WEEK 2 – Rapid Survey on COVID-19 behaviors, social, and economic impact on communities in Bone District, South Sulawesi, Indonesia

UNTUK VERSI BAHASA INDONESIA, SILAKAN KUNJUNGI TAUTAN INI: LINK

Weekly Findings Report 

Week 2, 27-30 April 2020

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Snapshot of Findings

• Cases (30 April 2020): In Bone, this week saw the first 4 positive cases confirmed. 19,033 people tested, 9 under treatment (PDP), 297 under surveillance (ODP); and 8,562 at risk (ODR). Source: Gugus Tugas.
• Survey total of 122 participants, data collected from 27-30 April 2020.
• Health behaviors. Use of fabric face masks increased from 74.2% to 90.2%, use of medical masks decreased from 19.1% to 9.8%. Reported hand washing with soap increased from 85.4% to 96.7%.
• Social distancing. Those going out every day increased to 27.9%. Those who went out at least 1-2 times a week increased to 98.4%. Only 1.6% did not go out at all, a decrease from last week. 62.3% kept a distance of 1 meter from other people, while 41% asked other people to stay at least 1 meter away. 
• Economic impacts. Respondents reporting less income increased 44.9% to 50.0%. Those having difficulty meeting daily needs increased from 42.7% to 50.0%, and more lost their jobs, increasing from 7.9% to 12.3%.
• Social support received. More has been received, although 68% still had received nothing, 18% (a 2% increase) received government help; 18% from community organizations (e.g., RT, RW, PKK) and 2.5% from NGOs.
• Social support given increased. 22.1% fundraised; 25.4% distributed donations; 18.9% donated to community organizations; and 16.4% became volunteers.
• Social and personal impacts. More people fear infection by/of other people, increasing to 68.9%. Those feeling stressed or angry increased by 4.5% to 31.5%.
• Communication channels. Information on COVID-19 from television was high (88.5%) and considered the most reliable channel (69.7%). The most reliable source of COVID-19 information was the national government (68.9%).
• Information still needed. 54.9% need fact checking of hoaxes and misinformation; and 53.3% wanted information on available health services.

1. Background

Coronavirus disease 2019 (COVID-19) is a virus first identified in China and reported to the WHO in December 2019. In January 2020, the WHO declared COVID-19 a global health emergency. Most people only experience mild respiratory illness symptoms. However, some people can experience severe symptoms, including pneumonia, resulting in lung damage and death. COVID-19 is more dangerous for older people and those with pre-existing medical conditions, such as diabetes, high blood pressure and heart disease. The first case was reported in Indonesia on 2 March 2020 and on 13 April the government declared a national disaster. On 10 April, the government initiated a Large Scale Social Restrictions (PSBB) policy, including closing schools, workplaces, restricting movement and closing public places. The local, Indonesian and global effects of COVID-19 have an impact on people’s lives, families, communities and economies.

Bone consists of 27 kecamatan (sub-district), 335 desa (villages), with Watampone as the capital. Bone has 751,026 people, the most populous in South Sulawesi Province. By 30 April 2020, a total of 19,033 people have been tested with four (4) confirmed cases; 9 patients under treatment (Pasien Dalam Pengawasan/PDP); 297 under surveillance (Orang Dalam Pantauan/ODP); and 8,562 people at risk (Orang Dalam Risiko/ODR) (COVID-19 Task Force). Health promotion efforts include cleaning with disinfectant, distribution of face masks, and hand sanitizer. In 2019, as part of its BERANI program, UNICEF commissioned Tulodo to manage a project in Bone to prevent child marriage and improve menstrual health. The project staff and networks are being used to implement this study.

2. Objectives

This study aims to answer the question: what is the impact of the Covid-19 pandemic in Indonesia over time? It explores how communities have responded, including any changes in health behaviors (e.g., use of face masks, practicing handwashing with soap, and social distancing) and how this outbreak has affected their economic status. We also explore their exposure to communication channels and campaign messages. This study also provides recommendations for partners and stakeholders in Bone to consider.

3. Methodology

This cross-sectional study uses a mix of quantitative and qualitative methods, conducted weekly from 23 April to 15 May 2020. This enables us to track changes from week to week and also over the life of the study. The quantitative survey is conducted via phone and online. We use snowball sampling methods to recruit participants via phone, while for online we distribute it through our partners. The total target sample is 450 respondents. For the qualitative study, we conduct 15 interviews via phone.

4. Results

Below are the results from the second week of data collection (27-30 April 2020). A total of 122 respondents joined the study (45 via phone and 77 via online). These results are preliminary and subject to change.

