Social Work Responses and Household-level Determinants of Coronavirus Preparedness in Rural Ethiopia

ABSTRACT The novel coronavirus caused the death of many people globally, and in Ethiopia. The death of people due to COVID surpasses 1,466,289with more than 63,135,973 cases in the world. This study aimed to identify the barriers toward the understanding of COVID-19, the rural (agrarians) public commitment to respond coronavirus, and the factors that affect their preparedness in rural Ethiopia. Probit regression and descriptive statistics were used to analyze data from a sample of 190 respondents. The result revealed that the public infrastructural problems (roads, health centers, telecommunication and broadcasting service) were the main barriers identified in this study. In response, the agricultural and health extension providers, college and university students, local administrators and government official, religious leaders, and community elders were contributing to enhance the public understanding and preparedness. The model result confirmed that gender, age group, family education level, membership to communal association, family mobile usage, health extension service, non-farm income, and economic situation were significant factors for preparedness. Intervention aimed at easing identified key limit factors to rural and agrarian community preparedness as well as the way to enhance public understanding through reasonable support to local stakeholders against COVID-19.


Introduction
The novel coronavirus pandemic  outbreak emerged in Wuhan, which is the Hubei Province of China and then spread out quickly to developed and underdeveloped countries (Haider et al., 2020). The virus resemblance to severe acute respiratory syndrome coronavirus (SARS-CoV) called "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" (Gorbalenya et al., 2020). Starting from the date of the announcement in China, coronavirus caused the death of many people, and globally COVID-19 death surpasses 1,466,289with more than 63,135,973 cases. The virus spreads from person to person through making physical contact with an infected person (disrespecting social distance), air when an infected person sneezes, coughs, and exhales during a meeting, at a time of being together. Also, washing hands, using a mask, avoiding physical contact, and valuing social distance decreases the transmission rate (WHO, 2020b).
Coronavirus has been a pressing problem of Ethiopia since the world health organization (WHO, 2020a) reported 282 cases of coronavirus from four countries. The quick spread of the discovered virus and meaningful association of spreading methods with Ethiopian people's lifestyle fear the Ethiopian government. Before the virus reached Ethiopia, the Ethiopian airline had designed directions to undertake preventive measures to the passengers and service providers. Ethiopia officially reports the first coronavirus case on March 13, 2020, and COVID death surpasses 1,700with more than on COVID 19 in Ethiopia focused on the probable impact of COVID 19 by employing desk review and experts point of view, without empirical evidence. However, in countries having poor health care centers in terms of quality and quantity to challenge the pandemic, much great work on peoples' understanding, societies' involvement, and peoples' preparedness and response through investigating gaps and making appropriate intervention are acceptable.
The effect of the novel coronavirus (2019-Ncov) on socioeconomic conditions for the majority of the agrarian-based economy dependent countries, including Ethiopia will be risky after COVID-19 unless significant attention is given to the rural area. Therefore, coronavirus would be dangerous if not managed well. In response, this study aimed to assess the attentiveness of the rural community to COVID 19, social work response, and major factors that affect rural community preparedness and response to COVID 19 in Ethiopia. The study aims to provide input for government intervention approaches to protect the current public health of rural peoples and future agricultural production as well. The study result may also provide information for future research related to this topic.

Data collection and participants
The study was designed to identify rural community understanding toward COVID-19 and preparedness to confront COVID-19 in Ethiopia, with the result that all participants were from 50 different peasant associations found in three largest administrative regions (Amhara, Oromia, and South Nation Nationalities Peoples Regional States (SNNPR)). Regarding the restriction of movement and other COVID 19 related protocol, including the need for social distance, the data collection process for this study had to be conducted without deviating these related COVID-19 protocols. The study identified a total of 204randomly chosen rural households (four each from 50 peasant association)to acquire relevant information. However, we were unable to acquired information from 14 sample respondents due to different reasons and then 190 respondents were used to conclude the result of this study.
The study used structured questionnaires, which was developed using closed-ended questionnaires by including the socio-demographic characteristics of the households and other institutional related factors in order to assess the determinants of preparedness and response of the respondents. Besides, questionnaires include questions related to knowledge, information sources, perception, social work activities to confront COVID 19 and, and preventive measures for the pandemic. The questionnaire was administered through an interview schedule with selected respondents. The study was conducted from April 20 to May 30, 2020 and the national language was used as mediating language during data collection.

Data type and sources
Both qualitative and quantitative data types were collected for the study. The majority of data used for the study are from primary sources; however secondary data sources are also used to strengthen the report. Information regarding the societal work engagement, demographic, socioeconomic, and institutional factors expected to determine the rural community preparedness to confront COVID-19 were collected from primary sources. In addition, secondary data were taken from journals, and statistical bulletin reports WHO, FMOH, WFP, and FAO for strengthening the result.

