Financial incentives for COVID-19 vaccines in a rural low-resource setting: a cluster-randomized trial.

We implemented a clustered randomized controlled trial with 6,963 residents in six rural Ghana districts to estimate the causal impact of financial incentives on coronavirus disease 2019 (COVID-19) vaccination uptake. Villages randomly received one of four video treatment arms: a placebo, a standard health message, a high cash incentive (60 Ghana cedis) and a low cash incentive (20 Ghana cedis). For the first co-primary outcome-COVID-19 vaccination intentions-non-vaccinated participants assigned to the cash incentive treatments had an average rate of 81% (1,733 of 2,168) compared to 71% (1,895 of 2,669) for those in the placebo treatment arm. For the other co-primary outcome of self-reported vaccinations 2 months after the initial intervention, the average rate for participants in the cash treatment was 3.5% higher than for participants in the placebo treatment (95% confidence interval (CI): 0.001, 6.9; P = 0.045): 40% (602 of 1,486) versus 36.3% (672 of 1,850). We also verified vaccination status of participants: in the cash treatment arm, 36.6% (355 of 1,058) of verified participants had at least one dose of the COVID-19 vaccine compared to 30.3% (439 of 1,544) for those in the placebo-a difference of 6.3% (95% CI: 2.4, 10.2; P = 0.001). For the intention and the vaccination outcomes, the low cash incentive (20 Ghana cedis) had a larger positive effect on COVID-19 vaccine uptake than the high cash incentive (60 Ghana cedis). Trial identifier: AEARCTR-0008775 .

Economic Recovery but Stagnating Mental Health During a Global Pandemic? Evidence from Ghana and South Africa.

Ghana and South Africa proactively implemented lockdowns very early in the pandemic. We analyze a three-wave panel of households in Accra and Greater Johannesburg to study the mental and economic well-being of the urban poor between the COVID-19 lockdown and the "new normal" one year later. We find that even if economic well-being has mostly recovered, life satisfaction has only improved slightly and feelings of depression are again at lockdown levels one year into the pandemic. While economic factors are strongly correlated with mental health and explain the differences in mental health between South Africa and Ghana, increasing worries about the future and limited knowledge about the pandemic (both countries) as well as deteriorating physical health (South Africa) and trust in government (Ghana) explain why mental health has not recovered. Therefore, we need broad and country-specific policies, beyond financial support, to accelerate the post-pandemic recovery of the urban poor.

A call for structured ethics appendices in social science papers.

Ethics in social science experimentation and data collection are often discussed but rarely articulated in writing as part of research outputs. Although papers typically reference human subjects research approvals from relevant institutional review boards, most recognize that such boards do not carry out comprehensive ethical assessments. We propose a structured ethics appendix to provide details on the following: policy equipoise, role of the researcher, potential harms to participants and nonparticipants, conflicts of interest, intellectual freedom, feedback to participants, and foreseeable misuse of research results. We discuss each of these and some of the norms and challenging situations of each. We believe that discussing such issues explicitly in appendices of papers, even if briefly, will serve two purposes: more complete communication of ethics can improve discussions of papers and can clarify and improve the norms themselves.

Managing the COVID-19 pandemic in poor urban neighborhoods: The case of Accra and Johannesburg.