4.1 Sample characteristics

• Location. 17.2% (n=21) from Tanete Riattang Barat sub-district, 10.7% (n=13) each from Tanete Riattang and Salomekko.
• Gender. 47.5% female, 52.5% male.
• Age. 31.1% aged 31-40 years; 23% aged 21-30 years; 20.5% aged 51-60 years; 17.2% aged 41-50 years; 5.7% aged 11-20 years, 1.6% aged above 70 years; and 0.8% aged 61-70 years.
• Breadwinner. Father (68%), mother (14.8%), other adult males (8.2%), and other adult females (2.5%).
• Education. 7.4% (n=9) completed elementary school, 3.3% (n=4) junior high school, 26.3% (n=32) senior high school, 60.7% (n=74) university/college, and 0.8% (n=1) no school.
• Income. 36.1% (n=44) had permanent jobs, 20.5% (n=25) said crop sales. 69.7% (n=85) received less than Provincial Minimum Wage (UMP).  Upah Minimum Provinsi (UMP) in South Sulawesi is IDR 2,860,382 (USD200) per month.
• Government support. 5.7% (n=7) received goods from government agencies, 2.5% (n=3) received cash, 6.6% (n=8) received services, and 85.2% (n=104) received nothing. Of those who received support, 22.2% received Beras Sejahtera (Rastra) rice allowance; 22.2% received Program Keluarga Harapan (PKH) cash payments; 5.6% received support from Asistensi Sosial Lanjut Usia Terlantar (ASLUT) program; 27.8% were registered on the Healthy Indonesia Card (KIS) program; and 27.8% were registered on the Kartu Indonesia Pintar (KIP) program.
• Elderly. 32% said there was one elderly person in the household; 14.8% had two elderly people, and 2.4% said there were three or more.

4.2 Behaviors

Figure 1. Social distancing behaviors

• Handwashing practice. 88.5% (n=108) washed their hands after doing activities outside the house, 68.9% (n=84) before/after eating and drinking, 59.8% (n=73) after handling goods from outside, 29.5% (n=36) after sneezing and coughing, 32.8% (n=40) after shaking hands, 39.3% (n=48) after using the toilet, and 30.3% (n=37) before/after preparing food. 
• Handwashing tools. hand washing with soap increased from 85.4% to 96.7%. 12.3% (n=15) used running water, 41% (n=50) used hand sanitizer (an increase of 8.7%), and 16.4% (n=20) wiped hands using cloth/tissue.
• Face masks. Use of fabric face masks (non medical) increased from 74.2% to 90.2% (n=110), while use of medical masks decreased from 19.1% to 9.8% (n=12).
• Social distancing. Those who kept a distance of 1 meter from other people have increased from 42.7% to 62.3%. 41% (n=50) asked other people to stay at least 1 meter away, 17.2% (n=21) asked others to wear a face mask, and only 33.6% (n=41) provided someone with a face mask. 21.3% (n=26) did not change any behavior. 
• Outside activities. Those going out at least 1-2 times a week increased from 97.7% to 98.4%. 43.4% (n=53) went out at least 1-2 times a week, 27.9% (n=34) went out every day, 27% (n=33) 3-5 times a week, and 1.6% (n=2) did not go out at all.

4.3 Impact of COVID-19

• Employment. Those working from home increased from 32.8% to 33.6% (n=41). 23.8% (n=29) worked as usual, 22.1% (n=27) temporarily did not work, 20.5% (n=25) worked as usual but with restrictions, e.g.: changes in work schedules or shifts.
• Income. More people reported less income, increasing from 44.9% to 50.0% (n=61). 20.5% (n=25) reported no income (IDR 0), and 29.5% (n=36) said the same income.
• Feeling isolated. Less people felt isolated, decreasing from 67.4% to 63.9% (n=78). 22.1% (n=27) reported sometimes feeling isolated.
• Other impacts. More people had difficulty meeting daily needs, increasing from 42.7% to 50.0%, and more lost their jobs, increasing from 7.9% to 12.3% (n=15). 49.2% (n=60) said their revenue has decreased, 28.7% (n=25%) felt stressed or angry, 68.9% (n=84) feared infection by/of other people; 27% (n=33) were afraid of being isolated (due to infection), 29.5% (n=36) reported being away from family.

“I live with my mother (aged above 60 years). We always watch TV together so that we can update the information (about COVID-19). My mother does not access social media, so I always tell her about the latest updates from social media. Her main information source of COVID-19 is just TV” (Female respondent, 32 years, Salomekko).

