Pregnant women's adherence to COVID-19 prevention practice and associated factors in Jinka Town, South Omo Zone, Southern Ethiopia, a community based cross-sectional study

Molalegn Mesele; Getachew Asmare; Gizachew Ambaw; Misganaw Asmamaw; Mohammed Abdu; Endeshaw Chekol; Denekew Tenaw; Sefineh Fenta; Tadesse Asmamaw; Melkamu Aderajew; Anteneh Mengist; Yenealem Solomon; Berihun Bantie; Wubet Alebachew; Natnael Amare; Ermias Sisay; Natnael Moges; Natnael Atnafu

doi:10.12688/f1000research.134843.1

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Research Article

Pregnant women's adherence to COVID-19 prevention practice and associated factors in Jinka Town, South Omo Zone, Southern Ethiopia, a community based cross-sectional study

[version 1; peer review: 1 approved, 1 approved with reservations]

Molalegn Mesele ¹, Getachew Asmare¹, Gizachew Ambaw², [...] Misganaw Asmamaw³, Mohammed Abdu⁴, Endeshaw Chekol⁵, Denekew Tenaw⁶, Sefineh Fenta⁷, Tadesse Asmamaw⁸, Melkamu Aderajew⁶, Anteneh Mengist⁶, Yenealem Solomon⁹, Berihun Bantie¹⁰, Wubet Alebachew¹¹, Natnael Amare¹², Ermias Sisay¹³, Natnael Moges¹⁴, Natnael Atnafu¹⁵

Molalegn Mesele ¹, Getachew Asmare¹, [...] Gizachew Ambaw², Misganaw Asmamaw³, Mohammed Abdu⁴, Endeshaw Chekol⁵, Denekew Tenaw⁶, Sefineh Fenta⁷, Tadesse Asmamaw⁸, Melkamu Aderajew⁶, Anteneh Mengist⁶, Yenealem Solomon⁹, Berihun Bantie¹⁰, Wubet Alebachew¹¹, Natnael Amare¹², Ermias Sisay¹³, Natnael Moges¹⁴, Natnael Atnafu¹⁵

PUBLISHED 08 Jan 2024

Author details Author details

¹ Department of Reproductive Health and Nutrition, School of Public Health, Wolaita Sodo University, Sodo, Ethiopia
² Department of Epidemiology and Biostatistics, School of Public Health, Wolaita Sodo University, Sodo, Ethiopia
³ Department of Biochemistry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
⁴ Unit of Physiology, Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
⁵ Department of Medical Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
⁶ Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
⁷ Department of Public Health, College of Health Sciences, Woldia University, Weldiya, Amhara, Ethiopia
⁸ Department of Medical Biochemistry, College of Medicine and Health Sciences, University of Gondar,, Gondar, Amhara, Ethiopia
⁹ Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
¹⁰ Department of Comprehensive Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
¹¹ Department of Maternal and Neonatal Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
¹² School of Medicine, College of Health Science, Woldia University, Weldiya, Amhara, Ethiopia
¹³ Pedatric and Child Health Nursing, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
¹⁴ Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
¹⁵ School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Southern Nations, Nationalities, and People's Region, Ethiopia

Molalegn Mesele
Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Getachew Asmare
Roles: Conceptualization, Supervision, Writing – Review & Editing

Gizachew Ambaw
Roles: Conceptualization, Supervision, Writing – Review & Editing

Misganaw Asmamaw
Roles: Conceptualization, Supervision, Writing – Review & Editing

Mohammed Abdu
Roles: Conceptualization, Supervision, Writing – Review & Editing

Endeshaw Chekol
Roles: Conceptualization, Supervision, Writing – Review & Editing

Denekew Tenaw
Roles: Conceptualization, Supervision, Writing – Review & Editing

Sefineh Fenta
Roles: Conceptualization, Supervision, Writing – Review & Editing

Tadesse Asmamaw
Roles: Conceptualization, Supervision, Writing – Review & Editing

Melkamu Aderajew
Roles: Conceptualization, Supervision, Writing – Review & Editing