Data analysis
The STATA software version 13 was used to analyze the collected data. Descriptive statistics were employed for describing the demographic and institutional characteristics of the participants in this study. Econometric model, particularly probit model was used to analyze factors affecting the preparedness and response of coronavirus in rural Ethiopia.

Probit model analysis
The study used a binary dependent variable that has two values, typically coded as 1 for a households engaged in any preparedness and response strategy to COVID 19 and 0 for households who did not engage. The dependent variable is linearly related to a set of independent variable x and a disturbance term (e). The link between the observed variable and the latent y* is made with simple measurement equation: Cases with a positive value of y* are observed as y = 1, while cases with negative or zero value of y* as y = 0. Accordingly, the surveyed respondents were asked if they made a behavioral change for either the preparedness or response to COVID 19 or not. Respondents differ in their opinion on the issue, and some respondents very adamantly agree with the adaption of behavioral change but, some very adamantly disagree, and others have only weak looks one way or on the others. The probit model estimated by the maximum likelihood estimation techniques and the loglikelihood function for the probit model is specified as follows: Following the analyses, the probit model is adopted as: Where Ф is the standard cumulative normal distribution function with variance one and numerically maximized concerning β. The predicted probability for any set of values of independent variables can be computed by using a verity of commands in STATA. Independent variables used for this study are presented in Table 1.  The majority (59%) of the sample respondents confirmed that the absence organized and formal extension service related to COVID 19 in their locality was observed. Concerning the relative economic status of the respondents, about 42.1% of the respondents were poor while about 46.2% were medium in their economic status. Only 11.1% of the respondents were economically good with better living condition and capability to cover COVID 19 related protocol costs. Also, about 37.4% of the respondents engaged in off-farming activities like a daily laborer, petty-trading, and craftsmanship to secure family needs. Considering the basic knowledge for responding to coronavirus the descriptive results of the study showed that close to 46% of the surveyed respondents were made preparedness to respond the pandemic. Of which, males (25.3%); married (35.3%); adult (29.5%); literate (30%); owned mobile (36.3%); participated in communal groups (30.5%); obtained extension information (26.3%); received from non-farm income (28.4%) and within the medium economic status (32.6%) ( Table 2).

Understanding of coronavirus pandemic
Regarding the basic knowledge of coronavirus, about 38.4% of respondents confirmed infectious nature of the pandemic while 60.5% of the respondents said that at the beginning of March 2020, COVID-19 virus reached Ethiopia. Regarding symptom manifest only about 13.2% of the respondents stated that symptoms occur within 0 to 14 days of suspicion to virus. Then, 46.3% of respondents said that they perceive on adequate knowledge of prevention, spreading and response to COVID-19.The majority of the respondents (55.8%) understood the existence of restriction of movement and state of emergency to reduce the vulnerability to coronavirus. About 34.2% of the respondents thought fever, sore throat, tiredness, and dry coughs symptoms happening in infected persons. Besides, about 35.3% of respondents consider other symptoms including difficulty of breathing, pain, diarrhea, nausea, and runny nose. However, surprisingly, the result revealed the existence of people, who practiced prevention methods without adequate information about the potential benefit from it. Thus, about 20.9% of the respondents practiced the prevention methods temporarily when they observed others to do so (Table 3).

Barriers to understanding of coronavirus in rural Ethiopia
The study identified five main barriers that constrain the rural public knowledge and preparedness to coronavirus in different rural Ethiopia. Firstly, limited/absent of formal extension information by the Ethiopian government, religious center, or other stakeholders. About 59.5% of the surveyed respondents revealed the absence of a formal extension source about coronavirus in their respective localities. Secondly, limited social media accesses in the rural community. Limited use of social media like mobile, internet, radio, and others enlarge the information gap in the rural peoples of Ethiopia. Accordingly, about 68.59% and 45.8% of the respondents had not owned mobile phones and radio at household levels (Table 4). Thirdly, the tough season for agricultural farming when the pandemic has reached Ethiopia decreased the possible information sharing opportunities among different stakeholders in their respective locality. In this regard, the majority (74.35%) of the respondents revealed that they gave much more focus on agricultural production than COVID 19. The fourth determining factor is directly associated with public infrastructure (inadequacy and poor quality for roads), and also health care centers (clinics) for making close contact with the majority of rural peoples by other external stakeholders associated with COVID 19. The limited number of health extension services also challenges health accessibility. In this respect, about 37.6% of the respondents revealed the unavailability of public roads close to their villages. The fifth determinant is related to the raining season (summer) caused by the breakdown of road, flooding, and crossing of larger rivers are impossible. It decreased the existed direct contact between the governments and its peoples, and also among the peoples themselves. It decreases the information dissemination process within and between different rural areas. Concerning this, about 48.9% of the respondents have challenged by this problem so far. Lastly, the dispersed nature of residents homes in rural area also constrained the information provision system for health extension service providers and in this regard almost close to 61.5% of the respondents revealed the unhappiness' of the health extension workers in the time other health services in their locality (Table 4).