4.4 Communications

• Exposure to COVID-19 related information. Those receiving information from television increased from 85.4% to 88.5% (n=108). Exposure to social media also increased from 73.0% to 77.0% (n=94). 54.9% (n=67) from online articles, 32.8% (n=40) from banners/posters, 30.3% (n=37) from mosques, 20.5% (n=25) from “mobil keliling”. 8.2% (n=10) from radio, 13.9% (n=17) from newspapers, 20.5% (n=25) from SMS, and 17.2% from pamphlets. Of those who mentioned social media, 88.3% (n=83) received information from WhatsApp, 81.9% (n=77) from Facebook, 29.8% (n=28) from Instagram, 39.4% (n=37) from YouTube, whilst 5.3% (n=5) from TikTok.
• Source of information. 85.2% (n=104) said their information was from national government, 73.8% (n=90) from provincial/sub-district government, 73.8% (n=69) from the village government, 33.6% (n=41) from religious leaders, 39.3% (n=48) from family members, 41% (n=50) from friends, and 26.2% (n=32) from neighbors.
• Most reliable information channels and sources. 69.7% (n=85) said television was the most reliable, whilst 13.9% (n=17) said online articles. The most reliable source was national government (68.9%, n=84) and provincial/district government (17.2%, n=21).
• Information still needed. 25.4% (n=31) said they need information about which types of face masks should be used; 41% (n=50) said the virus transmission; 42.6% (n=52) said the number of cases; 53.3% (n=65) wanted available health services; 27.9% (n=34) said hand washing practice; 43.4% (n=53) on the large-scale social restrictions (PSBB); 35.2% (n=43) on the lockdown areas, 54.9% (n=67) need fact checking of hoaxes and misinformation. Only 20.5% (n=25) need information about making face masks, 25.4% (n=31) on making hand sanitizer; 23.8% (n=29) about mental health; and 7.3% (n=9) information when this corona ends.

4.5 Social support given and received

• Social support received. 68% (n=83) never received any support, 18% (n=22) received government support; 18% (n=22) received community organization help (e.g., RT, RW, PKK) and 2.5% (n=3) received NGO support. Of those who received support, 75% (n=30) received face masks, 20% (n=8) received hand sanitizers, 32.5% (n=13) said groceries (food), and 10% (n=4) received other support (internet, electricity, gas or free water).
• Social support given. 50% (n=61) did not contribute to social support, 22.1% (n=27) collected donations or fundraised; 25.4% (n=31) distributed donations to beneficiaries; and 18.9% (n=23) donated to community organizations; 16.4% (n=20) became volunteers. Of those who gave social support, 49.3% (n=33) distributed masks, 14.9% (n=10) distributed hand sanitizer, 9% (n=6) distributed vitamins and supplements, 32.8% (n=22) distributed groceries (food), 25.4% (n=17) distributed cash, and 4.5% (n=3) distributed other things (internet, electricity, gas or free water).

Figure 2. Types of social support received

5. Recommendations

This week saw the first confirmed cases of COVID-19 in Bone, this is likely to have an impact on perceptions of vulnerability and fears for the future. To manage the impact of the virus, these are the priority recommendations for stakeholders in Bone to consider:

• Targeting elderly. More than 49% of households reported one or more elderly people aged above 60 years. Consider the right communication channels and materials targeting elderly people as they are more vulnerable to COVID-19. 
• Focus on social distancing behavior change activities. More people went out than last week, 98% at least once a week with 28% going out every day. Emphasis should be placed on staying at home, including economic incentives, such as wage subsidies and food, as well as disincentives, such as fines and warnings.
• Decreases in income and employment require intensive responses. While more support has been delivered, 68% have still not received anything. Existing programs can be used, such as KUBE, PKH, Rastras, KIS etc. Support, including labor intensive projects and microcredit, should be delivered through local channels, e.g. PKK, BKMT, farmer and fisher groups.
• Counter hoaxes. More than half (55%) asked for fact checking of hoaxes and misinformation. Social media was the second most popular source of COVID-19 information (77%) with around 88% receiving it from WhatsApp and 81.9% from Facebook. It is important to inform communities to check the information received. Regular cyber patrolling is needed by the police and Communication Office. Bone’s COVID-19 website (covid19.bone.go.id) can be used to counter hoaxes.

Dowload report: Findings Report Covid19-W2-4May2020

The third wave of data collection will be conducted from 4-8 May 2020. We will update the report on a weekly basis.

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References

Gugus Tugas Penanganan Covid-19. (2020). Update data Penanganan COVID-19 Kabupaten Bone. dated 23 April 2020: https://bone.go.id/2020/04/23/update-data-penanganan-covid-19-kabupaten-bone-kamis-23-april-2020-pukul-20-25-wita/

Liu, K., Chen, Y., Lin, R., & Han, K. (2020). Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. The Journal of infection, S0163-4453(20)30116-X.

Sani, T.P., Mariska, S,., Prasetya, V.G.(2020), How vulnerable are the elderly to COVID-19? https://alzi.or.id/how-vulnerable-are-the-elderly-to-covid-19/