Anteneh Mengist
Roles: Conceptualization, Supervision, Writing – Review & Editing

Yenealem Solomon
Roles: Conceptualization, Supervision, Writing – Review & Editing

Berihun Bantie
Roles: Conceptualization, Supervision, Writing – Review & Editing

Wubet Alebachew
Roles: Conceptualization, Supervision, Writing – Review & Editing

Natnael Amare
Roles: Conceptualization, Supervision, Writing – Review & Editing

Ermias Sisay
Roles: Conceptualization, Supervision, Writing – Review & Editing

Natnael Moges
Roles: Conceptualization, Supervision, Writing – Review & Editing

Natnael Atnafu
Roles: Conceptualization, Resources, Supervision, Writing – Review & Editing

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Abstract

Background

Pregnancy-related coronavirus disease 2019 (COVID-19) transmission and infection rates have continued to be a top public health concern. Pregnant mothers also have a higher risk of developing serious illness, needing to be admitted to an intensive care unit, and needing mechanical ventilation. More than six million people died as a result of COVID-19 worldwide. The aim of this study was to assess the level of adherence to COVID-19 preventive practice among pregnant mothers in Jinka Town.

Methods

In Jinka, South Omo Zone, between January 1 and January 30, 2023, a cross-sectional study was conducted. Using a simple random sampling technique, 412 pregnant women were selected. Data were collected using a face-to-face interviewer-administered, pre-tested questionnaire. The data were entered using Epi-data version 3.1, and after being exported, were analyzed using SPSS version 25. Bivariate and multivariable logistic regression analysis was carried out to identify relevant components. An adjusted odds ratio and a 95% confidence interval were used to report the relationship between the covariates and the outcome variable.

Results

The percentage of participants who adhered to COVID-19 prevention measures was only 11.4% (95% CI: 8.5, 14.8). Mothers with at least a bachelor’s degree 3.71 (AOR=3.71, 95% CI=1.28, 10.73), a residency of 4.40 (AOR=4.40, 95% CI=1.96, 9.87), and a history of chronic illness of 4.30 (AOR=4.30, 95% CI=1.69, 10.93) were significantly associated with good adherence to COVID-19 prevention practices.

Conclusions

Only a very small percentage of pregnant women, according to this poll, adhere to COVID-19 preventative practices. In order to raise pregnant women’s awareness of COVID-19 preventive practices, it is crucial to use a variety of media for health education. Further, it is preferable to focus on urban living and give special attention to women without a formal education.

Keywords

Adherence, COVID-19, pregnant mothers, Jinka Town, Ethiopia

Corresponding author: Molalegn Mesele

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2024 Mesele M et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Mesele M, Asmare G, Ambaw G et al. Pregnant women's adherence to COVID-19 prevention practice and associated factors in Jinka Town, South Omo Zone, Southern Ethiopia, a community based cross-sectional study [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2024, 13:47 (https://doi.org/10.12688/f1000research.134843.1) First published: 08 Jan 2024, 13:47 (https://doi.org/10.12688/f1000research.134843.1) Latest published: 08 Jan 2024, 13:47 (https://doi.org/10.12688/f1000research.134843.1)

Introduction

A contagious illness called coronavirus disease 2019 (COVID-19) is brought on by the SARS-CoV-2 virus, which first appeared in Wuhan, China.¹ On January 30, 2020, and March 11, 2020, respectively, the World Health Organization (WHO) proclaimed the 2019–2020 COVID–19 outbreaks to be Public Health Emergencies of International Concern (PHEIC) and pandemics, respectively.²^,³ There are primarily two ways to spread COVID-19: directly and indirectly other bodily fluids and secretions, including feces, saliva, urine, semen, and tears, also contribute to the direct route of transmission. The term “aerosols” refers to particles produced during surgical and dental procedures as well as particles from respiratory droplets.⁴

