Knowledge, perception and response to new media messages on COVID-19 among residents of a rural community in Nigeria

COVID-19 and Nigerian Government Efforts at Mitigating its Spread

There is no denying that COVID-19 took the world by surprise as there appeared to be inadequate preparation for a pandemic of such magnitude. However, the prediction for most African countries with respect to the effect of the coronavirus pandemic was that the continent will be the worst hit with devastating impacts including dead bodies on the streets (Okereke & Nielsen, 2020). However, based on critical observation of the period, the foregoing prediction was not quite the case.

Though governments in the African continent made efforts to halt the spread, a study conducted in Kenya revealed that the reasons the prediction did not come to fruition can be related to the fact that Africans have always been exposed to pathogens in the family of COVID-19 virus numbering over 40000 and therefore may have developed immunity. Other factors that might have helped are the acquired immunity against malaria over the years and the unsterile environment in the continent, which according to the study, provides some form of natural immunity (Adetiba, 2020). Though the foregoing may be subjected to further scientific investigations and counterarguments, it is important to state that they may have aided the fight against the deadly virus with some form of input from the government efforts.

Once the index case was reported in Nigeria in the early part of 2020, the NCDC swung into action by setting up a multisectoral National Coronavirus Preparedness Group (NCPG) – an organization poised to coordinate an effective and cohesive public response to the COVID-19 virus pandemic in the country (Dan-Nwafor et al., 2020). Within the same period of the announcement of an outbreak in the country, the relevant authority with the use of social media and traditional media platforms published the first public health advisory on COVID-19 (WHO, 2021). As part of concerted measures or efforts to mitigate the impact of the pandemic through communication intervention which was also to ensure that the pandemic is tamed, the NCDC reportedly set up an Emergency Operation Centre (EOC) which, among other things, provided risk communication (Dan-Nwafor et al., 2020; Oyebanji et al., 2021).

Relatedly, Rhima (2020) found that in the context of the COVID-19 pandemic in Nigeria, rural dwellers required information on the virus with respect to preventive and curative measures as well as other general information. The study further revealed that most of the respondents who took the survey preferred to get information regarding the virus from friends/family members, town criers, medical workers, and traditional healers, among others. With respect to the purpose or use of the information obtained, the study found that it was mainly to educate relatives, kinsmen, and friends on the virus, learn about precautionary measures needed to prevent its spread and get informed about the fatalities from the infections and many others.

New Media and the Practice of Communicating Public Health Epidemics

Mass media anywhere in the world is reputed for being major stakeholders across various areas including public health – as they are saddled with the responsibility of providing adequate and timely information to their audience. The foregoing is so because information is an important weapon for navigating people out of a health crisis. According to Pousadela (2020), a free flow of information during a pandemic is an important factor that determines the success of the fight. Sunday, Inobemhe, and Santas (2021) lend credence that in a pandemic, the more access people have to information, the more likely their chances of pulling through the troubled times.

The media play different roles in society from education to entertainment and enlightenment (Moemeka, 2016). The media is the fourth estate of the realm and even in the pandemic era, it provides the required health education throughout the period (Gever & Ezeah, 2020). The stated role of health education is one of the practices of the media in communicating public health during epidemics or pandemics. Further, Gever and Ezeah (2020) observed that the task of educating the public about their health requires the media to first engage in monitoring the environment to identify health issues that threaten human life, and then get equipped to provide information with a view to ensuring the requisite enlightenment is provided. On a general note, the media is seen as a veritable tool for the promotion of public health across different societies of the world (Adler et al., 2020).

