A successful response to Covid-19 requires not only financial and technical resources, but also the efficiency and insights that real-time data bring to the process. 

That’s why the MIT Governance Lab (MIT GOV/LAB) and the Institute for Governance Reform (IGR), in partnership with Sierra Leone’s Directorate of Science, Technology and Innovation and Ministry of Finance’s Research and Delivery Division, launched a nationally-representative survey on April 11 to gather critical information to measure people’s understanding of the virus, perceptions of how to prevent spread, and also the prevalence of misinformation across every district in the country.  

“It is important to us as a government that we understand what our people know and their ability to effectively respond to and support us in any interventions we plan in this fight against Covid-19” says David Moinina Sengeh SM ’12, PhD ’16, Sierra Leone’s minister of education and chief innovation officer. 

Initial results show that awareness of Covid-19 is high. Nearly 98 percent of respondents heard of the virus and 80 percent correctly named coughing as a symptom. Despite this good news, nearly half of respondents (43 percent) didn’t know fever is a symptom, and only 15 percent said they would self-isolate if they or a family member caught the virus or showed symptoms. Accurate and trustworthy messaging about the virus will be critical to ensure citizens are educated to take proper preventative action.

The survey sought to further understand how vulnerable and poor households will be able to withstand a potential lockdown. Preliminary data were grim, showing that most people (60 percent of respondents) say that they could not sustain a lockdown of more than three days at a time. Importantly, food insecurity was high, with only 12 percent of respondents saying they can prepare one week or more of food. The survey also gathered information on health and security, community engagement, trust in government, and the sources of news and information that people trust. 

Early results shared with government have already been taken up, Sengeh notes. “As part of the evidence-based and data-driven policymaking process used by the Presidential Taskforce on Covid-19, the results of this survey were used in combination with other evidence across government and from partners to design Sierra Leone’s lockdown framework.”

The results aim to rapidly inform the distribution of emergency resources, especially to address health, food security, and policy compliance issues. Since emergency responses are coordinated from the central government, understanding each district’s needs has been critical for developing evidence-based action plans. 

This partnership builds on IGR’s local research experience, including a rapid assessment of Sierra Leone’s preparedness for Covid-19 and MIT GOV/LAB’s experience in the region designing high-quality surveys that can be done safely and rolled out quickly. Based on both organizations’ experiences during the Ebola epidemic, the survey was been carefully designed to minimize and mitigate risks of person-to-person spread. Multiple rounds of survey responses will be able to provide data over the course of the pandemic.