Adherence to COVID-19 preventive measures among residents in selected townships, Yangon Region, Myanmar: a community-based cross-sectional study
Authors: Htun Ye Minn , Maung Nyan Lin , Ko Dwe Kyaw , Htut Han Myo , Phyo Min Khant , Aung Wai Lynn , Zaw Hein Khant , Min Aung Kyaw , Kyaw Aung Phyo , Swe Thet , Zaw Kaung Khant , Win Kyaw Swar Naing , Ko Khant Ko , Thaw Khant Min , Aung Saw Pyae , Aung Saw Yan , Htun Soe San , Paing Soe Htet , Htun Soe Lin , Naing Zaw Myo , Htun Zin Ko , Naung Htoo , Oo Htun Htun , Hla Naing Ye , San Aung Kyaw , Myat Hpone Myint , Htet Phone Shan , Mon Min Khant , Paing Ye Myat , Phyo Wai Lin , Paing Win Khant , Rein Thu , Oo Thit Lwin , Zaw Thet Paing , Oo Thet Lynn , Thu Thint Myat , Aung Than Toe , Soe Hein Htet , Soe Aung Kyaw , Oo Aung Myint , Aung Aung , Aung Pyae Phyo , Kyaw Htun Aung , Kyaw Hpone Pji , Soe Yan Naing Myint , Ko Myint Myat , Aung Zin Ko , Aung Kyaw Thiha , Lwin Yan Paing Chit , Yan Wai , Soe Phyo Tayza , Htet Zin Linn , Sint Nay Hein , Aung Zayar , Winn Zin Thu , Thu Kaung Si , Shan Nyan Htet , Htun Nyan Sint , Win Tun Tun , Tun Kyaw Myo 
Published: May 2024

Abstract
Background
To fight the current coronavirus disease (COVID-19) pandemic, many countries have implemented various mitigation measures to contain the spread of the disease. By engaging with health service providers, the community’s participation in adherence to preventive measures is certainly required in the implementation of COVID-19 mitigation strategies. Therefore, this study aimed to assess the level of adherence to COVID-19 preventive measures and its associated factors among the residents, Yangon Region, Myanmar.

Methods
A community-based cross-sectional study was carried out among 636 residents in Yangon Region, Myanmar, from October to December 2021. A multistage non-probability sampling method, purposively selected for three townships in Yangon Region and convenience sampling for 212 participants from each township, was applied and the data were collected by face-to-face interviews using structured and pretested questionnaires. Data were entered, coded, and analyzed using IBM SPSS version 25.0. Simple and multiple logistic regression analysis were performed to identify the significant variables of adherence to COVID-19 preventive measures.

Results
As a level of adherence to COVID-19 preventive measures, the proportion of residents who had good adherence was 39.3% (95% CI 35.5–43.2%), moderate adherence was 37.6% (95% CI 33.8–41.5%), and poor adherence was 23.1% (95% CI 19.9–26.6%). The age group of 31–40 years (AOR: 3.13, 95% CI 1.62–6.05), 30 years and younger (AOR: 3.22, 95% CI 1.75–5.92), Burmese ethnicity (AOR: 2.52, 95% CI 1.44–4.39), own business (AOR: 3.19, 95% CI 1.15–8.87), high school education level and below (AOR: 1.64, 95% CI 1.02–2.69), less than 280.90 USD of monthly family income (AOR: 1.51, 95% CI 1.01–2.29), low knowledge about COVID-19 (AOR: 1.90, 95% CI 1.26–2.88) were significantly associated with poor adherence to COVID-19 preventive measures.

Conclusions
In this study, nearly one-fourth of the residents were experiencing poor adherence to COVID-19 preventive measures. Therefore, building up the risk communication through the community using widely used mainstream media, the continuation of disease surveillance and announcement of updated information or advice for the public to increase awareness towards COVID-19, and enforcement to follow the recommended directions and regulations of health institutions are vital to consider for improving the adherence to preventive measures against COVID-19 among the residents.