In the fight against the COVID-19 pandemic in Nigeria and elsewhere in Africa and the world, new media technologies (as made manifest in mobile phones, social media, and associated internet-enabled devices) proved useful (Obi-Ani, Anikwenze & Isiani, 2020; Pandya & Lodha, 2021). Besides being used as tools to provide information, social media provided alternatives to ensure the continuation of education and provision of care during the COVID-19 pandemic era (Abbas et al., 2021). Evidence also abounds on how the Nigerian government through relevant organs or agencies took advantage of new media in the provision of the necessary information and in risk communication during the COVID-19 pandemic era in the country (Inobemhe et al., 2021). Therefore, there is no doubt that in Nigeria and elsewhere in the world, new media technologies proved useful in health communication during the period under review.

Though traditional communication systems were seen to be important in combating covid 19-related infodemic among rural communities in Nigeria (Lucas et al., 2021), the importance of new media technologies cannot be ignored when it comes to the matter of impact and effectiveness. In fact, a study conducted by Ekezie and Bosah (2021) revealed that through social media platforms such as Twitter, Nigerians from all parts gained unprecedented access to health-related messages regardless of the accuracy or otherwise of the shared information. The foregoing revelation shows that there was wide use and reliance on new media with respect to communication and COVID-19-related information.

Health Service Delivery and COVID-19 Outbreak in Nigeria

As a global health concern, COVID-19 affected human existence in diverse ways – and required coordinated health services response (Okorie, 2021). The coronavirus pandemic had a great impact on healthcare delivery systems in the country as certain health facilities were temporarily shut down in response to the virus and special facilities were created to treat cases, which also include isolation centers (Afolalu et al., 2021). Similarly, Obaseki (2021) avers that just like other nations of the world (even advanced ones to be precise), Nigeria’s health system was shaken by the impact of the COVID-19 though the nation made efforts to push back the impact. Obviously, there is a need to emphasize that the country’s health system needs strengthening across several areas of importance.

Besides other issues relating to care, the Nigerian health sector or system’s comprehensive response structures to the COVID-19 pandemic in the country revolved around travel lockdowns to curtail the spread of the virus and ease the lockdown measures (Dan-Nwafor et al., 2020; Obi-Ani et al., 2021). The study conducted by Dan-Nwafor et al. (2020) found that lockdown was one of the most significant measures by the Nigerian health system to fight the pandemic – first, it was “to slow down the spread of the virus across the country, and second, to buy time for the health system to increase preparedness” (p. 5). The study further revealed that on a whole, isolation centers were also introduced while contact tracing was activated to arrest the spread of the virus among the population – and it worked to a reasonable extent.

New Media and Public Enlightenment

Over the years, new media has become a viable tool for communication globally. The internet has transformed social communication among people and nations in the recent past. The impact of new media has permeated the spheres of global business, politics, tourism, healthcare delivery, and social interactions. The advancement in technology has made possible the availability of channels of communication that makes public health awareness and promotion achievable (Ebrahim et al., 2020). For instance, social media platforms such as Facebook, Twitter, Instagram, and WhatsApp have become increasingly important sources of health information in contemporary times. Most health organizations and institutions are utilizing them to disseminate health information. For example, in the wake of the emergence of COVID-19, the World Health Organization (WHO) extensively used its website and other social media platforms to update the general public on the COVID-19 virus (Obi-Ani et al., 2020).

The media are vital instruments of communication in society. This is especially important when it comes to any public health emergency or situation that would require mass education of citizens as it relates to stemming the tide of deadly viruses that may claim the lives of several people. It is based on this strength that new media wields its relevance as the fastest means of the information-sharing platform across large segments of the population. This unique feature of the new media, therefore, provides health professionals the latitude to engage the people in mass health education. There are also cases where the new media platforms provided alternatives for traditional media organizations in Nigeria to reach their target audience (Igyuve et al., 2020).

Whenever the general population is the target of health education, the media is a significant stakeholder. Moemeka (2012) observed that while it is true that effective health education can be carried out using the interpersonal method of communication, it is generally held that where a large population is a target, it is better to use modern channels of communication. With the outbreak of the COVID-19 pandemic, the mass media became the major source of information among most rural dwellers in Nigeria. As always, the case in the wake of the outbreak of most killer diseases, the focal point for most people to get authentic information is the media of communication. The media serve the role of being a source of information, as well as an advocate for correct health behaviors during times of health emergencies (Asemah, Nkwam-Uwaoma & Santas, 2017). In the same vein, new media (which happens to be modern media forms) played a significant role in information dissemination during the outbreak.