By July 26, 2022, it had resulted in 568,773,510 confirmed cases of COVID-19 and 6,381,643 fatalities globally. On the African continent, similar figures of 9,192,139 confirmed cases and 173,946 fatalities were recorded. Ethiopia had 491,759 confirmed COVID-19 cases as of July 26, 2022, and 7,566 deaths had been reported. At the beginning of March 2021, it was reported that pregnant women infected with the virus had more than 73,600 illnesses, with 80 maternal deaths.⁵ As of the 6^th of October, 2021, 1,637 infections caused by SARS-CoV-2 during pregnancy and 15 fatalities have been reported in Mississippi.⁶ Women are more likely than men to contract serious respiratory illnesses like SARS-CoV2 and respiratory syncytial virus (RSV) during pregnancy due to immunologic and physiological changes connected to the condition.⁷^,⁸

It recognized that some of the major causes of morbidity and mortality could be associated with health determinants linked to an individual’s health behaviour, such as the adoption of health behaviour against virus transmission (e.g., hand washing and wearing a mask outside) and the avoidance of health-harming behaviours (e.g., touching the face and assembling for events).⁹ Evidence suggests that COVID-19-infected pregnant women experienced unfavorable maternal and perinatal outcomes include preterm birth, low birth weight, severe sickness, hospitalization to an intensive care unit, mechanical ventilation, and death.¹⁰^–¹² A study found that during pregnancy, COVID-19 can be passed directly from the mother to the fetus.¹³ Additionally, studies have revealed that domestic violence, postpartum anxiety, and depression are more prevalent in pregnant women during pandemics.¹⁴ Although there have been no clinical trials for the COVID-19 vaccine that have included pregnant participants, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine encourage pregnant women to receive the COVID-19 vaccine if they desire to be immunized.¹⁵^,¹⁶

Additionally, studies have shown that diets high in vitamins and fiber can boost immunity and protect COVID-19 infected women from adverse pregnancy outcomes.¹⁷^,¹⁸ The Ethiopian government has also taken part in a variety of initiatives to prevent the virus from spreading throughout the nation, including community mobilization, raising public awareness, isolation, mandatory quarantine and treatment, strict passenger screening, house to house screening, and expanding diagnostic tests and treatment facilities.¹⁹

Although COVID-19 is becoming more widespread every day in Ethiopia, pregnant women cannot get the vaccine. Therefore, in order to reduce their risk of contracting the virus, pregnant women have to follow the prophylactic guidelines established by the Ministry of Health (MoH). This lowers morbidity and death among pregnant women and newborns.²⁰ There aren’t many studies in Ethiopia that focus on the extremely vulnerable pregnant women, especially in the study area. The purpose of this study was to determine how well pregnant women in Jinka Town, South Omo Zone, Southern Ethiopia, adhered to COVID-19 preventative practices and associated factors.

Methods

Ethical considerations

The Wolaita Sodo University College of Health Science and Medicine’s Ethical Review Board granted ethical approval on December 10/2022.

Finally, a formal letter of permission from the Jinka town Health Office was obtained in order to move forward with the data collecting. Participation was only permitted after receiving informed written consent. To enable thorough and sincere self-disclosure, we kept voluntary engagement and confidentiality.

Study setting and design

A cross-sectional study of pregnant women in Jinka, South Omo Zone, SNNPR, Ethiopia, was conducted in the community from January 1 to January 30, 2023. The administrative town of Jinka is located at 5°47′N 36°34′E/5.783°N 36.567°E latitude and longitude, 560 km from Hawassa and 750 km from Addis Abeba. The town acts as the South Omo Zone’s administrative hub in the Southern Nations, Nationalities and Peoples’ Region. In 2018, 30493 people were expected to live there, of whom 15,217 (49.9%) were males and 15,276 (50.1%) were women. The reproductive age group included 7,103 (23.3%) of the total females.²¹ There is one general hospital, two health centers, and six health posts in Jinka Town

Study population and eligibility criteria

All pregnant mothers who lived in Jinka town were the source population and all selected pregnant mothers in Jinka town was the study population. Pregnant mothers who lived for at least six months and more in Jinka town were eligible to be included in this study.

