Identifying factors associated with the issuance of coronavirus‐related stay‐at‐home orders in the Middle East and North Africa Region

• Published date: 01 September 2021
• Author: Gregg R. Murray,Nadia Jilani‐Hyler
• Date: 01 September 2021
• DOI: http://doi.org/10.1002/wmh3.444

World Med. & Health Policy. 2021;13:477–502. wileyonlinelibrary.com/journal/wmh3 © 2021 Policy Studies Organization

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477

Received: 22 August 2020

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Accepted: 8 April 2021

DOI: 10.1002/wmh3.444

ORIGINAL ARTICLE

Identifying factors associated with the

issuance of coronavirus‐related stay‐at‐home

orders in the Middle East and North Africa

Region

Gregg R. Murray

1,2

|Nadia Jilani‐Hyler

1

1

Augusta University, Augusta, Georgia, USA

2

Augusta University Center for Bioethics and

Health Policy, Augusta, Georgia, USA

Correspondence

Gregg R. Murray, Augusta University,

Augusta, GA 30912, USA.

Email: gmurray@augusta.edu

Abstract

The COVID‐19 pandemic has not spared the Middle

East and North Africa (MENA) Region. MENA is one of

the most politically, socially, and economically hetero-

geneous regions in the world, a characteristic reflected

in its governments' responses to COVID‐19. About two‐

thirds of these governments issued coronavirus‐related

stay‐at‐home orders (SAHOs), one of the most effective

tools public health officials have for slowing the spread

of infectious diseases. While SAHOs are very effective

in terms of countering infectious diseases, they are ex-

tremely disruptive in nonhealth domains. The objective

of this study is to identify reliable factors related to health

care policy making that shaped the decisions of MENA

governments to issue a SAHO or not in response to

COVID‐19. The results identify specific political, social,

and medical factors that played important roles and

provide a look at early government responses to a global

health crisis in a heterogeneous region of the world.

Key Points

•About two-thirds of MENA governments issued stay-

at-home orders (SAHOs) in response to the early

stages of the COVID-19 pandemic.

•While SAHOs are very effective in terms of countering

infectious diseases, they are extremely disruptive in

non-health domains.

•Among broad factors that typically affect public health

policy making, the results suggest medical and poli-

tical considerations as well as policy diffusion reliably

influenced the issuance of SAHOs in MENA.

•This research gives policy makers and researchers a

look at early government responses to a global health

crisis in a heterogeneous region of the world.

KEYWORDS

coronavirus, COVID‐19, lockdowns, MENA, pandemic, policy

diffusion, public health, stay‐at‐home orders

INTRODUCTION

The COVID‐19 pandemic has created turmoil around the world. Widespread infection and

deaths have led governments to take a number of steps to contain the disease including

running public awareness campaigns, limiting public gatherings and domestic travel, im-

posing curfews, changing prison policies, closing schools and borders, and issuing lock-

downs and stay‐at‐home orders (SAHOs; ACAPS, 2020). The most restrictive health

policies can dramatically limit the spread the disease (e.g., Kraemer et al., 2020), but in

nonhealth domains the consequences have been severe (e.g., Coetzee & Kagee, 2020).

For instance, UNESCO (2020) reports that nationwide school closures have affected more

than 60% of the world's student population with localized closures affecting millions of

additional students, and, according to some, these closures being among the most dis-

ruptive consequences of this pandemic (Hoffman & Miller, 2020). Further, locking down

businesses has led to severe economic consequences across a wide range of countries

(UNIDO, 2020; World Bank, 2020b). The contraction of economic activity has been sub-

stantial, and millions of workers around the world have been furloughed (Jones et al., 2020),

including more than 40 million workers in Europe's six biggest economies (O'Brien &

Schneeweiss, 2020).

The Middle East and North Africa (MENA) Region has suffered from the consequences

of the disease with the rest of the world. Seven months into the pandemic, the United

Nations (UN) Office for the Coordination of Humanitarian Affairs (OCHA) reported that the

region had suffered almost 1 million confirmed cases and more than 17,000 deaths (OCHA,

2020). Shortly before that, the OECD reported that the pandemic is imposing a “dramatic

economic cost”(OECD, 2020, p. 1) and “massive economic turmoil”(OECD, 2020,p.6)in

the region due to simultaneous shocks from large drops in oil prices, economic consump-

tion, and trade.

MENA includes a population of about 550 million people who embody highly hetero-

geneous governmental, socioeconomic, cultural, linguistic, and religious characteristics.

Strategically located between East and West, the MENA region garnered historic interest

due to trading routes, but now is better known for having a large share of the world's

petroleum reserves. A history of colonialism influenced a statist approach to governing, with

a significant emphasis on domestic and national security. Government types include mon-

archies, theocracies, single‐party authoritarian states, consociationalism, and parliamentary

democracies. Economies range from some of the world's wealthiest to some of its poorest.

Religious cleavages also influence domestic and international policy. The current war in

Yemen serves as an example, with Shia Houthi rebels supported by Iran and Sunni former

government officials supported by Saudi Arabia as both countries vie for regional hege-

mony. The MENA Region is complex and worth study under “normal”circumstances. During

the COVID‐19 pandemic, its varied and complex nature offers researchers and policy ma-

kers an important opportunity to evaluate public health decision making within the context of

a worldwide health crisis. As Okma and Marmor (2013, p. 490) note, “relationships that hold

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