In order to educate the people on COVID-19 and control its spread in the country, the Nigerian government adopted several communication strategies to reach out to its citizens. An aggressive media campaign was carried out across platforms/channels – radio and television, social media platforms, newspapers, and magazines among others. The Nigerian Centre for Disease Control in partnership with UNICEF embarked on an extensive public health campaign utilizing the new media-enabled Short Message Service (SMS) mechanism to send messages to people’s phones as part of awareness creation and campaigns. Zhuang, Xiang, Han, Yang, and Zhang (2016) lend credence to the assertion that health care intervention through short message service (SMS) based on cell phone text messages is beneficial in public health emergencies and other public health-related uses and administrative processes.

The aforementioned function of the media is imperative given the fact that a greater percentage of the Nigerian population resides in the rural communities where adequate and sufficient information about health issues is not readily available to the people (Olaoluwa & Rasheed, 2021). This is coupled with the notion that most rural dwellers in the country are not literate enough to understand the dynamics of managing emerging health epidemics and their related consequences when they eventually arise. Hence the role of the media to provide authentic information is critical in the lives of rural people. Barrante et al. (2009) posit that timely production and dissemination of proper information during a health crisis generate trust and credibility with the public to comply with measures that may be put in place by health professionals to mitigate the spread of disease.

In Nigeria, the government has recognized the important function of the media in providing health information to the citizens, especially during crisis situations like the current COVID-19 pandemic. Health public enlightenment programs have become a regular feature on both radio and television stations across the entire country. Radio and television broadcast has been deployed to educate the people on the COVID-19 virus, its mode of transmission, and the various measures of its containment. Therefore, the media has become an important tool of information dissemination with respect to public enlightenment – and the use of new media also widens its reach and audience base.

Health communication is crucial for the survival of the citizens of any given society. This is important because public safety is largely dependent on the information citizens are able to get from various sources of information at their disposal. It is against this backdrop that the media in collaboration with other institutions should establish viable communication strategies and mechanisms to engage the public in times of health crisis. This becomes imperative in rural communities because most people living in rural areas are not literate like those residing in the cities. Therefore, to reach these rural people, health experts and opinion leaders ought to create media messages that are appealing to the rural folks so as to (as much as possible) elicit positive behavior change from them (Asemah, 2021).

It is noteworthy that during a health crisis there is a synergy between health professionals and the media. This symbiotic relationship ensures that health professionals provide health direction to the people through the media of communication. This is crucial because necessary information provided through education on preventive and curative measures on killer diseases is significant in fighting their spread. Buttressing this argument, Ochuba (2013) notes that a nation without a sound health public enlightenment program (that may be of benefit to the public and educate its citizens) will definitely jeopardize the future leaders, who should help propel development for the future generation.

Previous studies conducted by scholars indicate that rural communities encountered several problems in accessing information on health-related issues which impacts negatively on behavior change communication on the side of most communities in Nigeria – and revealed that the issues that confront these rural communities range from poverty, hunger and lack of social amenities (see Santas & Asemah, 2013; Ekpenyong, 2021; Njanubok & Mbazie, 2021).

Health Belief Model & Risk Perception Theory

This study draws from the Health Belief Model (HBM) and the Risk Perception model. The Health Belief Model was developed in the early 1950s by Hochbaum, Rosenstock, Kegels & Levental while working as social psychologists in the US public health services (Rosenstock, 1974). These scholars wanted to find out why people would not want to accept disease preventive measures or early response to disease in terms of treatment.