Sample size determination and sampling procedure

The sample size was determined by using a single population proportion formula by considering a proportion of good adherence 44.8%,²⁰ level of confidence 95%, margin of error 5%. Thus, the sample size was

= \frac{{(Zα / 2)}^{2} * P (1 - P)}{d^{2}} = \frac{{(1.96)}^{2} * 0.448 (1 - 0.448)}{{(0.05)}^{2}} = 379

After considering a non-response rate of 10% the final sample size was 417.

Health extension workers work and give primary health care in the community by arranging and using family folder; all families in each kebele have their own family folder which contains a list of family members with the serial number, age, sex, marital status, educational status, under five, under one, pregnant mother, antenatal care (ANC) follow-up, non-communicable disease, HIV status and tuberculosis screening which is updated every year and helps as a source of information for each resident in each kebele. A simple random sampling technique was used to choose household from six kebeles in Jinka town utilizing an updated list from the kebeles administrative office. Then a basic random sampling approach created by a computer was used. According to the proportional to size allocation method, the likelihood that women were chosen depended on how many pregnant women were in the selected kebele. When more than one candidate was located in a household, a lottery procedure was used. When the interviewee was absent on the day of data collection, revisiting the interviewee helped to lower the frequency of nonresponses.

Variables of the study

The dependent variable was adherence to the COVID-19 preventive practice, and the independent variables were the mother’s age, religion, educational level, occupation, marital status, husband’s educational level, occupation, number of families residing in the same place, average monthly income, gravidity, number of living children, having an ANC visit, number of ANC visits, pregnancy condition, history of prior bad pregnancy outcomes, history of chronic illness, and knowledge of the COVID-19

Operational definitions and measurements

Adherence to COVID-19 preventive practice: Seven questions on recent practices were asked to participants and were based on a WHO recommendation for COVID-19 prevention methods.²⁰ One point was awarded for a proper response, while zero was awarded for a mistaken one. If a participant obtained a score of above the mean or four or more on the usage of preventive measures, they were considered to have good adherence to COVID-19 preventative practice. If participants’ scores fell below the mean or less than four, they were considered to have insufficient adherence to COVID-19 preventative practice.²⁰^–²³

Data collection tools and procedures

By studying pertinent literature, the data gathering technique was created.²³^,²⁴ Through a face-to-face interview during a home visit, data were gathered using semi-structured, pretested questions. The survey asks about socio-demographic traits, obstetric-associated variables, and knowledge of and preventive behavior related to COVID-19. For the purposes of data collection and monitoring, five BSc midwives and one MSc clinical midwife, respectively, were hired.

Data quality control measures

With the help of linguists, the questionnaire²⁵ was written in English, translated into the Amharic-speaking region’s language, and then translated again into English to preserve the tool’s consistency. In order to assess the questionnaire’s response, language clarity, and appropriateness prior to the actual data collection, 5% of the total sample size was pretested in the Karat town district. The goal of the study, the components of the tool, and the data collection methodologies were covered in a one-day training session for the supervisor and data collectors. Additionally, they were made aware of the critical safety measures that needed to be done to avoid contracting COVID-19. Data collectors were observed for any issues during data collecting. The data collectors and supervisor verified the consistency and completeness of the data, and the incomplete data were noted.

Data processing and analysis

The data were validated, coded, and entered in Epi data version 4.6 before being exported for analysis to SPSS version 25 (RRID:SCR_002865). Descriptive statistics, such as frequencies, percentages, means, and standard deviation, were computed. Bivariable logistic regression was used to establish the relationship between the independent and dependent variables. Then, variables with p-values less than 0.2 were included in the multivariable logistic regression analysis.

Result

Socio-demographic characteristics of study participants

In the current study, a total of 412 women from the study were included in the analysis, yielding a response rate of 98.8%. Of the responders, 164 (30.9%) were between the ages of 18 and 24. The majority of study participants (66.4%) identified as Orthodox Christians. According to information about participants’ marital status, 94% of the study them were married. Almost a third (31.5%) of their husbands had attended secondary school, according to their husband’s educational background (Table 1).

Table 1. Socio demographic characteristics of respondents Jinka Town, South Omo Zone, Southern Ethiopia, 2023 (412).

