Compliance level toward COVID-19 preventive measures and associated factors among the Ambo University community, 2021

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TYPE Original Research
PUBLISHED 27 September 2022
DOI 10.3389/fpubh.2022.958270
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EDITED BY
Reza Lashgari,
Shahid Beheshti University, Iran
REVIEWED BY
Manoj Kumar,
University of Petroleum and Energy
Studies, India
Habtamu Bekele,
Haramaya University, Ethiopia
*CORRESPONDENCE
Ephrem Yohannes Roga
efremjohn27@gmail.com
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This article was submitted to
Infectious Diseases - Surveillance,
Prevention and Treatment,
a section of the journal
Frontiers in Public Health
RECEIVED 31 May 2022
ACCEPTED 02 September 2022
PUBLISHED 27 September 2022
CITATION
Roga EY, Bekele GG and Gonfa DN
(2022) Compliance level toward
COVID-19 preventive measures and
associated factors among the Ambo
University community, 2021.
Front. Public Health 10:958270.
doi: 10.3389/fpubh.2022.958270
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Compliance level toward
COVID-19 preventive measures
and associated factors among
the Ambo University
community, 2021
Ephrem Yohannes Roga*, Gemechu Gelan Bekele and
Dajane Negesse Gonfa
Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo,
Ethiopia
Background: The coronavirus illness is a highly contagious viral infection
with serious health consequences that has occurred all around the world.
Application of COVID-19 prevention precautions and social interventions
by the general public are critical to successfully combating the epidemic.
Therefore, this study aimed to determine the level of compliance and
associated factors with COVID-19 prevention strategies.
Methods: A facility based cross-sectional study was conducted from June 01
to August 30, 2021 on a sample of 380 randomly selected Ambo University
community members. A self-administered structuralized questionnaire was
used to collect the data. The determining factors with the level of compliance
were finally identified using a multivariate logistic regression model. The
association was reported using odds ratios with a 95% CI, and significance was
declared using a P<0.05.
Results: A total of 378 respondents participated in the study with a response
rate of 98.9%. Most of the respondents, 75.7%, 57.9%, 47.4%, 61.9% had good
knowledge, favorable attitude, good practice and good compliance toward
COVID-19 preventive measures, respectively. In participants aged between 18
and 30 [AOR =AOR =2.23, 95% CI: (1.13, 4.41)], good knowledge [AOR =2.64,
95% CI: (1.46, 4.78)], favorable attitude [AOR =4.5, 95% CI: (2.63, 7.71)], and
good practice [AOR =2.98, 95% CI: (1.82, 4.89)] were significantly associated
with good compliance toward COVID-19 preventive measures.
Conclusion and recommendation: Despite the fact that COVID-19 is a global
and national priority, the preventive measures were not suciently followed.
Therefore, it is essential to continue working on the community’s knowledge,
practices, and attitude about COVID-19 preventive measures through media
campaigns, which will ultimately increase compliance. Additionally, the
concerned stakeholders should consider the required interventions for the
strongly associated factors that have been discovered in this current study.
KEYWORDS
COVID-19, Ambo University, compliance, practice, attitude, knowledge
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Background
Coronavirus disease 2019 (COVID-19) is a highly
contagious illness that has killed many people across the globe
(1). As of 7th May 2022, globally, there have been 600,875,353
confirmed cases of COVID-19, including 6,486,034 deaths, and
a total of 11,562,157,794 vaccine doses have been administered.
In Ethiopia (out of a total population of 116.4 million) 493,167
people have been confirmed for COVID-19, with over 7,571
deaths (2).
The impact of the COVID-19 outbreak on low-income
countries including Sub-Saharan Africa is expected to be far-
reaching and more disastrous than in high-income countries,
due to pre-existing conditions such as population size, health
system status, and health workforce, which are expected to
exacerbate any COVID-19-related health outcomes (3,4).
