Article Text
Abstract
Background India has a high COVID-19 burden. The Indian government responded to the pandemic by mandating its population to adhere to certain Protective Measures (PMs). Compliance to these PMs depends on the acceptability and adaptability of the general public to these PMs. However, there is a dearth of studies on this issue. Our study aimed to explore the perceptions and practices of COVID-19 related PMs among the general public in four districts of North India.
Methods The qualitative study was done in four administrative districts (Lucknow, Etawah, Patna and Darbhanga) in North India. All study districts had COVID-19 confirmed active cases at the time of data-collection. Participants in this study were healthy caregivers of under-five children, admitted for pneumonia, in a tertiary care hospital as part of ongoing study. Inclusion criteria was (i) child hospitalized in tertiary care hospital for pneumonia but presently discharged (ii) availability of telephone/mobile with caregiver and (iii) consent to participate. Audio in-depth interviews (IDIs) were conducted. Respondents were purposefully selected to represent both genders and two education groups (i) Below Primary Education Group ( <5 years education) and (ii) Above Primary Education Group (>5 years education). This ensured variability and heterogeneity in the population being studied. Data was managed using Atlast Ti. Conventional content analysis was used.
Results From July-Sep 2020, 60 IDIs were conducted; 36.6% (22/60) respondents were females and 26.6% (16/60) had below-primary education. Respondents concurred that most people in their society flouted the recommended PMs. The reasons for poor/non-compliance with PMs were: perceived poor susceptibility to illness, perceived less severity of COVID-19 and low perceived benefits of complying with PMs. Perceived severity of disease played a key role in shaping attitude and practices related to adherence of PMs. Most people believed that COVID-19 often had less severe outcome and is thus less fatal. The lack of direct experience with the disease also attenuated this belief and made them under-estimate the risk due to it. Social stigma associated with the disease caused many to hide the contagion and spread it rapidly. Respondents shared that many people in society ‘hide’ the disease due to fear of discrimination that was common for COVID-19 positive patients.
In addition, respondents opined that COVID-19 is less prevalent in rural areas and among the less educated population. Most respondents were aware of the recommended PMs and opined that these must be followed, however subjective norms, social norms and behavioural intentions negatively impacted compliance.
Conclusion Since there was poor community perception of susceptibility to COVID-19 as well as poor perceived severity, the community did not understand the benefits of applying to PMs. Therefore, future health communication strategies must take these into account to increase the possibility of success.