Jakubowski, Alexandra, Dennis Egger, Carolyne Nekesa, Layna Lowe, Michael Walker, Edward Miguel. (2021) “Self-reported vs Directly Observed Face Mask Use in Kenya”, JAMA Network Open, 4(7):e2118830, doi:10.1001/jamanetworkopen.2021.18830

Although countries in sub-Saharan Africa have so far avoided large-scale outbreaks of COVID-19, as of June 2021, the number of new cases has been surging in multiple nations. The official case count in Kenya was 179 876 confirmed cases in June 2021, including 1597 cases in Siaya county. One explanation for the relatively low spread of COVID-19 is the strict lockdown measures that were imposed early but were eventually eased because of their harsh socioeconomic consequences. Masks emerged as a prominent strategy to reduce SARS-CoV-2 transmission before widespread vaccinations and have been legally mandated in Kenya since April 2020. Yet compliance with public health guidelines is not guaranteed and motivating people to adopt new preventive health behaviors is inherently difficult. In this cross-sectional study, we examine the extent to which mask mandates are followed and quantify the bias of self-reported mask usage.