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  1. Abdul Aziz NI, Flanders S, Nungsari M
    PLoS One, 2022;17(9):e0275010.
    PMID: 36156604 DOI: 10.1371/journal.pone.0275010
    High vaccination rates are integral to reducing infection and severity rates of COVID-19 infections within a community. We examine the role of social expectations in COVID-19 vaccination take-ups and its interaction with potential government actions in Malaysia. We find that individuals' expectations of others in their social groups towards vaccination predicts those individuals' vaccination registrations. Using a vignette experiment, we examine the extent of normative expectations in normalizing pro-vaccination behavior beyond an individual's reference group. We find that unless moderated by a high level of public trust, individuals prefer punitive policies as a way to increase vaccination rates in their communities.
  2. Nungsari M, Chuah HY, Flanders S
    PLoS One, 2022;17(8):e0271977.
    PMID: 35913929 DOI: 10.1371/journal.pone.0271977
    This paper examines the experiences of refugees in a developing country during its first COVID-19 lockdown by utilizing a two-stage qualitative data analysis of 39 interviews with refugees and asylum-seekers. We find that their experiences during the lockdown are shaped by identity, trauma and help from external parties-such as community leaders and local non-governmental organizations (NGOs). Experiences during the pandemic in turn moderate the relationship between policy changes and trust in domestic authority figures, which consequently affects attitudes towards and compliance with public health measures put in place to contain the pandemic. We then explore the role of identity in refugees' pandemic experiences by comparing the differences between two refugee groups (Syrians and Rohingyas), validating them by utilizing comparative thematic analysis. Finally, the paper presents policy implications for crisis response in developing countries by suggesting improvements that can be made on the ground regarding the delivery of aid and assistance to vulnerable groups.
  3. Nungsari M, Hui Yin C, Fong N, Pillai V
    Wellcome Open Res, 2021;6:263.
    PMID: 35111977 DOI: 10.12688/wellcomeopenres.17239.2
    Background: Globally, vulnerable populations have been disproportionately affected by the COVID-19 pandemic and subsequent responses, such as lockdown measures and mass vaccinations. Numerous ethical challenges have arisen at different levels, be it at the policy-making level or on the ground. For example, policymakers have to contain a highly contagious disease with high morbidity using scarce resources, while minimizing the medium- to long-term social and economic impacts induced by containment measures. This study explores the impact of COVID-19 on vulnerable populations in Malaysia by using an intersectional framework that accounts for overlapping forms of marginalization.   Methods: This study utilizes in-depth qualitative data obtained from 34 individuals and organizations to understand the impact of the COVID-19 outbreak on vulnerable populations in Malaysia. We utilize four principles of ethics to guide our coding and interpretation of the data - namely beneficence, non-maleficence, justice and autonomy. We utilize a frequency analysis to roughly understand the types of ethical issues that emerged. Using hermeneutic content analysis (HCA), we then explore how the principles interact with each other. Results: Through the frequently analysis, we found that although beneficence was very prevalent in our dataset, so was a significant amount of harm - as perpetuated through injustice, the removal or lack of autonomy and maleficence. We also unearthed a worrying landscape of harm and deep systemic issues associated with a lack of support for vulnerable households - further exacerbated during the pandemic. Conclusions: Policy recommendations for aid organizations and society to mitigate these ethical problems are presented, such as long overdue institutional reforms and stronger ethical practices rooted in human rights principles, which government agencies and aid providers can then use in the provision of aid to vulnerable populations.
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