In their study, Okwudiri et al. (2021) point to the fact that HBM is used to describe and foretell individual changes in health behaviors and is one of the popular models that is used to explain or understand how people respond to health behavior. The underlying tenet of the model is hinged on the premise that an individual propensity to adopt a new form of health habit or lifestyle in a crisis is to a large extent informed by the perception of that individual in relation to the health problem at hand. In other words, when a person perceives that COVID-19 poses a serious threat to his or her life, he or she would adopt a different lifestyle. However, if the individual sees that COVID-19 does not portend any threat to his life, then his or her response to the disease would be different.

According to Glanz (2010), the “HBM basically underscores the risk associated with a health concern and people’s perception of the benefit they would derive by taking appropriate step of action to change their behavior” (p.8). Further, Northouse and Northouse (1985) opined three elements are vital to HBM: an individual’s perception of susceptibility to and severity of a disease, an individual’s perception of the benefits and barriers to taking a preventive health action to prevent the disease, and the cues available to an individual that would stimulate him or her to engage in preventive health activity. It is foregoing that makes the model a force to reckon with in the area of health studies.

The model is based on the notion that people will act concerning their health if they feel that a health condition can be prevented and if they are positive that by taking a recommended action, negative health implications can be avoided. This theory finds relevance to this study because rural folks seek health information when they know that they are sick or might be infected by a particular disease that may be of a pandemic proportion (perceived susceptibility) and that the mild symptoms can increase its severity (perceived severity) that would make them seek quick medical attention. An individual that does not see bodily changes (cues to action) that took place during illness as threatening, may tend to delay seeking health information during the manifestations of fewer symptoms. However, in a circumstance where a person sees the benefit of seeking quick health information rather than perceived barriers to taking such actions, they may tend to quickly seek professional health information to help them deal with their health concerns (Ovie & Asemah, 2021).

Risk Perception Theory is the second theoretical framework that our study is based on. The primary concern of this theory stems from the assumption that people’s perception regarding a health risk in relation to public health disease or pandemic can be shaped by the way the media covers or presents such matters to the public. Since the public relies so much on information shared on various media channels, there is a tendency for the public to be influenced by the information they receive on various media. This is especially true in relation to the use of new media by the public as sources of health information. Lending credence to this assertion, Ahmad and Murad (2020) found in their study that due to constant exposure to different COVID-19 information on social media platforms, the majority of respondents developed a lot of anxiety about the COVID-19 virus (Paek & Hove, 2017).

The above postulation is substantiated by the notion that individuals are free moral agents and capable of making good decisions. This is because before people make rational choices, they must count both the benefit and the cost they would likely incur from such a costly decision. The major thrust of risk perception theory is to facilitate the reduction of the outbreak of diseases as well as the threat of its magnitude to the media audience.

For example, Renner and Reuter (2012) found in their study that peoples’ responses to the A/H1N1 virus and ‘swine Flu” outbreak in 2009 in Germany revealed that the success of public health intervention campaigns was to a large extent dependent on individual risk perception. The study further discovered that even though the government launched a public campaign about the virus, only a fraction of the people agreed to be vaccinated against the virus even though vaccination is the only effective means of preventing people from being infected. This implies that people do not only need to be aware of an existing potential risk of a virus, but they also need to feel personally at risk that they may possibly contract the virus otherwise their response to comply with public health information may not be effective. For rural dwellers to feel at risk of contracting the COVID-19 virus, the media should be able to disseminate information on the potential risks of the virus to their health so as to elicit compliance from the people to all the measures put in place by the government to stem the spread of the virus.

Study Design

The study employed a qualitative research design following the phenomenological approach described by Stake (2013) and Braun and Clarke (2013). In-depth-interviews were conducted among 10 purposefully selected participants. An in-depth interview entails a researcher having face to face conversation with an interviewee to generate data. Thus, the general open-ended questions asked during the interview allowed the participants to provide answers in their own words. The reason for using in-depth interviews was because it provides the opportunity to probe deeply into the subject of the study. This method allows participants ample freedom to describe their feelings in their own words and possibly in their local language, given the fact that most rural people in Nigeria are not literate and proficient in the English language like the urban citizens. In addition, the observation method was used to complement the in-depth interviews.

