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Background In circumstances where vaccine hesitancy is high, like in Tanzania in 2021, measures to control the spread of COVID-19 infection through non-pharmaceutical interventions, specifically mask-wearing, hand-washing and physical distancing, become crucial. This study was undertaken to inform the development of a context-adapted communication campaign to control COVID-19 in Tanzania. Focus of the Article The study examines the effectiveness of three different behaviour change campaign ads created as part of the same control effort, and two of them by the same creative process, with the same creative team, at roughly the same time, in altering behavioural propensities for relevant target behaviours, including the washing of hands, the wearing of masks and social distancing, and key participant attitudes, such as the sense of obligation to others. Research Question The main research question was: what are the effects of behaviour change campaign ads on propensities for engaging in COVID-19 target behaviours? We also examined behavioural attitudes and consumer appreciation of the ads (believability, likeability, relevance and surprise). The purpose of the study was to provide empirical evidence on the effectiveness of different messaging logics, in order to help improve future campaigns. Methods We designed a controlled survey experiment where participants were randomly assigned to receive one of the three campaign ads. These were called: the "Setting" campaign, which was designed using a theory-based Behaviour Centred Design (BCD) approach and produced with local partners; the "Password" campaign, which was the result of a substantial investment by a major international consortium; and the "Balance" campaign, a local adaption of "Password"; as well as an educational public service announcement, which served as an active control. An SMS survey was administered online to 2080 participants in Tanzania in 2022 to evaluate the potential effectiveness and consumer appreciation of the campaigns. Results The results showed that the most costly campaign, "Password", did not perform better than the other campaigns on any test. In particular, "Password" was not more effective than the theory-based "Setting" campaign on any single behavioural indicator or exposure variable. The "Setting" campaign was more effective than other ads on the expected qualities of appreciation (surprise, believability). However, the educational announcement achieved higher average response levels than all of the narrative-based treatments on measures of consumer appreciation, such as likeability, believability and relevance. Recommendations for Practice This study supported the proposition that a campaign specifically designed to elicit particular kinds of psychological responses could do so. It showed that a theory-based campaign, produced locally and at low cost, can compete on standard marketing values with high-quality creative processes and production values.

Non-randomized studies of intervention effects (NRS), also called quasi-experiments, provide useful decision support about development impacts. However, the assumptions underpinning them are usually untestable, their verification resting on empirical replication. The internal replication study aims to do this by comparing results from a causal benchmark study, usually a randomized controlled trial (RCT), with those from an NRS conducted at the same time in the sampled population. We aimed to determine the credibility and generalizability of findings in internal replication studies in development economics, through a systematic review and meta-analysis. We systematically searched for internal replication studies of RCTs conducted on socioeconomic interventions in low- and middle-income countries. We critically appraised the benchmark randomized studies, using an adapted tool. We extracted and statistically synthesized empirical measures of bias. We included 600 estimates of correspondence between NRS and benchmark RCTs. All internal replication studies were found to have at least "some concerns" about bias and some had high risk of bias. We found that study designs with selection on unobservables, in particular regression discontinuity, on average produced absolute standardized bias estimates that were approximately zero, that is, equivalent to the estimates produced by RCTs. But study conduct also mattered. For example, matching using pre-tests and nearest neighbor algorithms corresponded more closely to the benchmarks. The findings from this systematic review confirm that NRS can produce unbiased estimates. Authors of internal replication studies should publish pre-analysis protocols to enhance their credibility.

Background: How do governance interventions that engage citizens in public service delivery planning, management and oversight impact the quality of and access to services and citizens' quality of life? This systematic review examined high quality evidence from 35 citizen engagement programmes in low- and middle-income countries that promote the engagement of citizens in service delivery through four routes: participation (participatory priority setting); inclusion of marginalised groups; transparency (information on rights and public service performance), and/or citizen efforts to ensure public service accountability (citizen feedback and monitoring); collectively, PITA mechanisms. We collected quantitative and qualitative data from the included studies and used statistical meta-analysis and realist-informed framework synthesis to analyse the findings. Results: The findings suggest that interventions promoting citizen engagement by improving direct engagement between service users and service providers, are often effective in stimulating active citizen engagement in service delivery and realising improvements in access to services and quality of service provision, particularly for services that involve direct interaction between citizens and providers. However, in the absence of complementary interventions to address bottlenecks around service provider supply chains and service use, citizen engagement interventions alone may not improve key wellbeing outcomes for target communities or state-society relations. In addition, interventions promoting citizen engagement by increasing citizen pressures on politicians to hold providers to account, are not usually able to influence service delivery. Conclusions: The citizen engagement interventions studied were more likely to be successful: (1) where the programme targeted a service that citizens access directly from front-line staff, such as healthcare, as opposed to services accessed independently of service provider staff, such as roads; (2) where implementers were able to generate active support and buy-in for the intervention from both citizens and front-line public service staff and officials; and (3) where the implementation approach drew on and/or stimulated local capacity for collective action. From a research perspective, the review found few studies that investigated the impact of these interventions on women or other vulnerable groups within communities, and that rigorous impact evaluations often lack adequately transparent reporting, particularly of information on what interventions actually did and how conditions compared to those in comparison communities.