Addressed to:

  1. Chairman of National Security Council/ COVID-19 Presidential Task Force
  2. Public Health National Emergency Operations Center (EOC)
  3. Mayors of Local Council Governments
  4. Development Partners

Summary

Sierra Leone’s implementation of mandatory wearing of face masks in public spaces has so far resulted in low compliance by the general public. Evidence suggests that citizens’ compliance is low and is characterized by only a need-to-access-public-place basis. Although low public compliance, particularly in Freetown, is inherently due to challenges with voluntary behavior change, most, however, are attributed to lack of clear policy objective and lack of a clear-cut road map for policy implementation that is informed by research data, communication, and behavior intervention design. This analysis examines an alternative policy to ensure maximum community adoption of facemasks in Sierra Leone. The alternative is assessed on its ability to meet the following policy goals: 1) ease of enforcement that supports universal adoption of face masks 2) community ownership through an opportunity for citizen agencies to enforce the use of face masks in public spaces. 3) opportunity for community-wide awareness and education.

What are the Symptoms of the Problem?

The use of face masks by the public has been recommended by the Center for Disease Control (CDC)[1] as a measure to protect and limit community-wide transmission of coronavirus. Similarly, the government of Sierra Leone on April 22nd, 2020, proclaimed a mandatory use of cloth face masks in all public spaces[2] as part of its nationwide COVID-19 measure to limit the transmission of the virus. However, a quantitative and qualitative study conducted between April 15th and May 2nd, 2020, showed a gap in knowledge and general low compliance on the use of face masks in public spaces. Specifically, 92% of market women who participated in a survey across seven main markets in Freetown urban municipality, do not use face masks[3]. A recent study involving beach bars revealed very low compliance[4]. Furthermore, ethnographic study of people in public spaces especially, at Banks and government offices, has proven that most people only use face masks to access public spaces but afterward remove them. In addition, observation of 100 public transportation vehicles revealed low compliance on the use of face masks by commuters or passengers, with at most an average of only four people wearing facemasks in a twenty-seater poda-poda and an average of one person wearing a facemask in a taxi or keke.

What are the Policy Goals?

What policy should govern the use of face masks in public spaces? This brief proposes ease of enforcement that supports national adoption of face mask, community ownership through an opportunity for independent citizen agency to enforce the use of face mask in public spaces, an opportunity for community-wide awareness and education as prime policy goals.

The lack of clear policy goals for the use of face masks correlates with low compliance on public use of face masks. An alternative policy goal that deliberately enforces universal adoption of the use of face masks is crucial in limiting community-wide transmission of the virus. With 78% of people with coronavirus being asymptomatic[5], and given the congested nature of public spaces especially in Freetown, a policy that focuses on capturing the wider public rather than people who go to government offices and banks is crucial to limiting community-wide transmission of the virus. This alternative policy is interested in implementing a community design strategy that supports community involvement and behavioral change to ensure high public compliance on the use of face masks. The policy also looks at opportunities for effective public education on the proper use of face masks to prevent community-wide transmission of coronavirus.

Possible Policy Alternative

Maintaining current policy on the use of facemask is not effective in promoting community-wide use of facemasks. The government of Sierra Leone, through its various implementation bodies on COVID-19, should seek to adopt an alternative policy that:

1. Makes mandatory use of face masks by all drivers and passengers in all private and public transportation vehicles and motorcycles. Research evidence through ethnographic studies of public spaces suggests that the success of community-wide adoption of the use of facemasks will be achieved by making use of face masks by the public as a public road safety regulation. That is, mandatory use of facemask by all passengers in public and private vehicles and motorcycles will be most effective in capturing wide community use of face masks and also effective in encouraging behavioral change. An alternative policy like this is designed by taking into consideration citizens’ frequent and daily use of public transport to move from place to place. The frequency of use of transportation systems by the public, especially in Freetown, will enhance a quick behavioral change/adaptation to the use of facemask and will also make enforcement easier for authorities.

2. Road safety and security personnel such as Sierra Leone Police (SLP) and Sierra Leone Road Safety Authority (SLRSA) can use the new policy to enforce compliance of the use of facemasks by all automobiles. This can be implemented through the inspection of vehicles for 100% compliance. Inspection of all automobiles should be done at major junctions with space for temporary parking of vehicles in order to accommodate further policy action for vehicles that may default on 100% compliance by passengers.

3. Defaulters (motorists and passengers) who violate road safety rules by not having a 100% compliance can be asked by road safety officers to park their vehicles for further actions. Action by road safety officers can be in the following order:

a. use a government approved sensitization material on coronavirus and educate passengers on the benefits of the use of facemasks in public spaces.

b. donate facemasks to passengers who do not have one. Distribution should be done in the most hygienic fashion.

c. Warn drivers, apprentices, and riders who default for the first time, and with a levied fine on second default.

Conclusion

Developing policy for coronavirus prevention in Sierra Leone should be informed by local community centered design interventions that apply directly to the social context and way of life of the people. With high population density in major cities in Sierra Leone, especially, Freetown; the government and all its partners should consider an alternative policy on the use of face masks in public spaces. Disregarding the urgent need for a new policy will risk wide community transmission of coronavirus in Sierra Leone. An effective policy with a sound objective and a clear-cut plan for implementation will have community design at the center and will have desirable outcomes for community-wide prevention of coronavirus. In earnest, consistent and robust enforcement of this alternative policy for one week will result in high compliance on the use of face masks and a likelihood of more people habitually using face masks in public spaces.

[1] https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

[2] ]https://www.facebook.com/mic.gov.sl/photos/a.310063372915015/615863632334986/?type=3&theater

[3] http://gaptracker.bushtinker.org/resultsformarketwomen/

[4] http://gaptracker.bushtinker.org/covid-19-gap-tracker-results-for-freetown-aberdeen-lumley-beach-bars-and-resturants/?et_fb=1&PageSpeed=off

[5] https://theconversation.com/coronavirus-bmj-study-suggests-78-dont-show-symptoms-heres-what-that-could-mean-135732