In order to analyze the data collected from the interview sessions, the study adopted the six thematic data analysis steps identified by Braun and Clarke (2013) which state that the process requires researchers to transcribe the recorded interviews. Having obtained the consent of the respondents to voluntarily participate in the interview session, the participants were told that their identity would be kept secret to encourage them to freely discuss the subject matter under investigation. For instance, to conceal the identity of the respondents, participants were coded as participants 1, 2 3…10.

Study Location

Angwan Garmai is a small rural settlement in Kokona Local Government Area of Nasarawa State, Sub-Saharan Africa in Nigeria. The rural area has a population of three hundred people. The rural settlement shares a boundary with Keffi LGA. The major preoccupation of the people is farming. The selection of this community by the researchers was because the location is a typical farming village in Nigeria where access to social amenities is often not readily available.

Participant Selection and Data Collection

Purposive sampling was used to select 10 participants from a rural settlement to participate in the study. Clearance was sought from the leader of the village to enable the researchers to conduct the study as well as appoint a person that would coordinate participants for the study. Permission was graciously granted, and an individual was appointed to mobilize participants to attend the interview session. The meeting for the interview session with the participants was conducted separately and individually based on their convenience. The interviews took a period of two weeks to be conducted.

The venue of the interview session was the village square. A village square is a designated area in a typical African rural setting where members of a community converge for relaxation and meetings. The nature of the interview was that when a question was given to a participant, he or she was given time to think about the question asked. Out of the 10 participants that participated in the study 7 were males while 3 were females. In terms of age, the participants were between the ages of 25-39 years. Out of the 10 participants, only 4 could read and write in English. So, we had to use the predominant language spoken by the people which is Hausa Language (a popular language spoken by most residents of North-Central Nigeria) to conduct the interview.

The interviews adopted the semi-structured format which ensures consistency thereby giving participants the latitude to discuss their understanding of the concept of investigation in a more in-depth manner. During the interview session, each respondent was given about 25-30 minutes to respond to the questions. While listening to participants’ answers, the researchers were recording the conversation as well as taking notes of key information in response to the questions that were asked. It is also worth mentioning here that, during the interview session, the researcher’s paid keen attention to the expression of nonverbal communication cues from the participants to gauge their approval, disapproval, or acceptance of the subject of discourse. After each participant exhausted his or her time, the main point of their submission was summarized and documented appropriately (Kontagora, Watts, & Allsop, 2018). The participants were asked to identify the new media platforms through which they were exposed to COVID-19-related information, the extent to which they were exposed to media messages on COVID-19, their perception of COVID-19 messages, and the influence of COVID-19 messages on their attitude towards the virus.

Data Analysis

We analyzed the recorded data and notes collected from the interview session to ensure the information was accurate and reflected the views of the participants. A thorough analysis of the information gathered from the in-depth interviews was presented thematically by identifying themes elicited from the interview sessions with the participants. This was done in line with the analysis of the qualitative data technique put forward by Braun & Clarke (2013). The researchers ensure that these steps were adequately followed during and after the interview. The findings of the study were discussed in tandem with the objectives of the study in relation to the theory and literature reviewed in the study. This method aligns with previous studies (Braun & Clarke, 2006; Parajuli & Doneys, 2017). So, the themes centered on gauging the perception of the rural people and their attitude towards COVID-19 media messages.

