Compliance, Barriers, and Facilitators to Social Distancing Measures for Prevention of COVID-19 in Northwest Ethiopia, 2020

Abstract

Background: The Coronavirus disease (COVID-19) pandemic is the defining global health crisis of our time. To date there is no definitive treatment for COVID-19 and prevention remains the main strategy in tackling it. Social distancing has been proven to contain the epidemic and limit disease spread. The Ethiopian government has declared state of emergency and have taken several measures to impose social distancing measures. Given its strong culture and norms, the level of compliance to social distancing measures in Ethiopia is unknown. This study aims to determine the compliance, associated factors, barriers, and facilitators to social distancing measures for the prevention of COVID-19 in Northwest Ethiopia.Methods: A telephone interview based cross-sectional survey triangulated by a qualitative study was conducted from April 20 to May 20, 2020. A total of 401 participants and 12 key informants included for the quantitative and qualitative study respectively. Information on socio-demography, knowledge about COVID-19, practice on preventive measures, particularly social distancing was collected. The barriers and facilitators of social distancing were elicited qualitatively using in-depth interviews. Data were entered and analyzed using Epi- data and Stata software, respectively. Frequencies and odds ratio are used to explain and analyze the results. P-values < 0.05 and confidence level of 95% were considered statistical significance and strength of association, respectively.Results: Out of 401 study participants, 55.36 %( 95% CI 50.43, 60.18) had poor compliance to social distancing measures. The mean age of the participants was 36.4 years with SD ±11.76. Majority of participants (63.84%) went to crowded places without putting face mask. Of the participants, 60.6% and 76.31% had good knowledge on COVID-19 transmission and prevention, respectively. Multivariate logistic regression analysis revealed only age (AOR= 1.02, 95%CI: 1.00–1.04) was significantly associated with social distancing measures. Conclusion: The majority of the study participants have poor compliance with social distancing measures set by the government and health authorities. Compliance with social distancing measures was increased with increasing age. Continuous health education and enforcing of social distancing rules are recommended.

Evidence Gaps and Challenges in the Fight Against COVID-19 in Africa: Scoping Review of the Ethiopian Experience

“…For instance, mask use at workplaces and public gatherings was reported to be low. 28 , 29 , 47 , 56 , 58 Only a few reported avoiding social gatherings and crowded settings 58 and practicing social distancing. 45 , 47 , 56 Most importantly, 21.2% of the participants opposed the wearing of face masks 23 and 28.3% had low intention to carry out those prevention measures.…”

“… 28 , 29 , 47 , 56 , 58 Only a few reported avoiding social gatherings and crowded settings 58 and practicing social distancing. 45 , 47 , 56 Most importantly, 21.2% of the participants opposed the wearing of face masks 23 and 28.3% had low intention to carry out those prevention measures. 57 Even though HCWs and community participants reported frequent hand washing practice, 24 , 25 , 52 only 16.3% of HCWs were observed to follow the correct sequence in hand washing.…”

“…Exposure to IPC-related training, having a better knowledge and a positive attitude about COVID-19, having a chronic medical illness, and being married were associated with better IPC practices. 26 , 53 On the other hand, younger age, 47 rural residency, working at low level healthcare facility, shortage of personal protective equipment (PPE), and high workload were associated with poor practice of infection prevention measures among HCWs. 26 …”

“…22,25,44,52,[54][55][56]58,59 Adherence to social distancing and mask use by both HCWs and the general public was reported to be poor. 23,28,29,45,47,[56][57][58] Moreover, HCWs, the healthcare system in general, and the community were not prepared for COVID-19 pandemic. 74,76,77 Lack of proper training and guidelines, critical shortage of PPE, lack of scientific evidence at hand, low local support, lack of proper communication and collaboration between stakeholders, and fear of contracting the infection were reported by the HCWs to be the major limiting factors.…”

“…Exposure to IPC-related training, having a better knowledge and a positive attitude about COVID-19, having a chronic medical illness, and being married were associated with better IPC practices. 26,53 On the other hand, younger age, 47 rural residency, working at low level healthcare facility, shortage of personal protective equipment (PPE), and high workload were associated with poor practice of infection prevention measures among HCWs. 26 For the general public, younger age, 50,55,56 urban residency, 50 college level education, 50,55,56 access to TV/ Radio and internet, 20,56 having large family size, 50,55 and having chronic medical illness 56 were associated with good level of knowledge and favorable attitude for COVID-19 prevention.…”