Social work responses and agricultural activities in time of COVID-19
As stated by Heather and Walter (2020), successful control of the novel coronavirus (COVID 19) requires interactive social work response. Hence, the government of Ethiopia considers this and asks the different youths, experts, leaders and managers starting from local to federal level to work together in ceasing the spread of the virus. In this respect, about 66.45% of the respondents revealed the absence of influential social work response practices to enhance knowledge of the rural communities in their respective locality. The remaining 43.55% of the respondents showed the availability of a few social work response practices by youths (university & preparatory students), religious leaders, community leaders, agricultural extension service providers, supervisor of road transport and traffic police, health extension service providers and also the input providers(farmers cooperatives and unions). Thus, about 35.8% of the respondents acknowledged the students' effort to enhance the community conciseness to COVID 19. Nevertheless, their engagement was limited to awareness creation only rather than mobilizing peoples by preparing hand wash programs, enhance peoples to use masks through incentives due to socio-economic, and institutional constraints.
Local religious leaders are engaged in designing either partial or complete restriction on different rural communal association and accordingly, about 21.57% of the respondents revealed the presence of restriction on mahiber whereas about 47.06% and 25.49% of the respondents revealed the availability of partial restriction on iquib, and idir and tezkar, respectively, in their locality .Among the vulnerable cause for coronavirus in the rural community religious-based monthly anniversary practiced by Ethiopian orthodox Christianity followers creates suitable conditions for the spread of the virus. Therefore, restrictions on anniversary that are exposed for virus spread is required and accordingly, about 35.29% of the respondents confirmed partial restrictions on the wedding anniversary (Table 5).
The other vulnerable cause for the spread of the virus is agriculture in which almost all sample households (99%) are depending on it that require a team or group work. This nature of the agricultural activities resisted the sample households to implement the preventive measures provided that unless they work together, their final fate is to loss their production since they must plough/sow, weed and harvest in an appropriate time by group. But to do so, working in a group (E.g. through Debo and Wonfel) is a must. Debo and wonfel are the labor-mobilizing techniques for those households, who have cultivated land or small family size, and are used for sharing labor for agricultural production. Therefore, the sample households were not fully respond to the pandemic. However, the local communities' leaders play a significant role in preventing coronavirus by imposing restrictions and therefore, about 58.86% of the respondents revealed the restriction on debo and wonfel (Table 5). Agricultural extension service providers are actively involved in advising rural households about COVID 19 and other alternative means of farming mechanism in Ethiopia. Consequently, about 33.5% of the respondents revealed the positive contribution of development agents to facilitate agricultural farming, despite significant attention is also given to the pandemic. Agricultural cooperatives and its unions, who are a potential provider of agricultural inputs in different regions of Ethiopia, are also actively participated in preventing and reducing the spread out of the coronavirus, and also to secure future agricultural production. Close to 43.65% of the respondents agreed with the positive contribution of agricultural input distributors by lecturing about social distancing in the time of input provision and also by reducing the unnecessarily delay of input provided to farmers in the time of COVID 19. Also, transport supervisors, ordinary police, and traffic police also play a significant role in preventing the spread of the virus, and about 35.9% of the respondents confirmed the effective and responsible duty of public transport supervisors and traffic police in their respective locality (Table 5).
Moreover, about 46.5% of the respondents confirm that public health professionals and other health workers are engaged, and train community health workers, youths, community leaders and members, and university and college students about risk communication, community engagement to prevent risks of COVID-19, physical distancing, limit movement and minimize gathering. Thus, community health workers are vital to ensure risk communication, using community-based networks and key influencers and building capacity of local entities.

