Perceptions and compliance with COVID-19 preventive measures in Southern and Central regions of Mozambique: a quantitative in-person household survey in the districts of Manhiça and Quelimane
Authors: Nhacolo Ariel , Magaço Amílcar , Amosse Felizarda , Hunguana Aura , Matsena Teodomiro , Nhacolo Arsénio , Xerinda Elisio , Bassat Quique , Sacoor Charfudin , Mandomando Inácio , Munguambe Khátia 
Published: November 2022

Background

The COVID-19 pandemic has led countries into urgent implementation of stringent preventive measures at the population level. However, implementing these measures in low-income countries like Mozambique was incredibly difficult, coupled with lack of scientific evidence on the community understanding and compliance with these measures. This study assessed the perceptions and implementation of COVID-19 preventive measures recommended by Mozambican authorities in Manhiça and Quelimane districts, taking confinement, social distancing, frequent handwashing, mask wearing, and quarantine as the key practices to evaluate.

Methods

A quantitative survey interviewing households’ heads in-person was conducted in October 2020 and February 2021; collecting data on perceptions of COVID-19, symptoms, means of transmission/prevention; including self-evaluation of compliance with the key measures, existence of handwashing facilities, and the ratio of face-masks per person. The analysis presents descriptive statistics on perceptions and compliance with anti-COVID-19 measures at individual and household levels, comparing by district and other variables. T-test was performed to assess the differences on proportions between the districts or categories of respondents in the same district.

Results

The study interviewed 770 individuals of which 62.3% were heads of households, 18.6% their spouses, and 11.0% sons/daughters. Most participants (98.7%) had heard of COVID-19 disease. The most difficult measure to comply with was staying at home (35.8% of respondents said they could not comply with it at all); followed by avoiding touching the month/nose/eyes (28.7%), and social distancing at home (27.3%). Mask wearing in public places was the measure that more respondents (48.8%) thought they complied 100% with it, followed by avoiding unnecessary traveling (40.0%), avoiding crowed places (34.0%), and social distancing outside home (29.0%). Only 30.4% of households had handwashing devices or disinfectant (36.7% in Manhiça and 24.1% in Quelimane); and of those with devices, only 41.0% had water in the device, 37.6% had soap, and 22.6% had other disinfectant. The ratio of masks per person was only 1, which suggests that people may have used the same mask for longer periods than recommended.

Conclusions

Community members in Manhiça and Quelimane were aware of COVID-19 but they lacked understanding for implementing the preventive measures. This, together with socio-economic constraints, led to lower levels of compliance with the key measures. Understanding and addressing the factors affecting proper implementation of these measures is crucial for informing decision-makers about ways to improve community knowledge and practices to prevent infectious diseases with epidemic potential.