Variable	Category	Number	Percent (%)
Maternal age	18-24	164	39.8
	25-34	152	36.9
	35-44	91	22.1
	>44	5	1.2
Numbers of family	<3	167	40.5
	3-4	138	33.5
	>4	107	26
Mothers religion	Orthodox	143	34.7
	Protestant	163	39.6
	Muslim	101	24.5
	Catholic	5	1.2
Marital status	Single, Divorced/widowed	8	1.9
Marital status	Married	404	98.1
Mothers educational status	No ability to read or write	55	13.3
	Read and writing	87	21.1
	Basic education	85	20.6
	In secondary school	103	25
	College or higher	82	19.9
Mother’s occupational status	Merchant	43	10.5
	Government employee	145	35.2
	Housewife	132	32
	Private business	77	18,7
	Daily labore	15	3.6
Communication media	Yes	270	65.5
Communication media	No	142	34,5
Mothers residence	Urban	298	70.4
Mothers residence	Rural	125	29.6
Father residence	Urban	316	76.7
Father residence	Rural	96	23.3
Husband education	No ability to read or write	132	31.2
	Read and writing	153	36.2
	Basic education	113	26.7
	In secondary school	15	3.5
	College or higher	10	2.3
Husband’s occupational status	Government employee	128	31.1
	Merchant	116	28.2
	Private business	108	26.2
	Farmer	52	12.6
	Other	8	1.9
Average monthly income	<5000	200	48.5
	5000-10000	134	32.5
	>10000	78	19

Obstetric and reproductive characteristics of study participants

The majority of the participants in the study, 370 (89.8%), were multigravida in their gravidity and more than half of the participants, 254 (61.7%), had planned pregnancies. A majority of the individuals, 362 (87.9%), had ANC follow-up (Table 2).

Table 2. Obstetric history of pregnant women in Jinka Town, South Omo Zone, Southern Ethiopia, 2023 (412).

Variables	Category	Frequency (%)	Percentage (%)
Gravidity	Primigravida	158	38.3
Gravidity	Multigravida	254	61.7
Condition of pregnancy	Planned	370	89.8
Condition of pregnancy	Unplanned	42	10,2
ANC follow up	Yes	362	87.9
ANC follow up	No	50	12.1
Numbers of antenatal care follow up	< 4	283	68.7
Numbers of antenatal care follow up	>3	129	31.3
Alive children	<3	230	55.8
Alive children	>2	182	44.2
History of previous adverse pregnancy outcome	Yes	83	20.1
History of previous adverse pregnancy outcome	No	329	79.9
History of chronic disease	Yes	68	16.5
History of chronic disease	No	344	83.5

Knowledge about COVID-19

Almost all of the respondents (99.3%) in the study as a whole had heard of COVID-19. More than half of pregnant women said that a headache (61.7%) and runny nose (59.2%) are a symptom of COVID-19. From the total participants, 320 (77.7%) pregnant women were aware that pregnant women are more susceptible to COVID-19 than other groups (Figure 1).

Figure 1. Knowledge of pregnant women about coronavirus disease 2019 (COVID-19) in Jinka Town, South Omo Zone, Southern Ethiopia, 2023 (412).

Commulative adherence to COVID-19 preventive practice

The results of this study revealed that only 11.4% (95% CI: 8.5, 14.8) of the participants had good adherence to COVID-19 preventive practises (Figure 2).

Figure 2. Cumulative adherence to coronavirus disease 2019 (COVID-19) preventive practice among pregnant mothers in Jinka Town, South Omo Zone, Southern Ethiopia, 2023 (412).

Adherence to COVID-19 preventive practice

Less than half (43%) of participants washed their hands with water and soap or with an alcohol-based sanitizer and only 9.7% of participants wore a face mask in public to reduce the spread of infection, respectively. From the total respondents, only 103 (25%) cover their mouth and nose during coughing and sneezing (Table 3).

Table 3. Level of adherence to coronavirus disease 2019 (COVID-19) preventive practice among pregnant mothers in Jinka Town, South Omo Zone, Southern Ethiopia, 2023 (412).