Without a vaccine, practicing social distancing and protective hygiene are the most effective measures to curb the spread of COVID-19. In order to understand how the urban poor mitigate their risk of infection, we conducted a survey with more than 1,400 poor households in two of the African cities with the most COVID-19 infections, Accra and Greater Johannesburg, early in the pandemic, during lockdowns of public life. We find that many of the urban poor already engage in the appropriate hygienic behavior and follow social distancing rules. However, despite citywide lockdowns, about 25-40% of people still report attending large gatherings, 10-20% report receiving guests at home, and 30-35% report leaving the house more than once per week. Lack of cooperation with governmental regulations seems to be more related to a lack of infrastructure or poverty rather than unwillingness to engage in behavioral change. Interestingly, even with the stricter lockdown in South Africa, people are at least equally likely to deviate from social distancing rules. Our results indicate that more South African respondents perceive their government's actions as too extreme and underestimate COVID-19 cases in their country. About half of the sample in both countries report knowing (mainly through TV) about current COVID-19 case numbers. Most participants know that coughing is a symptom, but only half mention fever and difficulty breathing, and very few people mention tiredness. Ghanaians seem to be somewhat better informed. While lack of information is an issue, misinformation appears to be limited. We conclude that a costly shutdown of public life is only effective-and might even be prevented-with a well-informed population, who perceives their government's actions as appropriate and who has access to the infrastructure required to follow WHO safety regulations.

Agrochemical Health Risks Exposure and Its Determinants: Empirical Evidence among Cassava Farmers in Nigeria.

Background: Over the years there has been a change in the dimensions of agricultural health risk exposure among crop farmers in Nigeria due to innovation adoption. This study assessed agrochemical health risk exposures and its determinants among cassava farmers in Nigeria.Method: The study engaged the baseline of a longitudinal study conducted using a standardized questionnaire. Randomly selected and interviewed for the study were 480 small-scale cassava farmers across 24 farming communities in Kogi and Kwara States, Nigeria. Descriptive statistics, binary regression model, and Likert scale were used for analysis.Results: Most of the farmers were exposed to agrochemical health risks in cassava operations. The frequently used chemicals belong to WHO class II and III. There was poor knowledge of safe farm practices among cassava farmers. About 77% of farmers reported not using complete protective equipment while handling farm chemicals. Several risk factors were associated with farm chemical health risks exposure, including inappropriate time of spray (Odd ratio [OR] = 1.21), frequency of spray (OR = 1.06), long hours of daily chemical spray (OR = 1.10), and non-usage of chemical labels (OR = 2.31).Conclusion:The study concluded cassava farmers in some selected communities in Kogi and Kwara States, North-Central Nigeria engage in unsafe farm practices via the use of farm chemicals that expose them to health risks. There is, therefore, a need for efficiently delivered agricultural health education as an intervention tool to alleviate Nigerian crop farmers from being exposed to such health risks.

Erratum to "Aid to Africa's agriculture towards building physical capital: Empirical evidence and implications for post-COVID-19 food insecurity" [World Dev. Perspect. 20 (2020) 100269].

[This corrects the article DOI: 10.1016/j.wdp.2020.100269.].

Aid to Africa's agriculture towards building physical capital: Empirical evidence and implications for post-COVID-19 food insecurity.

The formation of physical capital in Sub-Saharan Africa (SSA) in agriculture is imperative to help the continent (1) overcome the effect of the COVID-19 pandemic on food insecurity and (2) still be on track towards achieving the Sustainable Development Goals (SDGs) of "No poverty" and "Zero hunger" in the midst of the COVID-19 pandemic. Using country-level data on 40 SSA countries from 1996 to 2014 and rainfall deviations as an instrument for agricultural official development assistance (ODA) in fixed-effect estimation settings, this paper examines the 'instantaneous' impact of agricultural ODA on agricultural fixed capital formation in SSA. The question here is whether aid to agriculture does translate instantaneously to building fixed capital urgently needed to address the effect of any potential crisis on food insecurity. Measuring agricultural fixed capital as fixed investments in farm machinery, dams, industrial buildings for agricultural and agro-processing, fences, ditches, drains, etc., we find that capital formation in SSA agriculture improves instantaneously with agricultural ODA inflows. Second, we find that even though rainfall deviations are associated with agricultural ODA inflows to SSA, institutions particularly those designed to control corruption and strengthen rule of law, do matter for agricultural aid inflows to SSA. These results suggest that agricultural ODA is necessary to accelerate agricultural investments and achieve food security. Our results are robust to sensitivity analysis on the specification of the instantaneous model.