JMIR Publications

ABSTRACT

Background:

The Covid-19 pandemic has profoundly affected the movement of people across borders in Eastern and Southern Africa. The implementation of border closures and restrictive measures has disrupted the region's economic and social dynamics. In areas where national authorities lack full control over official and unofficial land crossings, enforcing public health protocols to mitigate health risks may prove challenging.

Objective:

This study aimed to assess perceived factors that influence the spread and control of Covid-19 among Somali communities living on and near ground crossings in Tog-wajaale, Somali region, Ethiopia.

Methods:

A community-based cross-sectional study was conducted using a multistage sampling technique. Beliefs and perceptions of the virus's spread and control were partially adapted from WHO resources, exploring four main perception themes: perceived facilitators for the spread of the virus, perceived inhibitors, risk labelling, and socio-demographic variables. A sample size of 634 was determined using the single proportion formula. Standardized scores (0-100) and standard deviations categorized perception themes, with mean differences by sociodemographic variables analyzed using ANOVA and t-tests. Statistical significance was established with a 95% confidence interval and a p-value below 0.05. The data were analyzed using STATA version 14.1.

Results:

Factors influencing Covid-19 spread, and control include behavioral non-adherence and enabling environments. A total of 81.9% did not comply with social distancing, and 92.2% faced constraints preventing them from staying home and enabling environments. Misconceptions were prevalent, including beliefs about hot weather (66.8%), traditional medicine (6.7%) and religiosity (79.3%). False assurances also contributed, such as feeling safe due to geographic distance from hotspots (14.2%) and perceiving the virus as low-risk or exaggerated (30.2%). Only 25.2% followed standard precautions and 29.9% were vaccinated. Employment, region, income, sex, education, and information sources significantly influenced behavioral non-adherence, myth prevalence, and false assurances.

Conclusions:

The findings highlight the need for substantial risk communication and community engagement. Only 46.6% of individuals adhered to precautionary measures, there was a high perception of non-adherence, and essential Covid-19 resources were lacking. Additionally, numerous misconceptions and false reassurances were noted. Understanding cross-border community behavior is crucial for developing effective, contextually appropriate strategies to mitigate Covid-19 risk in these regions.