Health Behaviors in Four Asian Countries During the COVID-19 Pandemic: Presentation Delivered at the 2021 Annual Meeting of Japan Association for International Health


On Nov. 27 and 28, 2021, the 36th Congress of Japan Association for International Health was hosted by the National Institutes of Biomedical Innovation, Health and Nutrition online under the theme “International Cooperation for Post-pandemic Sustainable Healthcare” (provisional translation). Saito Kiyoko, senior research fellow, and Komasawa Makiko, research fellow, both of JICA Ogata Sadako Research Institute for Peace and Development (JICA Ogata Research Institute), participated and gave presentations titled “Public Health Activities During the COVID-19 Pandemic in Four Asian Countries: Analysis of Vaccination Trends and Willingness,” and “Health Behaviors During the COVID-19 Pandemic in Four Asian Countries: Reduced Access to Health Facilities and Associated Factors,” respectively. These were part of “COVID-19 Study: Toward Universal Health Coverage and a Resilient Society,” a research project currently being conducted by JICA Ogata Research Institute.

The presentations were based on a re-analysis of data collected previously by JICA’s Infrastructure Management Department as part of a survey of urban populations in Thailand, Indonesia, the Philippines and Vietnam (n = 4,072).

Saito provided an analysis on the trend and background around the willingness to get vaccinated in these four Asian countries. The vaccination coverage rate of subjects as of April to May 2021 was high in Indonesia at 63% but low in the other three countries, generally less than 30%. However, more than 90% of the subjects were willing to be vaccinated in these three countries, and thus it is assumed that the people in these countries have a positive attitude toward vaccination. Furthermore, when the overall trend of the relevance between how they think about COVID-19 and their willingness to get vaccinated was analyzed, it was shown that those who agreed with the following statements strongly wanted to be vaccinated: people of all age groups are dying because of COVID-19; the world is in the middle of a crisis because of COVID-19; and/or the economy in this pandemic is currently worse than that during the financial crisis of 2008. It was therefore suggested that not only awareness on health risks but also on the economy could be related to the willingness to get vaccinated.

Komasawa revealed that the frequency of accessing health facilities dropped for more than 80% of the urban populations in the four Asian countries because of COVID-19, and about 70% of these people cited fear of getting infected inside health facilities as the reason. This drop was particularly significant among younger generations and those experiencing income decrease. Furthermore, her study found out that 60–80% of the people are practicing public health measures like wearing masks, staying at home and avoiding public spaces that could get crowded. It also found out that the high percentage of demonstrating preventive health behaviors and the low trust in local governments were factors associated with the lowered frequency of accessing health facilities. Based on these results, Komasawa pointed out that national governments must thoroughly reduce the risk of getting infected in health facilities and disseminate the measures implemented to secure safety there. Finally, she emphasized that more assistance must be provided to younger generations and those going through economic hardships.

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