Factors affecting preparedness to confront coronavirus
Tables 1 and 2 depict the descriptive and summary of explanatory variables used in the probit models, respectively. Based on the result, about 46.4% of the respondents have participated in preparedness and response to COVID 19. The model was checked for the suitability and explanatory power of independent variables over the dependent variables. The test results indicated that the likelihood function of the Probit model was significant (Wald χ2 =84.36 with P < ·001), showing its explanatory power. The results of the Probit model are presented in Table 6, and some of the explanatory variables and their respective marginal values are statistically significant in determining households' preparedness and response to COVID 19 as expected. The marginal effects of the result indicated the changes in the probability of rural society in preparedness and response to COVID 19 for a change in the explanatory variable. The marginal effects of significant explanatory variables are used in estimating the likelihood of preparedness and response to COVID 19. The marginal effect for gender of respondents showed that male household head decreases the probability of enhancing and engaging in preparedness and response to COVID 19 by 29% as compared to female household heads. Compared to younger household heads, adult household heads have a 33% higher probability of engaging in the preparedness and response to coronavirus but, the elder household heads have a 31% lesser probability of engagement. Households who attended the preparatory level of education have a 41% higher probability of engaging in preparedness and response to COVID 19 as compared to the illiterate one. Besides, households who have a mobile phone have a 52% higher probability of engaging COVID-19 preparedness and response compared with households survived without phones (Table 6).
Furthermore, compared to their counterparts, households received extension information about COVID-19 extension information, social community groups' participants, and income from off/nonfarm activities have 25%, 34%, and 26% higher probability of engagement in preparedness to the novel coronavirus. Also, compared to households without family who attended formal education, households with family members attended preparatory education levels have a 59% higher probability of engaging in preparedness and response to combat coronavirus. Besides, households who belong to middle economic status have a 32%higher probability of making preparedness and response compared to the lowest economic group households.

Discussion
Improving the rural societies understanding of COVID 19 is vital for safeguarding the health and livelihoods of the most vulnerable people, including Ethiopia. Hence, the majority of rural households are from low socioeconomic groups that probably exposed to adverse conditions, such as financial, food, and medicine safety problems (Abdulkadir et al., 2020). In line with this, this study surveyed the rural peoples' consciousness of coronavirus and possible factors hindering their preparedness and response. The result revealed the low-level cognizant and insufficient attention to coronavirus. The level of community engagement to reduce the vulnerability is still at the infant stage, and the majority of the rural peoples behave in a usual manner before the outbreak of novel coronavirus (2019-nCOV).
The result of the study presented in Table 3 indicated that only a few of the respondents understand the transmission, prevention, and way of confronting its effect, and then engage in changing their social behavior to minimize the possible consequences. Thus, the pandemic requires organized community-based prevention and response rather than a few engagements. Rural household health, agricultural production, and food security condition would expand and hinders the country's strategic objective of reducing food security problems and increasing agricultural production levels. The world health organization recommends individuals to quarantine or to trips to areas where a large number of peoples probably exist. In this respect, social and communal association groups of either religiously or culturally practiced in Ethiopia creates suitable conditions for COVID 19. The result presented in Table 3 shows the availability partial and complete restriction on communal association stetted by religious leaders, elders, and local administer but, the absence of any formal measures majority of the peoples have practiced it. It could be due to the unavailability of legitimacy coverage in the restriction by the religious center. However, different socio-economic and institutional factors affect rural peoples' preparedness and the response of COVID 19.
The probit model regression analysis was employed to identify factors affecting the preparedness and response to COVID 19 in rural Ethiopia. The marginal effects of the probit regression analysis presented in Table 2 showed that the age of household head, educational level of a household head, ownership mobile phone within a household, access to formal extension information, educational level of household members, social group participation, households economic situation, and income from off/non-farm activities have a positive and significant effect on the rural households' preparedness and response to novel coronavirus (2019-nCOV) while the sex of a household head affects negatively. This difference among rural communities calls further intervention to facilitate the prospect of enhanced rural households preparedness and response to COVID 19.
Based on the results, male-headed households' are less likely to engage in preparedness and response to novel coronavirus compared to female household heads. It could be due to the more attentiveness of females to practices actions by others or could link to perspicacious characteristics compared to males. On the other hand, males might not fear and not provide match emphasis on the information due to the natural character compared to females. As expected, the age category of a household head is significantly associated with households' preparedness and response to confront coronavirus pandemic. Compared to young household heads, household heads within the adult age category are more likely to engage in preparedness and response to confront coronavirus but, the elder household heads are less likely to engage in preparedness and response activities. It could be associated with the adult age category is the stage where the majority of peoples coming relatively wise for the sake of others, including families. This suggesting that adult headed households better recognizing the risks associated with the novel coronavirus (2019-nCOV). On the other hand, elder households' heads are not disturbed by the outbreak of the new pandemic as they experienced many indigenous and global diseases so far. Besides, elders believed that GOD saves our lives rather than engaging in preparedness and response COVID 19. Even the all aged groups of the population in the country believe that their immunity and religion prevent them from COVID 19 so that they failed to appropriately practice the preparedness and response activities (Akalu, Ayelign, & Molla, 2020).
Ownership of mobile phones within a household level is positively and significantly related to household preparedness and response to coronavirus. The result showed that households who own mobile phones in their families are more likely prepared to prevent and respond to the pandemic. This can be associated with the fact that the Ethiopian telecommunication office provides extension information about COVID 19 instead of a ring voice of the caller before it reached the receiver. Households who did not own mobile phones have relatively less access to real information, and this decreases the probability of engagement in preparedness and response to coronavirus.
The extension service on COVID-19 provided by the Ethiopian government or religious centers is the only trusted and accepted information sources in almost all parents of rural Ethiopia. Those respondents who received extension information about COVID 19 from above-listed sources could have a better understanding of prevention, transmission, and response mechanisms, and therefore, more likely to engage in preparedness and response to the virus. The result also suggests households who received extension information tend to use their family labor and other technology packages instead of shared labor to practices agricultural production.
The education level of the families/children identified as a significant factor for preparedness and response to COVID 19, and households with family members attended preparatory or university level education are more likely to engage in preparedness and response to novel coronavirus. It could be due to the students who have actively attended preparatory and university level education are matured and acceptable in their family, and this could help the family to have a full understanding of the pandemic. Besides, the majority of them owned mobile phones either smart phone or others for information, and this helps them to get updated information from either internet or phone call for sharing with their family. Moreover, households who currently participated in social community groups are more likely to prepare and respond to coronavirus as they received information about these community group members. This is consistent with the findings of Akalu et al. (2020),who found that the more educated person can have multiple ways of acquiring information to know about the prevention of COVID 19 and practice accordingly so that they would prepare and respond it.
Compared to the poor (lower economic status), households with a medium economic level are more likely to engage in coronavirus preparedness and response. The preparedness and response mechanisms of COVID 19 require additional costs, and those who afford such costs for hygienic, sanitary, and others could engage in the adaptive response of COVID 19. Moreover, compared to their counterpart, households who had off/non-farm income are more likely to engage in preparedness and response to COVID 19. It could be the nature of non-farm activities, the potential information accesses about the pandemic, and the income from non-farm sources may probably determine their engagement.