New media platforms through which rural dwellers were exposed to COVID-19 media messages

The entire study participants recognized the fact that their knowledge of COVID-19 came from their exposure to media. The participants got information on COVID-19 largely from Facebook, YouTube, WhatsApp, websites, cell phones, and text messages from NCDC. Out of the 10 participants, seven of them opined that they got information on COVID-19 via text messages on their mobile devices, while the remainder asserts that they got to know about the virus through information on Facebook. For instance, one of the participants stated that:

The response of the above participant indicates that his knowledge about COVID-19 came because of his brother’s exposure to the information shared on Facebook through a co-worker in his workplace. The consensus among the participants is that they receive most of their information on COVID-19 through several social media platforms. The participants reveal that Facebook and WhatsApp health public enlightenment campaign messages happened to be the dominant channels of communication that they rarely used to receive information on COVID-19 in the rural community. These findings align with an earlier study conducted by Obi-Ani et al. (2020), which alluded to the fact that health organizations and institutions utilized new media technologies to create awareness and educate the public on the novel COVID-19 virus.

Level of exposure to new media messages on COVID-19 among rural dwellers in Nigeria

The findings from the participants showed that their level of exposure to COVID-19 media messages was quite high. One of the participants was of the view that:

Another participant corroborated the above statement by saying:

The assertion by the participant above presupposes that he was inundated with so many text messages on COVID-19 from the NCDC (the body charged with the responsibility to control the spread of the virus in Nigeria). This implies that the participants frequently received COVID-19 messages. Other respondents equally attested to the fact that they frequently receive text messages on their mobile devices about the novel virus.

Level of understanding of COVID-19 preventive measures among rural folks

There was a general understanding of how COVID-19 can be transmitted and the safety measures that could be deployed in managing the virus among the rural dwellers. This suggests that the rural folks understood the messages they receive via the various new media platforms. When one of the participants was asked how COVID-19 could be contracted, the response was that:

In addition, to demonstrate that the respondents were familiar with the safety measures or protocols put in place to mitigate the spread of the virus to reduce the rate of citizens getting infected with the virus, a participant said the following measures could be used to mitigate the spread of the disease.

However, there was a general lack of knowledge about the origin of COVID-19 among the rural folks. Some participants believed that COVID-19 was a punishment from God for the sins of humanity while some others believed COVID-19 was created by the West to reduce the population of Africa. Several misconceptions trailed the outbreak of the disease among the rural people. For instance, a participant held the view that:

Generally, most of the participants do not have clear-cut knowledge of the origin of COVID-19. Many of the participants held divergent views regarding the source from which the virus originated from. The rural folks seem to be misinformed through some rumor or fake news peddling around on the circumstances that surrounded the emergence of the novel virus.

Perception of rural dwellers on COVID-19 media messages

Participants generally have a negative perception concerning media messages on the coronavirus disease. When asked why they have a negative perception of COVID-19 media messages, several answers were put forward by the respondents. One of the participants affirmed that:

Another participant shared the same notion with the participant above by saying:

The above perception seems to be the consensus among most rural dwellers in relation to COVID-19. Many participants believe that COVID-19 was a scam to siphon government funds. To buttress this position, a participant said that “we in this village did not receive any palliative items the government claimed it gave as relief materials as a result of the pandemic.” This argument is the general perception of the participants about how the government handled the COVID-19 pandemic crisis in Nigerian rural communities.

Influence of new media messages on COVID-19 on the attitude of the rural dwellers towards the virus

The findings indicated that most of the participants were not influenced by new media messages on COVID-19. Many of them attested to the fact that they did not comply with the non-pharmaceutical guidelines issued by the NCDC to control the spread of the disease. A respondent remarked that:

The above submission represents the responses of the majority of the other participants. Most of the participants were of the view that there was no compliance with safety measures because no member of the community contracted the disease. One of the participants recounted that:

Probing further to know whether the participants did not comply with government directives for people to be vaccinated against COVID-19 revealed that none of the participants or their family members got vaccinated. A participant affirmed that:

From the data gathered from the in-depth interview session, all the respondents expressed feelings of fear and disbelief at the thought of going for vaccination. The attitude of the villagers to COVID-19 was negative hence most of them could not comply with the safety measures prescribed by health professionals and the government to control the disease.