A survey by Indonesia’s COVID-19 Task Force revealed that by the beginning of 2022, only 54 percent of respondents had received two doses of the COVID-19 vaccine. In response to this situation, Empatika carried out action-oriented research in areas of Indonesia with lower vaccination rates and reportedly less adherence to COVID-19 health protocols. Four districts were included across four different provinces, including North Aceh, Aceh; Serang, Banten; Pamekasan, East Java; and Seram Bagian Barat, Maluku.

The study included adapted immersions, in which Empatika researchers spent time in four communities for three days and gathered insights through iterative informal conversations, observations, and direct experiences.This phase explored community context and the determinants shaping people’s behaviors in relation to COVID-19 prevention and vaccine uptake.

Building on findings from the adapted immersion phase, a series of people-driven design workshops were conducted in communities, which aimed to develop solutions and communication messages encouraging positive behaviors related to prevention practices and the COVID-19 vaccine. Insights from this study informed UNICEF Indonesia’s Risk Communication and Community Engagement (RCCE) strategy to encourage the adoption of positive behaviors on COVID-19 prevention and vaccination.

Some of the key insights included:

• In all locations, many people we met believed that COVID-19 was not present in their village. This view was typically influenced by a lack of first-hand experience compared with what they saw on TV, in the news, or on social media.

• In areas like Pamekasan and Serang, people were generally aware that many people had suffered from an illness, particularly around the middle of 2021, but still did not refer to this as COVID-19 due to general disbelief and denial about COVID-19. In fact, these illnesses were often attributed to evil spirits.

• Many people could not relate to the idea of prevention (for COVID-19 or other illnesses) because they perceived this as treating people who are healthy. 

• Most people tried to avoid being tested for COVID-19 because they did not want to quarantine and be separated from family, and in some locations also to avoid stigma, in case they tested positive. The stigma encompasses being pressured to quarantine, being excluded from school, becoming the focus of gossip in the community, receiving inadequate treatment from health services, and fearing dying in isolation.

• In Seram Bagian Barat, prevention measures were enforced strictly at the beginning of the pandemic, but this was mainly driven by compliance to the government's regulations rather than an understanding of COVID-19.

• Most people did not think they needed the vaccine since they did not believe there was COVID-19 in the village. There was also strong hesitance due to rumors of bad side effects.