Based on a national telephone survey and a mixed-method approach using an appropriate conceptual framework , this study showed how the social acceptability of government measures to combat the COVID-19 pandemic in Senegal was highly variable. While the level of acceptability was generally satisfactory at the time of this study (June/July 2020), quantitative analyses highlighted differences according to age, gender, region, and also according to the measures organised by the state. The qualitative survey that followed was fruitful in understanding these differences and grasping the social context of their explanation, which quantitative measures cannot always highlight. Researchers have shown how the spread and explanation of the pandemic was heterogeneous and depended very much on the contexts . It is also the organisation of universal measures in relation to interventions adapted to regional contexts, gender, or age that is referred to in these results. Many studies highlight the importance of adapting interventions to the contexts and people concerned in order for them to be effective . However, this adaptation is obviously a challenge for governments in their desire to act for all their citizens.
In Senegal, another telephone survey carried out in early April 2020 showed that 86% of people were very or rather confident in the government's ability to take care of its citizens without any gender or regional differences . Another telephone survey conducted only in the capital (Dakar) in early April showed that 88% of people were very or somewhat satisfied with government measures. Similarly, 86% of Dakar residents were in favour of the closure of places of worship without any known differences according to age and gender . These differences with our survey, where confidence levels are relatively lower, could be explained by the fact that it took place more than two months later, thus giving respondents time to notice the spread of the virus (Fig. 1) despite government measures. Another national telephone survey in Senegal conducted in August 2020, just after our survey, confirms our findings by showing that men are less satisfied with the government response than women (52% vs. 60%). Contrary to our study, they did not find any difference between the youngest and the oldest regarding this level of satisfaction (62% vs. 64%) .
Elsewhere in the world, research shows the importance of the role of trust in the state for the acceptability of measures taken to fight the pandemic [8–10, 24, 40]. Conceptually, trust is one of the important determinants of acceptability . In Nigeria, mistrust of the state and its forms of corruption play a negative role in the acceptance of measures to combat the COVID-19 pandemic especially since in the same West African country and in Egypt, two other studies show that respondents believe that the states are not doing enough to curb the pandemic [16, 17]. The fight against Ebola in West Africa has also shown how central the issue of trust is in the acceptability of control strategies . In Senegal, several of our respondents denounced a politicisation of the management of the pandemic, as seems to be the case in West Africa  and elsewhere [44, 45]. The management of the HIV epidemic in Africa had also given rise to such analyses .
Beyond the negative effects of curfews on health noted in Senegal and Kenya  example, our study showed that while the perception was very positive for the majority of people, it was not necessarily to fight the pandemic. The qualitative aspect showed that the curfew was appreciated for its unintended effects: security and social/family cohesion. The analysis of the unintended effects of public health interventions is rarely carried out, particularly in Africa . In this case, it is thanks to our qualitative approach that they have been brought to light. This result shows the value of mixed methods and qualitative studies for understanding complex situations. The analysis of the unexpected effects of the measures taken by States to combat the pandemic remains to be done . While in Senegal the unintended effects perceived by respondents are essentially positive, work is beginning to show some negative unintended effects of government responses, particularly for the most vulnerable people or in low-income countries [51–53]. Here we are obviously thinking of economic issues, but also mental health issues.
On the other hand, a relatively expected perception was that of gender difference. The results of the study confirm gender stereotypes and their integration into thought patterns. Men are rebellious and strong, women are sensitive and confident (and in their opinion intelligent). It is essential to take gender into account in the fight against the pandemic particularly in West Africa (. While the quantitative survey was carried out by women, the qualitative survey was carried out by a man, which may not have made it possible, particularly over the telephone, to deepen this gendered vision of perceptions. Further analysis of our data in this regard is planned in a future article.
A survey carried out in Senegal in August 2020 showed that 49% of the over-56 s say they have not been to their place of worship in the last seven days compared to 33% of the under-25 s , confirming the perception of our study according to age. The question of closing places of worship and then reopening them seven weeks later was certainly the most discussed by the respondents in our research. Religion is a very important social issue in Senegal. This issue affects people's values but also the way in which the Senegalese state governs its relations with Muslim brotherhoods and Catholic authorities. Older people were most in agreement with their closure, and then disagreed with their reopening. Since they are the people who frequent places of worship the most, one might have thought the opposite. This was not the case because older persons are genuinely aware that they are most at risk in the context of the COVID-19 pandemic, especially when one considers their challenges in terms of access to care , intergenerational solidarity in Senegal, and the difficulties in applying measures in places of worship. The average age of serious cases has been estimated at 64 years in Senegal, with lethality ranging from 41–45% . This perception of their vulnerability acquired in a few months is remarkable and can be a positive element in terms of communication about the pandemic. As in the case of the analyses concerning the spread of HIV on the continent , it could be hypothesised that, although susceptibility to the COVID-19 pandemic appears to be lower than elsewhere in the world for reasons which remain to be explained, the vulnerability of the elderly is obvious and perceived as such by those concerned. Similarly, could this low population susceptibility in Senegal be explained by strong social cohesion in a low-income country, following the theoretical propositions of the HIV analysis ?
On the other hand, like others, they did not understand the lifting of these measures when the pandemic was still going on and was constantly being discussed in the media. The challenges of policy coherence were not limited to places of worship, as a Senegalese social scientist notes . They also emerged when it was announced that schools would reopen for examination classes on June 2, cancelled on June 1st and finally authorised on June 25. Then the Senegalese President, who was himself in quarantine, announced the lifting of the state of emergency and curfew on June 29 only 24 hours before, leaving the population sceptical about this swift decision. In addition, as in Côte d'Ivoire, displacement measures for teachers returning to Senegalese regions were lifted on June 4 (in the midst of a pandemic, see Fig. 1), with the immediate consequence of the virus circulating. We are, therefore, at the heart of the study of the coherence of public policies, a new criterion for evaluating development interventions , and a central concept in political science [13, 61]. The national press has also widely commented on the state's decision to authorise the reopening of places of worship, claiming that the justification was in no way health-related, but political, as it gave way in particular to pressure from Muslim brotherhoods, which are known to have enormous political and economic weight in Senegal . The Catholic community decided not to follow this directive, as did some brotherhoods who "refused to close their mosques and continue collective prayers" . Denial of the pandemic was already noted by anthropological research at the beginning of the pandemic in these regions . The great annual pilgrimage of Touba, bringing together more than four million people in October 2020 in these same regions, has not been cancelled (62) even though this region was one of the first clusters of the pandemic . Obviously, the economic stakes of these decisions cannot be denied in countries where the informal and agricultural sectors are very important. A national survey by ANSD in July 2020 in Senegal showed that 85% of households claimed to have suffered a drop in income, and 36% of heads of household said they had stopped working: 30% of them for reasons linked to the pandemic .
The strength of this study is that it used a nationally representative sample of quota criteria whose quantitative results were explained by a qualitative survey, using a sound conceptual approach . The technical innovation of a telephone survey in a country without a national telephone directory is particularly noteworthy and will be the subject of another article. The study showed its feasibility, particularly in a pandemic context where it was a question of respecting barrier measures. The limitations concern the statistical analyses, which remain relatively descriptive for the moment, but will be explored in greater depth for a future article. This relative simplicity was an essential condition for carrying out a rapid qualitative survey, so as not to increase the memory bias of the participants.