Tapping into well-held beliefs to change public behaviour

On May 16, Bill Foege, former director of the Centers for Disease Control who worked on the smallpox eradication programme, made a case for taking lessons from small pox in the fight against COVID-19. Incidentally, around the same time, the State government released an ad, urging the public to look at COVID-19 like they would pox (ammai).

However, it is no casual coincidence, because one of the cornerstones of public health practice is believed to be behaviour change communication – enabling people to see the health benefits of modifying their behaviour. As WHO Chief Scientist Soumya Swaminathan, tweeting recently, said, “Communicating the facts in an easy-to-understand manner for the public and community participation in response are key.”

Faced with rising numbers and non-conformity to recommended personal hygiene strategies against COVID-19, the State seems to be tapping into well-entrenched community beliefs in order to get people to follow these practices.

In the ad, an elderly woman pooh-poohs the idea of COVID-19 as a spectre, saying she has already encountered pox (ammai). She says all one has to do is to treat the current pandemic in the same manner as one would pox - following the same hygiene practices. She spells them out: maintaining distance from the patients, not using their personal belongings, ensuring good sanitation practices at home, including frequent washing, and avoiding walking into patients’ homes.

The areas with higher numbers tend to be in dense urban clusters, including in, but not exclusive to, urban slums and housing board quarters, where a number of people live.

“In Tamil Nadu, there is great reverence and awe that surrounds pox; chicken pox is treated as ammai - as a curse of the goddess and nearly everyone tries to make sure that they follow certain practises strictly. It’s not a belief that comes out of a scientific understanding, but we thought we could capitalise on this innate belief,” says an official, reasoning that COVID-19 transmission is heavily dependent on people changing their habits to reduce risk.