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The Nigerian government, like those of most other countries, is trying to protect their population from COVID-19 while staving off economic collapse. Most decisions require trade-offs, as delivering on one can mean jeopardising the other, particularly for majority of the population who survive on low incomes and have minimal access to support. Public, private and third-sector responses must navigate these stark choices, recognising if they are unable to help their vulnerable populations survive both the public health and economic crises, progress could be handicapped for a generation.

Key insights 

  • High burdens and restrictions on health facilities during the pandemic, limits on the number of appointments, along with the fear and stigma of being diagnosed with COVID-19, have deterred many people from accessing healthcare."
    FOCUS ON COVID-19 PATIENTS When COVID-19 first hit Mali, people were reluctant to go to hospitals and health centers out of fear of contracting the virus and its stigma. As time went on, people's fear reduced, and they began to resume going into health centers. However, many hospitals and medical centers have diverted their resources towards responding to COVID-19, and people reported not being able to access routine services, like free mosquito nets and vaccinations.[13] Mali has just 0.6 health personnel for every 1,000 people, and resources are unevenly distributed across regions (for instance, Bamako has nearly 2 staff per 1,000, compared to less than 0.3 in Taoudénit, Sikasso, Gao, and Mopti).[14] Even before the pandemic, more than 241 health centers had closed or become non-operational due to insecurity in Burkina Faso, Mali, and Western Niger regions.[15] The presence of COVID-19 has only added to the health system's existing burden. ALTERNATIVE TREATMENT OPTIONS The closure and repurposing of health facilities during the pandemic have made accessing healthcare more onerous. For instance, people reported having to take a ticket for a consultation, wait in long queues, or go to the facility early in the morning to get guaranteed care and attention. These factors deter people from seeking care at health facilities. People either delay treatment or don't get it at all, with some choosing to rely on traditional medicine or unproven home remedies instead.
  • People see the government as a reliable source of information on COVID-19 precautions, as interventions support the precautions. However, there is little trust in the government’s economic announcements, which many regard as empty promises. Most people seek out their information through TV and radio and rely on their community peers, even though this contributes to the spread of misinformation."
    INFORMATION FROM GOVERNEMENT People consider information from the government on COVID-19 prevention and health-related matters to be reliable because they have seen evidence of the government taking practical steps in response to the pandemic. For instance, many have received safety kits from their local authorities, witnessed social distancing enforcement, and heard of COVID-19 patients receiving free treatment. However, when it comes to financial relief measures, many have listened to the government's declarations of economic support but have not seen or received it, leading to little trust in what the government has to say on the matter. This builds on the governments' poor track record of welfare provision and the already existing notion people hold of the governments' failure to take action on economic issues. TRUSTED CHANNELS In the hierarchy of trusted channels of information, TV and radio are at the top, with people saying they were less likely to doubt what they heard through these channels. Radio is the most popular media in Mali, and most urban households have access to a TV, too (though access is lower in rural areas).[21] Still, traditional forms of communication remain popular,[22] and people seek out information and advice from peers and community networks. For many, this information comes with an inherent sense of trust and has been a valuable way for people, especially small business owners, to access advice on dealing with COVID-19 that they have not been able to get elsewhere. However, it has also added to the spread of misinformation on the pandemic and precautionary measures.
  • High burdens and restrictions on health facilities during the pandemic, limits on the number of appointments, along with the fear and stigma of being diagnosed with COVID-19, have deterred many people from accessing healthcare."
    FOCUS ON COVID-19 PATIENTS When COVID-19 first hit Mali, people were reluctant to go to hospitals and health centers out of fear of contracting the virus and its stigma. As time went on, people's fear reduced, and they began to resume going into health centers. However, many hospitals and medical centers have diverted their resources towards responding to COVID-19, and people reported not being able to access routine services, like free mosquito nets and vaccinations.[13] Mali has just 0.6 health personnel for every 1,000 people, and resources are unevenly distributed across regions (for instance, Bamako has nearly 2 staff per 1,000, compared to less than 0.3 in Taoudénit, Sikasso, Gao, and Mopti).[14] Even before the pandemic, more than 241 health centers had closed or become non-operational due to insecurity in Burkina Faso, Mali, and Western Niger regions.[15] The presence of COVID-19 has only added to the health system's existing burden. ALTERNATIVE TREATMENT OPTIONS The closure and repurposing of health facilities during the pandemic have made accessing healthcare more onerous. For instance, people reported having to take a ticket for a consultation, wait in long queues, or go to the facility early in the morning to get guaranteed care and attention. These factors deter people from seeking care at health facilities. People either delay treatment or don't get it at all, with some choosing to rely on traditional medicine or unproven home remedies instead.