According to a study conducted in Ethiopia, the pandemic
has severely impacted the academic and business operations
of higher education institutions by dwindling their sources
of income, lowering employee productivity, and limiting
institutional capacity to cover key costs such as salary and
rent (5).
The WHO has devised a number of mitigation techniques to
curb the spread of COVID-19 due to its pandemic nature and
lack of effective treatment. Staying at home, social distancing,
wearing masks, and practicing hand hygiene are some of
the most frequently advised pandemic prevention techniques.
Furthermore, in reaction to the pandemic, countries all over
the world have taken numerous measures to halt the virus’
spread and protect vulnerable people from infection (6). These
strategies are critical for lowering mortality and alleviating the
burden on healthcare systems (4,7). Such safeguards are thought
to reduce COVID-19 transmissions in general and in particular
to protect those at higher risk of severe illness, such as the elderly
and those with underlying medical conditions like diabetes
mellitus (8), and in frontline health workers (9,10).
Moreover, in order to optimize the vaccination program
and achieve a notable success in the COVID-19 immunization
program across the continent, these remedies and other
crucial recommendations to these problems were offered
(11). A thorough and timely planning process, prompt plan
implementation, rigorous community involvement, and a strong
multi-sector partnership all contributed to the success of the
COVID-19 vaccination campaign in Africa (12).
Even though people had high knowledge, gaps and laxity
have been observed in the application of preventive measures for
COVID-19 among citizens (13–15). New cases have continued
to emerge despite efforts to expand public health interventions
Abbreviations: COVID-19, Coronavirus disease 2019; HCWs, Health Care
Workers; KAP, Knowledge Attitude Practice; PPE, Personal protective
equipment.
to contain and control the spread of the coronavirus throughout
the world. Moreover, a study done in India revealed that on April
25, 2020, the recovery rate from COVID-19 was 21.97%, and
by June 1, 2020, it was 79%. Furthermore, the authors forecast
a monthly percentage increase in the number of COVID-
19 cases from May 1st to December 1st, 2020. This analysis
would enable the relevant authorities to implement effective
preventive measures during the decision-making process (16).
According to the study conducted in India, France, China,
and Nepal to predict the coronavirus outbreak, the number of
COVID-19 cases will increase gradually and the epidemic will
continue, but the number of active cases has been drastically
reduced in three of these countries with France being the
exception (17).
Currently, there is no conclusive cure or specific antiviral
therapeutics suggested for preventing or treating COVID-19.
Thus, preventive measures ranging from individuals to large-
scale societal level practices are the only available means to
control the spread of the virus and minimize its impacts (18,
19). So, the aim of this study was to assess the compliance
level of the Ambo University community toward prevention
measures for COVID-19. The finding of this study might
help the higher administrators, policy makers, researchers, and
concerned stakeholders review their guidelines to contain the
pandemic and take appropriate measures against those who
break the prevention protocol. Therefore, this study aimed to
determine the level of compliance and associated factors with
regard to COVID-19 prevention measures at Ambo University,
in 2021.
Methods
Study area and period
This study was conducted at Ambo University campuses
from June 01 to August 30, 2021. Ambo University is
located in Ambo, the capital of West Shaw Zone of Oromia
Regional State. According to the information from the Office
of Vice President for Administration and Student Services,
Ambo University was established in 1947 as the School of
Agriculture, the first agricultural school in Ethiopia. Ambo
University is one of the foremost higher education institutions
boasting significant contributions to the country‘s overall
development by producing skilled human resources in various
fields. Currently, the university runs 48 graduate and 70
undergraduate programs. The programs are classified into nine
colleges/institutes/schools with several academic departments.
Besides the main campus at Ambo, the university has three
campuses at Awaro, Guder, and Woliso. The university also
owns three research centers; two of them (one at Ejere and
the other at Bilo) focus on research and conservation of
indigenous trees, while the third at Birbirsa (about 20 km from
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Roga et al. 10.3389/fpubh.2022.958270
Ambo) works on overall agricultural research and development
and was named after a prominent Ethiopian humanitarian,
Abebech Gobena.
