Compliance with COVID-19 protocols among college students in Ghana: evidence from 2020–2021

The COVID-19 pandemic caused global illness, death, and economic setbacks, emphasizing the need for WHO-recommended safety protocols. Young adults, often asymptomatic yet rapid transmitters, show low compliance with safety protocols. This study examined the compliance of young Ghanaian adults during the pandemic, a group with limited data at the time. Understanding these behaviors has important implications for shaping public health measures in a post-pandemic world. To examine conformity with public health protocols recommended for preventing the spread of COVID-19, and the factors related to it. This cross-sectional study involved an online survey of 303 University of Ghana students residing on campus. Testing of any relationship between sociodemographic characteristics, COVID-19 knowledge, anxiety levels, risk perception, personality/psychological characteristics and compliance with COVID-19 hygiene and social distancing protocols was achieved using Chi-square and Fisher’s exact tests. Multiple and penalized logistic regression models were employed to identify factors linked to compliance with these protocols. Among students, 72.9% had average awareness of COVID-19 prevention measures, 26% showed very high awareness, and just over 1% had limited awareness. Compliance was highest for respiratory hygiene (59%), followed by physical distancing (22%) and hand hygiene (9%). Notably, 71% did not adhere to most recommended safety protocols. Perceived likelihood of COVID-19 infection significantly influenced hand hygiene compliance. Students moderately or extremely concerned about infection were 3.8 and 4.4 times more likely, respectively, to comply with hand hygiene protocols. The adjusted odds ratios (AOR) were 2.9 (95% CI = 1.3–11.0, p = 0.016) for moderate concern and 4.4 (95% CI = 1.4–13.6, p = 0.009) for extreme concern. Despite adequate awareness of COVID-19 safety protocols, student compliance to COVID-10 safety protocols was low, underscoring challenges in behavior change. These findings highlight lessons for post-pandemic public health strategies. Future efforts should focus on building trust, improving resource access, and enhancing education to prepare for global health emergencies. The study underscores the importance of applying pandemic insights to shape effective future responses.