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.