  • People see the government as a reliable source of information on COVID-19 precautions, as interventions support the precautions. However, there is little trust in the government’s economic announcements, which many regard as empty promises. Most people seek out their information through TV and radio and rely on their community peers, even though this contributes to the spread of misinformation."
    INFORMATION FROM GOVERNEMENT People consider information from the government on COVID-19 prevention and health-related matters to be reliable because they have seen evidence of the government taking practical steps in response to the pandemic. For instance, many have received safety kits from their local authorities, witnessed social distancing enforcement, and heard of COVID-19 patients receiving free treatment. However, when it comes to financial relief measures, many have listened to the government's declarations of economic support but have not seen or received it, leading to little trust in what the government has to say on the matter. This builds on the governments' poor track record of welfare provision and the already existing notion people hold of the governments' failure to take action on economic issues. TRUSTED CHANNELS In the hierarchy of trusted channels of information, TV and radio are at the top, with people saying they were less likely to doubt what they heard through these channels. Radio is the most popular media in Mali, and most urban households have access to a TV, too (though access is lower in rural areas).[21] Still, traditional forms of communication remain popular,[22] and people seek out information and advice from peers and community networks. For many, this information comes with an inherent sense of trust and has been a valuable way for people, especially small business owners, to access advice on dealing with COVID-19 that they have not been able to get elsewhere. However, it has also added to the spread of misinformation on the pandemic and precautionary measures.
  • High burdens and restrictions on health facilities during the pandemic, limits on the number of appointments, along with the fear and stigma of being diagnosed with COVID-19, have deterred many people from accessing healthcare."
    FOCUS ON COVID-19 PATIENTS When COVID-19 first hit Mali, people were reluctant to go to hospitals and health centers out of fear of contracting the virus and its stigma. As time went on, people's fear reduced, and they began to resume going into health centers. However, many hospitals and medical centers have diverted their resources towards responding to COVID-19, and people reported not being able to access routine services, like free mosquito nets and vaccinations.[13] Mali has just 0.6 health personnel for every 1,000 people, and resources are unevenly distributed across regions (for instance, Bamako has nearly 2 staff per 1,000, compared to less than 0.3 in Taoudénit, Sikasso, Gao, and Mopti).[14] Even before the pandemic, more than 241 health centers had closed or become non-operational due to insecurity in Burkina Faso, Mali, and Western Niger regions.[15] The presence of COVID-19 has only added to the health system's existing burden. ALTERNATIVE TREATMENT OPTIONS The closure and repurposing of health facilities during the pandemic have made accessing healthcare more onerous. For instance, people reported having to take a ticket for a consultation, wait in long queues, or go to the facility early in the morning to get guaranteed care and attention. These factors deter people from seeking care at health facilities. People either delay treatment or don't get it at all, with some choosing to rely on traditional medicine or unproven home remedies instead.
  • People see the government as a reliable source of information on COVID-19 precautions, as interventions support the precautions. However, there is little trust in the government’s economic announcements, which many regard as empty promises. Most people seek out their information through TV and radio and rely on their community peers, even though this contributes to the spread of misinformation."
    INFORMATION FROM GOVERNEMENT People consider information from the government on COVID-19 prevention and health-related matters to be reliable because they have seen evidence of the government taking practical steps in response to the pandemic. For instance, many have received safety kits from their local authorities, witnessed social distancing enforcement, and heard of COVID-19 patients receiving free treatment. However, when it comes to financial relief measures, many have listened to the government's declarations of economic support but have not seen or received it, leading to little trust in what the government has to say on the matter. This builds on the governments' poor track record of welfare provision and the already existing notion people hold of the governments' failure to take action on economic issues. TRUSTED CHANNELS In the hierarchy of trusted channels of information, TV and radio are at the top, with people saying they were less likely to doubt what they heard through these channels. Radio is the most popular media in Mali, and most urban households have access to a TV, too (though access is lower in rural areas).[21] Still, traditional forms of communication remain popular,[22] and people seek out information and advice from peers and community networks. For many, this information comes with an inherent sense of trust and has been a valuable way for people, especially small business owners, to access advice on dealing with COVID-19 that they have not been able to get elsewhere. However, it has also added to the spread of misinformation on the pandemic and precautionary measures.

Peoples stories

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