Study design
An institution-based perspective cross-sectional study was
conducted among the Ambo University community.
Study population
The study was comprised of all Ambo University employees,
both academic and administrative, who provided services at
Ambo University during the study period. Those who were
unable to reply due to illness or who refused to engage in the
study were omitted.
Sample size determination and sampling
procedure
Because no studies had been undertaken in this area, the
sample size was calculated using a single population proportion
formula with a confidence level of 95%, significance level of 1.96,
5% margin of error (d), and a prevalence of compliance level (P
=50%). The population correction formula was utilized in this
study because the population (3,469) was <10,000. After adding
10% to account for the non-response rate, the final sample size
was 380. Two campuses out of four were chosen at random,
ensuring that at least 30% of Ambo University’s campuses were
covered. As a sampling frame, a list of employed attendance
content comprising both administrative and academic staff
was used. As a result, the participants of this study were
chosen using a simple random sampling technique with a
lottery method.
Study variables
Independent variables
Socio-demographic factors (sex, age, religion, educational
level, marital status, ethnicity, family size, and average
monthly income), practice, knowledge, and attitude were
independent variables.
Dependent variable
Compliance level toward COVID-19 preventive measures.
Operational definitions
Compliance level toward COVID-19 preventive
measures
The score for compliance-related questions was 18
points and respondents who rated a sum score of 50%
and above were considered to have good compliance and
those who rated below 50% were considered to have poor
compliance (20).
Knowledge toward COVID-19 preventive
measures
There were 22 knowledge-related questions and respondents
with a sum score of 50% or more were regarded to have strong
knowledge, while those with a score of <50% were considered to
have poor knowledge (21).
Attitude toward COVID-19 preventive
measures
The score for attitude-related questions was 16 points
and respondents who rated a sum score of 50% and above
were considered to have a favorable attitude and those who
rated below 50% were considered to have an unfavorable
attitude (22).
Practices toward COVID-19 preventive
measures
Practices-related questions were scored out of 14 possible
points, with respondents with an overall score of 50% or
higher being considered to have good practices, and respondents
with an overall score of <50% were considered to have poor
practices (23).
Data collection technique and tool
The data were gathered by a self-administered questionnaire
devised by the investigators after reading several COVID-19
guidelines and other sources (24–26). The questionnaire was
divided into four sections. The study contained questions about
respondents’ socio-demographic factors, attitudes, practices,
knowledge, and compliance toward COVID-19 preventive
measures. The data collection tool was originally written in
English, then translated into Afaan Oromo (the local language),
and finally back to English by language experts to ensure
its consistency. In addition, four trained BSc nurses (two
data collectors for each campus) and three MSc-holder nurses
oversaw the data collection process.
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Data quality assurance
This study recruited experienced data collectors to assure
data quality. The questionnaire was developed by the lead
investigator using questions from previously published peer-
reviewed studies. The pretest was conducted on 5% of the
sample size at Guder Campus. For one day, data collectors
and supervisors received training on research objectives, data
collection tools and processes, and interview techniques.
Furthermore, each supervisor was responsible for overseeing the
data collection process on a daily basis.
Data processing and analysis
The data were double-checked for accuracy and
completeness before being entered into Epinfo version
7.2.2.6. The data were then cleaned, coded, and analyzed using
SPSS version 25. Missed values and outliers were checked in
the data. To define the required variable, descriptive analysis
(such as frequencies, tables, percentages, means, and standard
deviation) was used. Then, based on bivariate logistic analysis,
any variables with a P<0.25 were considered candidates for
multivariate logistic regression models. The factors associated
with compliance level to COVID-19 preventive measures were
identified using multivariable logistic regression at the 95%
confidence level. A significance level of 0.05 was taken as a
cutoff value for all statistical significance tests. Multi-collinearity
was checked between each variable using the variance inflation
factor. Accordingly, no multi-collinearity was detected. Hosmer
and Lemeshow’s goodness of fit test was administered to check
the model fitness.