Variables	Category	Frequency (%)	Percentage (%)
Wash hand with water and sanitizer	Yes	177	43
Wash hand with water and sanitizer	No	235	57
Avoid touching eye nose and mouth	Yes	122	29.6
Avoid touching eye nose and mouth	No	290	70.4
Cover mouth and nose during coughing and sneez	Yes	103	25
Cover mouth and nose during coughing and sneez	No	309	75
Wear face mask	Yes	40	9.7
Wear face mask	No	372	90.3
Stay at home	Yes	16	3.9
Stay at home	No	396	96.1
Maintain 1 meter distance	Yes	19	4.6
Maintain 1 meter distance	No	393	95.4
Disinfecting remote mobile or door llocks	Yes	28	6.8
Disinfecting remote mobile or door llocks	No	384	93.2

Factors affecting adherence to COVID-19 preventive practice

In the examination of bi-variables, there was a significant relationship between mother’s educational status, communication media, residence, husband’s educational status, gravidity, history of prior bad pregnancy outcome, and history of chronic illness, with a p-value of less than 0.2. Multivariable logistic regression revealed that the mother’s educational level, communication media, residence, and history of chronic illness were statistically significant factors in adherence with COVID-19 preventative practice. Mothers with an educational status of college or higher were 3.71 (AOR=3.71, 95% CI=1.28, 10.73) times more likely to follow COVID-19 preventive practices than individuals whose educational status was limited to not being able to read or write. Another element that was strongly connected with strong adherence was communication media. Mothers who used communication media had a 4.33 (AOR=4.33, 95% CI=1.54, 12.15) times higher likelihood of adhering to COVID-19 preventative practices than those who did not. Mothers in rural regions were 4.40 (AOR=4.40, 95% CI=1.96, 9.87) times more likely to follow COVID-19 preventive practices than mothers in urban areas.

Another significant factor which was strongly associated with good adherence to COVID-19 preventative practices was history of chronic illness. Mothers with a chronic disease were 4.30 times more likely to follow COVID-19 preventative practices (AOR=4.30, 95% CI=1.69, 10.93) than mothers without a chronic illness (Table 4).

Table 4. Factors affecting adherence to coronavirus disease 2019 (COVID-19) preventive practice among pregnant mothers in Jinka Town, South Omo Zone, Southern Ethiopia, 2023 (412).

Variable	Good Adherence
Variable	Good	Poor	COR	P-value	AOR	P-value
Mothers educational status
Unable to read and write	7	48	1		1
Able to read and write	2	85	0.16 (0.032, 0.89)	0.26	0.27 (0.049, 1.47)	0.13
Primary education	2	83	0.16 (0.03, 0.82)	0.29	0.24 (0.04, 1.39)	0.11
Secondary education	7	96	0.50 (0.16, 1.50)	0.21	0.53 (0’16. 1.79)	0.31
Collage and above	29	53	3.75 (1.50, 9.35)	0.005	3.71 (1.28, 10.73)*	0.015
Communication media
Yes	39	231	2.82 (1.28, 6.23)	0.01	4.33 (1.54, 12.15)*	0.005
No	8	134	1		1
Mothers residence
Urban	22	294	1		1
Rural	25	71	4.70 (2.50, 8.82)	0.001	4.40, (1.96, 9.87)*	0.001
Husband education
Unable to read and write	1	20	0.26 (0.03, 2.04)	0.27	0.61 (0.06, 5.93)	0.67
Able to read and write	4	47	0.44 (0.14, 1.35)	0.20	0.70 (0.17, 2.86)	0.62
Primary education	6	61	0.51 (0.19,1.32)	0.15	0.69 (0.21, 2.23)	0.54
Secondary education	13	117	0.58 (0.28, 1.19)	0.16	0.55 (0.23, 1.32)	0.18
Collage and above	23	120	1		1
Gravidity
Primigravida	13	143	1		1
Multigravida	34	222	1.68 (0.86, 3.30)	0.12.	1.28 (0.54, 3.01)	0.56
History of previous adverse pregnancy outcome						0.59
Yes	17	66	2.56 (1.33, 4.92)	0.005	1.28 (0.51, 3.23)
No	30	299	1		1
History chronic illness
Yes	17	51	3.48 (1.79, 6.78)	0.001	4.30 (1.69, 10.93)*	0.002
No	30	314			1

* Significant association at P-value <0.05.

