Antonella Bancalari

There remains limited evidence on the instruments that facilitate or counteract misinformation, especially in lower-income contexts. We study microtargeting, an approach used by political parties throughout the world to influence voters. The development of the COVID-19 pandemic in India provides a unique setting as the surge in misinformation was accompanied by the prevalence of misconceptions based on religious identity, a politically-salient dimension. We implement a field experiment in a population at high risk of misinformation – slum residents – by randomly allocating participants to receive on their mobile phones messages introduced by a local citizen, the messenger, and in which doctors debunk misconceptions. We randomly vary the signaled religious identity of the messenger into either Muslim or Hindu, guaranteeing exogenous variation in religion concordance with the recipient. Doctor messages are effective at increasing citizens’ knowledge, but misconceptions are affected only in presence of religion concordance and for religious-salient misconceptions.

We implement a randomized controlled trial and a qualitative study to assess whether, and if so how, behavioral change can be sustained. We do so in the context of Pakistan’s national sanitation strategy to combat open defecation, Community-Led Total Sanitation. Our findings demonstrate that continued follow-up activities that build on the original intervention lead to only modest reductions in reversal to unsafe sanitation on average, but gain in importance where initial conditions are unfavorable, i.e. poor public infrastructure and sanitation facilities. Promotion efforts are hence best targeted towards those who face larger difficulties in constructing and maintaining high-quality sanitation. The effects were sustained at least one year after the implementation of activities.

As vaccination campaigns are deployed worldwide, addressing vaccine hesitancy is of critical importance to ensure sufficient immunization coverage. We analyzed COVID-19 vaccine acceptance across 15 samples covering ten low- and middle- income countries (LMICs) in Asia, Africa, and South America, and two higher income countries (Russia and the United States). Methods Standardized survey responses were collected from 45,928 individuals between June 2020 and January 2021. We estimate vaccine acceptance with robust standard errors clustered at the study level. We analyze stated reasons for vaccine acceptance and hesitancy, and the most trusted sources for advice on vaccination, and we disaggregate acceptance rates by gender, age, and education level. Findings We document willingness to take a COVID-19 vaccine across LMIC samples, ranging from 67% (Burkina Faso) to 97% (Nepal). Willingness was considerably higher in LMICs (80%) than in the United States (65%) and Russia (30%). Vaccine acceptance was primarily explained by an interest in personal protection against the disease (91%). Concern about side effects (40%) was the most common reason for reluctance. Health workers were considered the most trusted sources of information about COVID-19 vaccines. Interpretation Given high levels of stated willingness to accept a COVID-19 vaccine across LMIC samples, our study suggests that prioritizing efficient and equitable vaccine distribution to LMICs will yield high returns in promoting immunization on a global scale.