Conclusion
This study investigated factors affecting rural (agrarians) people's preparedness and response to the novel coronavirus (2019-nCOV). The study employed the probit model to explore the determinants of rural households' preparedness and response to coronavirus. The rural parts of Ethiopia were wrongly expected to be advantageous and easily accessed information about COVID 19 due to the homecoming of the educated youths from cities, small towns, and university students can access social media. However, as it evidenced by the results of this study, the majority of the study site has challenged by the availability of full and real information gap, inadequate, and ineffective, infant, and not wellorganized social response mechanisms due to socioeconomic and institutional constraints.
The government of the country tried to prevent the spread of COVID 19 through the closure of schools, ceasing the transportation/movement, announcing the different organizations/offices to reduce the numbers of staffs and attend by shift, reducing the number of religious leaders and followers in the church, ordering the shuttering of nightclubs and entertainment outlets, wearing mask, and announcing the social distancing measures. However, these activities, except school and borders closure, were implemented in cities and towns; and the inhabitants, who live in rural areas of the country, were failed to implement this measures, and even the government couldn't take any measures on them.
The result of the study showed that the rural and agriculture-dependent households' preparedness to the novel pandemic is affected by demographic, institutional, and socioeconomic factors. The majority of the significant variables (ownership of mobile phones, access to formal extension information, educational level of household members, social group participation) determining rural peoples' preparedness and response in this study came from the information gap on the novel coronavirus (2019-nCOV). On the other hand, the majority of rural households are existed in the low economic groups and challenged by cash income sources (farming is their only source of income while they have small land areas), and cannot afford to buy the prevention equipment of COVID 19. Thus, more attention needs to give for the rural agriculture-dependent community in term of awareness by using technical language and local language; temporary support (sanitary equipment and cash) to these more vulnerable groups as an incentive enhance peoples to apply prevention and response methods of coronavirus in rural Ethiopia. Besides, the government should do beyond the announcement of orders and awareness creations, and ensure whether the right measures are taken at the right time and place or not, through promoting local leaders for implementation and fulfilling or establishing the infrastructural facilities (e.g. quarantine, water) for rural agrarian peoples in the country.
This research is mainly focused on the identifying the determinants of rural (agrarians) people's preparedness and response to the pandemic, not on its impact. Therefore, the future research should focus on the impact of COVID 19 and government's action to face COVID 19, especially public policies, on the livelihood of agrarian people of Ethiopia.