Discussion

This study sought to determine whether pregnant women in Jinka Town, South Omo Zone, Southern Ethiopia, 2023, adhered to COVID-19 preventative practices and associated related factors in 2023. The current study showed that only 11.4% (95% CI: 8.5, 14.8) had good adherence with COVID-19 preventive practice. This finding is lower than studies conducted in Gurage zone 76.2%,²² in Northern Ghana 46.6%,²⁶ in Nigeria 78%,²⁷ Gondar city 44.8%,²⁰ and a study conduct Debre Berhan Town 56.1%.²⁸

The disparity in the study setting, the variation in the outcome variable used to measure the outcome, and the socio-demographic features of the study participants are all potential reasons of this discrepancy. Each of the aforementioned research was a cross-sectional institution-based study. Time differences could also be the reason for the discrepancy. The majority of the population is presently attempting to adjust to and cope with COVID-19.

The study also found that women with college degrees or higher were 3.71 times more likely than women who couldn’t read and write to follow COVID-19 preventive practices. The conclusion made in the current article was supported by studies conducted in Gondar,²⁰ Debre Tabor, Ethiopia²⁴ and Ghana.²⁶ This may be due to the fact that educated people have easier access to knowledge about COVID-19 and its preventative strategy than those who are illiterate. Additionally, educated people might be better aware of the dangers of forgoing this preventive precaution as well as the preventive measures themselves.

The existence of mass media was another factor that was connected to good adherence. Participants with media access were 4.33 times more likely than those without to adhere well to COVID-19 preventive measures. The majority of the time in Ethiopia COVID-19 prevention strategies were promoted through the mass media. Pregnant women with communication media (mass media) might be more aware than those who have no communication media because they get information related to how to prevent COVID-19 through media.

Rural residents were more likely to practice COVID-19 preventative actions than urban dwellers. According to a study²⁹ conducted in a low-resource African nation, rural populations were more likely to put COVID-19 prevention measures into practice. A study conducted in Guraghe Zone Hospitals²² indicated that urban residents were more likely than rural ones to practice COVID-19 preventive measures, which contrasted with the findings of the present study.

This may be because individuals in rural areas are more accustomed to hearing and applying government and health professional advice than people in urban areas, which enables them to take better COVID-19 prevention measures.

Another significant factor which was strongly associated with good adherence to COVID-19 preventative practices was history of chronic illness. Mothers with a chronic disease were 4.30 times more likely to follow COVID-19 preventative practices (AOR=4.30, 95% CI=1.69, 10.93) than mothers without a chronic illness. Because they feel they should, people with COVID-19 co-morbidities may be more cautious than people without co-morbidities.

Limitation of the study

Conclusions regarding the causes and effects of pregnant women adhering to COVID-19 preventative practises and the associated factors may be challenging given the cross-sectional nature of the study. There may also be a predisposition towards social desirability.

Conclusion

According to this survey, only a very small percentage of pregnant women follow COVID-19 preventive practises. The mother’s level of education, her use of communication tools, her residency, and her history of chronic illness all had an impact on how well she followed COVID-19 preventive practise. As a result, it’s critical to improve pregnant women’s health education about COVID-19 preventive practises through a variety of media. Additionally, by emphasising urban residency and giving women without formal education special consideration.

Data availability

Underlying data

Figshare: DATASET. https://doi.org/10.6084/m9.figshare.24147465.v1.³⁰

Extended data

Figshare: Questionar.docx. https://doi.org/10.6084/m9.figshare.23796720.²⁵

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Acknowledgment

We would like to express our heartfelt thanks for Wolaita Sodo University, all individual for their contribution and cooperation.

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