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

Hailu, Workagegnehu; Derseh, Lemma; Hunegnaw, Melkamu Tamir; Tesfaye, Tsebaot; Abebaw, Dessie

BACKGROUND: The Coronavirus disease (COVID-19) pandemic is the defining global health crisis of our time. To date, there is no curative treatment for COVID-19, and with vaccines only recently being rolled out predominantly in wealthy countries, prevention still remains the main strategy. Social distancing has been proven to mitigate the epidemic and limit disease spread. As is the case in many other countries, the Ethiopian government has declared a state of emergency and taken several measures to impose social distancing. The level of compliance with social distancing measures in Ethiopia is unknown. The aim of this study was to assess the compliance, barriers, and facilitators to social distancing measures for the prevention of COVID-19 in Northwest Ethiopia. METHODS: A cross-sectional survey using telephone interview triangulated by a qualitative study was conducted over a period of one month from April 20(th) to May 20(th), 2020 at the University of Gondar Hospital in Gondar, Ethiopia. A total of 401 randomly selected participants, and 12 key representative informants selected by convenience were included for the quantitative and qualitative studies, respectively. Information on socio-demographic factors, knowledge about COVID-19, and practices concerning preventive measures––particularly social distancing––was collected. Respondents were asked what they thought were the barriers and facilitators of social distancing during in-depth face-to-face interviews. Data were entered and analyzed using Epi-data and Stata software, respectively. Frequencies and odds ratios were analyzed. P-values < 0.05 were considered statistically significant, and a confidence level of 95% strength of association was used. RESULTS: A total of 425 study subjects were approached and 401 responded positively (response rate of 94.4%). Of the 401 study participants, 55.4% (95% CI 50.4, 60.2) reported poor compliance with social distancing measures. The mean age of the participants was 36.4 years (SD ± 11.8). The majority of participants (63.84%) reported that they went to crowded places without putting on a face mask. Of the participants, 243 (60.6%) and 306 (76.3%) had good knowledge on COVID-19 transmission and prevention, respectively. Multivariate logistic regression analysis revealed that only age (AOR= 1.02, 95% CI: 1.00–1.04) was significantly associated with social distancing measures, with older persons more likely than younger to comply with social distancing guidelines. CONCLUSION: The majority of the study's participants reported poor compliance with social distancing measures set by the government and health authorities. Reported compliance with social distancing measures was increased with increasing age.