COVID-19 ‘Nudge’ Theory: Till What Extent Can It Work in India?
Nudge theory can prove to be beneficial for India’s vaccination drive, allowing people time to think and evaluate.
From the onset of the COVID-19 pandemic, governments around the world have grappled with fundamental issues surrounding citizens’ rights. From imposing lockdowns and quarantines to ensuring masks and vaccines, various public health measures have been strongly implemented.
In the context of the rapidly spreading virus, many are willing to make substantial lifestyle changes in order to reduce rate of social contact to reduce transmission.
However, many countries have also witnessed protestors taking to the streets, railing against the strict measures introduced by their respective governments.
The rollout of national vaccination programs worldwide has been massive but many governments have stopped short of making the COVID-19 vaccine mandatory. Instead, they have chosen to opt for the “nudge” approach.
In the Indian context, despite the mass vaccination drive taken forward by the government, many citizens seem to have developed ‘vaccine hesitancy.’
Crucially in this respect, the nudge theory can prove to be a beneficial change, allowing people the time to think and evaluate but consistently nudging them to get the jab.
Origins of Nudge Theory
Developed by behavioral economists Richard Thaler and Cass Sunstein, ‘the nudge theory’ was laid out in the 2008 book titled Nudge. It explains the principle that “people can make better life choices when nudged in the right direction by a mild intervention that alters behaviour without ruling out any options or introducing incentives beyond the positive outcome of changing the behaviour itself.”
For instance, banning fast food would not count as a nudge, but putting fruit at eye level next to a poster extolling the virtues of healthy eating would qualify.
In the context of COVID-19, governments across the world have been working with so-called “nudge units” to help steer populations into making decisions that help reduce the spread of the virus or increase the likelihood of becoming vaccinated.
World Health Organisation has highlighted that an essential use of nudge theory in the success of vaccine programs has been to publicise the fact that trusted community members and influencers were taking the jab.
‘Nudging’ India’s COVID Crisis
In India, Nobel Laureate Abhjit Banerjee, who previously published a study regarding the use of nudge techniques for COVID-19-related behaviours, proved the effectiveness of nudging in a population of 2.5 million residents of West Bengal. He and his team launched a series of eight video messages, less than 2.5 minutes long, covering points such as the need to wear masks and to socially distance.
The messages were distributed as videos via mobile phone networks. Despite the information already being widely available, this nudge intervention to pay attention increased the reporting of symptoms and boosted preventive behaviours.
‘Nudge’ Practices in a COVID World
But, the nudge need not be obvious as a video message. For instance, officials in Ireland decided to use informational signs displayed in prominent locations, in vivid colours, since the bright, clear design and layout of information could have a greater impact and reach than a poster packed with text with a dull colour.
Nudging can be as simple as putting a poster at eye level or placing hand sanitiser in a prominent location or even potentially in somebody’s way so they are encouraged to use it.
Studies have found that interventions need to attract attention and make compliance convenient.
To cite an example, several volunteer groups in India have been on-ground to nudge people on the streets to ensure safer COVID practices such as wearing the mask correctly.
Following a similar approach, at the start of the pandemic, the UK Department of Health and Social Care worked closely with its own nudge unit, the Behavioural Insights Team, to develop a communications campaign promoting hand washing and deterring face-touching.
The campaign used the idea of disgust as an incentive to wash hands and suggested singing “Happy Birthday” to ensure that people were washing their hands for at least 20 seconds.
Boosting Constructive Behaviour
Several governments are also using nudge units to help promote positive behaviours amongst its citizens. In the UAE, the recently launched National Program for Behavioural Rewards, entices people to eat and live more healthily using points-based rewards schemes.
It promotes a healthy diet and active lifestyle, as well as encouraging social responsibility through volunteering and compliance with laws.
The Behavioural Economics Team of the Australian Government (BETA) has recently introduced a raft of initiatives aimed at using nudge tactics to encourage positive behaviours in the areas of personal finance, health, and cybersecurity.
One such project entitled “Nudge vs Superbugs” which involved BETA sending letters to the top 30 percent of prescribers at the start of the 2017 flu season, comparing their prescribing to their peers.
The subject of the letter read: “Dear Dr XX, your prescribing rate is higher than 91 percent of doctors for the Canberra region.”
The results of this were fascinating. The simple nudge helped GPs bring scripts down by 13.6 percent after three months; it went down to 9 percent after one year, and down by 8 percent again into the next flu season. This overall resulted in 1,90,000 fewer prescriptions over 12 months.
In Singapore, the National Steps Challenge campaign was launched in 2015. The Challenge was for people to walk 10,000 steps a day. It was successful due to the prompts to share and interact on social media. It led to 8.8 percent of the inactive adult population (1,26,000 people) participating in the challenge.
The National Steps Challenge is now on Season 5, offering monetary eVoucher rewards, not only for steps but also for clocking minutes of Moderate to Vigorous Physical Activities (MVPA).
The Singaporean Ministry of Health has already awarded the tender for the management of Season 6 and 7 of the National Steps Challenge running to 2025, proving that through constant small changes and updates to keep people interested, a programme like this can be a continued success.
Challenges With Nudge Initiatives
One core challenge identified with nudge theory is that the effectiveness of nudge tactics fades over time.
For instance, radio or TV advertising campaigns promoting social distancing or hand washing eventually becomes background noise.
If nudging by means of messages or public announcements uses the same material over a long period of time, it loses its effect and pull on the public.
Having diverse influential people or different images that will nudge citizens can contribute to a greater change.
The good news is that nudge techniques don’t always need to be instigated by dedicated government agencies. It can be the case that governments are often nudging citizens without even being consciously aware of it.
Indian researcher Ramit Debnath used an artificial intelligence algorithm to monitor the recurrence of particular keywords in official government communications. He found that the more frequently occurring words matched typical nudge terms, even if there was no official nudge initiative in place.
The fact that so many governments, wittingly or otherwise, use nudge theory in managing citizens' behaviours speaks to its efficacy.
These initiatives are needed as they would educate the public, and make them feel connected to their governments, thus promoting a stronger level of solidarity during these unprecedented times.
The onus is on governments to continue innovating and experimenting with nudge techniques to ensure they remain effective in achieving the desired results.
The pandemic has proved to be a turning point in how the government and society interact with one another, and therefore, the nudge theory looking at how humans behave has been at the forefront. The key takeaway from this? The virus cannot be nudged, but we can be.
(Hamad Khatir is Director of the Secure Communities Forum secretariat. The Secure Communities Forum (SCF) is an initiative supported by the Ministry of Interior of the United Arab Emirates. The SCF was established to bring professionals from law enforcement, education, healthcare, and technology together to tackle global challenges. This is an opinion piece, and the views expressed above are of the author’s own. The Quint neither endorses nor is responsible for the same.)
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