Results
Socio-demographic characteristics of the
participants
In this study 378 participants completed the questionnaire,
translating to a 98.95% response rate. The sample consisted of
51.3% (n=194) males, with a median age of 29.9 years (SD
±4.98), with the majority aged (43.1%, n=140) between 31
and 40 years. Participants with bachelor’s degrees constituted
40.7% (n=154) and the highest educational achievement in the
sample was a PhD degree. More than half (55.8%, n=211) of the
respondents were from the Oromo ethnic group. The majority
of the participants, 50.8% (192), were followers of a protestant
religion. Moreover, most of the respondents’, 56.9% (n=215),
average monthly income was between 4000 and 9000 Ethiopian
Birr. In terms of the respondents’ marital status, 148 (39.2%)
of them were married. The majority of the participants’, 215
(56.7%), had a family size of 1–4 in number (Table 1).
TABLE 1 Socio-demographic characteristics of the Ambo University
community participating in the study, Ethiopia, 2022.
Variables Category Frequency Percent
Sex Male 194 51.3
Female 184 48.6
Age 18–30 140 37.0
31–40 163 43.1
≥41 75 19.8
Ethnicity Oromo 211 55.8
Amhara 152 40.2
Tigre 10 2.6
Gurage 5 1.3
Religious Orthodox 165 43.7
Protestant 192 50.8
Muslim 10 2.6
Catholic 11 2.9
Averagely monthly income 1,200–3,000 89 23.5
4,000–9,000 215 56.9
10,000–15,000 74 19.6
Educational level Diploma 86 22.8
First degree 154 40.7
Second degree 104 27.5
PhD/Assistant professor 34 9.0
Marital status Single 117 31
Married 148 39.2
Divorced 76 20.1
Widow 37 9.8
Family size 1–4 215 56.9
5–8 126 33.3
9–15 37 9.8
Knowledge, attitude, practice, and
compliance of respondents toward
COVID-19 preventive measures
The composite of overall knowledge of the participants
showed that a majority of the respondents, 286 (75.7%),
have good knowledge about COVID-19 preventive measures.
Additionally, more than half, 219 (57.9%), of the participants
show a favorable attitude toward COVID-19 preventive
measures. Moreover, the current study shows that less than half
of the participants, 179 (47.4%), have good practices regarding
COVID-19 preventive measures. Additionally, a majority, 234
(61.9%), of the participants have good compliance toward
COVID-19 preventive measures. Most of the study participants,
196 (51.9%), report that they wear a facemask frequently. Most
of the respondents, 240 (63.5%), did not follow advice to avoid
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TABLE 2 Preventive practices of COVID-19 among the Ambo University community, 2022 (n=378).
Preventive practices of COVID-19 characteristics Category Frequency Percent
In order to prevent contracting and spreading COVID-19, I avoid going out of my home No 183 48.4
Yes 195 51.6
In order to prevent contracting and spreading COVID-19, I avoid unnecessary vacations No 179 47.4
Yes 199 52.6
In order to prevent contracting and spreading COVID-19, I avoid consuming outdoor food No 240 63.5
Yes 138 36.5
In order to prevent contracting and spreading COVID-19 I avoid handshaking, hugging, and kissing No 187 49.5
Yes 191 50.5
In order to prevent contracting and spreading COVID-19, I avoid public transportations (taxi, bus, plane, train) No 203 53.7
Yes 175 46.3
In order to prevent contracting and spreading COVID-19, I avoid going to work No 191 50.5
Yes 187 49.5
In order to prevent contracting and spreading COVID-19, I frequently wash my hands No 211 55.8
Yes 167 44.2
In order to prevent contracting and spreading COVID-19, I pay more attention to my personal hygiene than usual No 192 50.8
Yes 186 49.2
In order to prevent contracting and spreading COVID-19, I use disinfectant and solutions No 194 51.3
Yes 184 48.7
In order to prevent contracting COVID-19, I use herbal products and traditional medicine No 218 57.7
Yes 160 42.3
In order to prevent contracting COVID-19, I take vitamin supplements No 218 57.7
Yes 160 42.3
In order to prevent contracting and spreading COVID-19, I use facial masks frequently No 182 48.1
Yes 196 51.9
consuming outdoor food in order to prevent contracting and
spreading COVID-19 (Table 2).
Factors associated with compliance
toward COVID-19 preventive measures
among the Ambo University community
Bivariate logistic analysis identified candidate variables
such as age, educational status, sex, family size, knowledge,
attitude, and practices which were associated with compliance
of COVID-19 preventive measures at P<0.25. Then
multivariate logistic analysis was conducted and found to
be a good fit for these factors. At a P<0.05, multivariate
logistic regression analysis revealed that age, knowledge,
attitude, and practice were considerably and statistically
associated with compliance to COVID-19 preventive
measures. Younger respondents were two times more likely
to have good compliance toward COVID-19 preventive
measures than those >40 years old. Participants with good
knowledge, favorable attitude, and good practice were 2.6,
4.5, and 2.9 times respectively more likely to have good
compliance toward COVID-19 preventative measures than
their counterparts (Table 3).
Discussion
This study found that most of the respondents, 61.9%
(95% CI: 56.9, 66.7), had good compliance toward COVID-
19 preventive measures. Moreover, the current study revealed
that age, knowledge, attitude, and practice were identified as
important factors associated with compliance toward COVID-
19 preventive measures in the study area. This finding is in
line with the study conducted in Ethiopia that found that
about 55.3 and 57.8% had good compliance toward COVID-
19 preventive measures (21). Another study conducted in
Uganda showed that 74% had good compliance toward COVID-
19 preventive measures (27). A study conducted in Debre
Birhan, Ethiopia showed that 56.1% of women exhibited good
compliance with COVID-19 preventive measures (28). A study
conducted in South Korea also showed that participants’ overall
compliance rate was 50.5% (29). However, the study conducted
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TABLE 3 Bivariate and multivariate logistic regression of factors aecting respondents’ compliance toward COVID-19 preventive measure among
the Ambo University community, 2022, (n=378).
Variable Compliance COR (95% CI) AOR (95%CI) P-value
Good Poor
Nu % Nu %
Age 18–30 91 65 49 35 1.71 (0.97, 3.03) 2.23 (1.13, 4.41) 0.001
31–40 104 63.8 59 36.2 1.63 (0.94, 2.83) 1.67 (0.88, 3.16)
≥41 39 52 36 48 1.00 1.00
Educational status Diploma 39 45.3 47 54.7 1.00 1.00
First degree 101 65.6 53 34.4 2.29 (1.34, 3.94) 1.59 (0.84, 3.01)
Second degree 67 64.4 37 35.6 2.18 (1.22, 3.91) 0.79 (0.37, 1.68)
PhD (Assistant Professor) 27 79.4 7 20.6 4.65 (1.83, 11.8) 1.35 (0.44, 4.21)
Knowledge Good 194 67.8 92 32.2 2.74 (1.69, 4.45) 2.64 (1.46, 4.78) 0.003
Poor 40 43.5 52 56.5 1.00 1.00
Attitude Favorable 168 76.7 51 23.3 4.64 (2.98, 7.24) 4.5 (2.63, 7.71) 0.004
Unfavorable 66 41.5 93 58.5 1.00 1.00
Practice Good 137 76.5 42 23.5 3.43 (2.2, 5.35) 2.9 (1.82, 4.89) 0.001
Poor 97 48.7 102 51.3 1.00 1.00
Bold values indicate that the variables are significantly associated with the compliance towards COVID-19 preventive measures.
in Southeastern Ethiopia showed the overall good compliance
and knowledge of health professionals regarding COVID-19
preventive measures were 21.6 and 25.5%, respectively (30).
Despite the current finding, a comparative cross-sectional study
between the developed and developing countries demonstrated
that the overall compliance to COVID-19-related preventive
measures was poor (31). A study done in Gondar indicated that
nearly half of the study participants [48.96% (95% CI: 45.05%,
52.89%)] had poor adherence toward COVID-19 mitigation
measures (23). This could be related to differences in study
design, socioeconomic status, and sample size. In comparison to
prior research, the current data demonstrated that compliance
with COVID-19 prevention strategies was enhanced. This
could be because information regarding COVID-19 prevention
methods has been widely disseminated through various media.
The current study, however, is not entirely satisfied with the
findings, indicating that there is still a gap that needs to
be filled.
The current study showed that younger people are more
compliant than older ones. This finding is supported with
the evidence from a study conducted in Ethiopia (28). Adults
and people in their later years have the lowest compliance
rates in both developing and wealthy countries, according
to a study. Older adults are often reliant on other family
members and may not be up to date on current events,
which reduces their compliance (31). This could be because, at
this age, people’s conduct is still largely governed by extrinsic
motivation (reward–punishment) and is focused on achieving
quick short-term goals (32) rather than social awareness.
Furthermore, people who view regulations as being too stringent
or demanding are more likely to break them (33), which may
be particularly common in this age range. However, according
to a study conducted in Spain, the younger group was less
compliant than the older group (34). A study conducted in
Ghana found that strong COVID-19 prevention strategies were
favorably linked with older women (35). According to studies,
advanced maternal age is a risk factor for severe complications
and mortality connected to COVID-19 preventative measures
during pregnancy, which explains why this group of people
adheres to them well (36). According to a study conducted
in Ethiopia, younger people were more knowledgeable than
elderly people (20). As a result, there may be a difference
due to the level of knowledge, understanding, and recalling
evidence about COVID-19 preventive actions being better
among younger people than among older people. This could lead
to younger age groups having a better awareness of COVID-
19 preventive actions and the severity and implications of
contracting the illness, resulting in better compliance with
preventive measures.
The current study found that compliance toward COVID-19
preventive measures was highly linked to participants’ positive
attitudes. This conclusion is backed up by a cross-sectional
study conducted in 12 Asian nations, which found that
good sentiments toward COVID-19 prevention measures
were linked to high compliance (37). The study conducted
in Gondar, Ethiopia showed that the respondents who
had a favorable attitude toward COVID-19 preventive
measures were 2.54 times more likely to adhere to the
mitigation measures than respondents who had an unfavorable
attitude toward COVID-19 preventive measures (23). This is
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corroborated by the findings of a qualitative method study,
which found that social variables, such as negative attitudes
toward persons who practice prevention measures, were
the main reasons for people not following the prevention
measures. People with a negative attitude regard a person
who wears a facemask and uses hand sanitizer as aliens
or as those who are afraid of death. As a result, people do
not take preventative precautions in order to avoid being
classified as such. Furthermore, a key source from the Borena
Health Office stated that “stigma is one of the elements
that has influenced the usage of preventative methods.
“Furthermore, some believe that the country is free of
coronavirus” (20). One possible explanation is that those
who have a positive attitude about COVID-19 prevention
measures trust the science of mitigation measures and follow
the guidelines’ directions.
This study discovered that having a solid understanding
of COVID-19 preventive measures is highly linked to good
compliance with COVID-19 preventive measures. Participants
with a low degree of understanding of COVID-19 preventive
measures had a decreased chance of adhering to COVID-19
preventive measures. A study conducted elsewhere supports
knowledge as the product of awareness based on receiving
relevant information (20). According to a study conducted
in Southeast Ethiopia, participants with adequate awareness
of COVID-19 prevention strategies had a roughly 1.8 times
better likelihood of good compliance. This could be due to
proper instruction (training duration), the availability of reading
materials/internet connections, and personal commitments
(30). Furthermore, another study conducted in China found
a link between knowledge of COVID-19 preventive measures
and compliance with COVID-19 preventive measures (38).
Moreover, a study conducted in Nigeria found that a lack of
awareness can have a negative impact on the level of compliance
with coronavirus prevention methods (39).
The current study found that the participants’ level of
compliance with COVID-19 prevention measures is influenced
by their practice. Participants who have a high degree of
practice also have a high level of compliance with the COVID-
19 preventive measure. This conclusion is consistent with
a research study conducted in Nigeria (40). Individual and
governmental preventive measures’ perceived effectiveness had
a significant impact on PPM compliance. Other research
studies have emphasized the importance of believing that
preventive actions will be effective (41). As a result, the
advertisements were successful in boosting public knowledge
about the effectiveness of preventive measures in reducing
COVID-19. Subsequently, greater resources for such efforts
should be allocated (42). Furthermore, the other study found
that good preventive practices were substantially linked to high
COVID-19 preventative measure compliance (37).
This current study might be exposed to a social desirability
bias due to the nature of the study. As a result of this
limitation, the findings of this study should be interpreted with
caution. However, this weakness was attempted to be minimized
by observing participants’ observable compliance dimensions
immediately following the interview and correcting responses as
needed. Furthermore, the lack of prior studies on compliance
with COVID-19 prevention and control strategies in various
settings restricted the discussion of this study to the available
circular guidelines. This may have jeopardized the findings’
comparability and generalizability, and readers should be aware
of this limitation.
Conclusion and recommendation
The overall level of compliance with COVID-19 prevention
measures has been assessed to be satisfactory. Age, knowledge,
attitude, and practice have all been associated to a high level of
compliance with COVID-19 prevention measures. Furthermore,
all stakeholders should consider the interventions that are
required for the identified highly connected factors. These
findings point to the need for programs and policies to increase
people’s understanding, attitudes, and COVID-19 preventive
activities in Ethiopia. Furthermore, the concerned entities
should adopt actions to enhance adherence to COVID-19
preventive measures.
Language plain summary
Coronavirus disease is a highly contagious viral infection
with major health consequences that has been introduced
globally. The general public’s compliance with public health
and social initiatives is important to successfully combatting
the epidemic. The goal of this study was to investigate
the level of COVID-19 prevention strategy compliance and
associated factors. A facility-based cross-sectional study of
380 randomly selected Ambo University community members
was undertaken from June 1 to August 30, 2021. To
collect data, a self-administered structured questionnaire was
used. Using a multivariate logistic regression model, the
determining factors affecting the level of compliance were
finally discovered. According to the findings, the majority of
respondents had good knowledge, a positive attitude, good
practice, and good compliance with COVID-19 prevention
measures. Participants aged 18–30, who had a positive attitude
and good practice, were associated with good compliance with
COVID-19 prevention strategies. The overall level of COVID-
19 prevention knowledge, attitude, and compliance was deemed
to be satisfactory. Age, knowledge, attitude, and practice were
all found to be substantially linked to successful COVID-19
prevention compliance. As a result, all stakeholders should
evaluate the necessary interventions for the identified highly-
linked factors.
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Data availability statement
The original contributions presented in the study are
included in the article/supplementary material, further inquiries
can be directed to the corresponding author/s.
Ethics statement
The studies involving human participants were reviewed and
approved by Ambo University Institutional Review Board. The
patients/participants provided their written informed consent to
participate in this study.
Author contributions
ER and GB contributed significantly to the
conceptualization, design of the project, and contributed
to the article’s development or critical revision for essential
intellectual content. DG assisted with data collecting, handled
data analysis, and interpretation. All authors agreed to be
responsible for all elements of the work, agreed to submit to the
current journal, and gave final approval of the published version.
Acknowledgments
We would like to express our gratitude to Ambo University
College of Medicine and Health Sciences Department of
Midwifery. We appreciate the assistance of the West Shewa
Zonal Health Office, study participants, data collectors,
and supervisors.
Conflict of interest
The authors declare that the research was conducted in the
absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
Publisher’s note
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authors and do not necessarily represent those of their affiliated
organizations, or those of the publisher, the editors and the
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