Background: India has  high COVID-19 burden. The government of India responded to the pandemic by mandating their population to adhere to certain Protective Measures (PMs). Compliance to these PMs depends on the acceptability and adaptability of general public to these PMs.

Aims: To explore the perceptions and practices of Covid-19 related PMs among the healthy individuals in North India

Methods: Qualitative study conducted in four districts (Lucknow, Etawah, Patna and Darbhanga) of North India. All study districts had COVID-19 confirmed active cases at the time of study conduction. Audio in-depth interviews (IDIs) were conducted with healthy caregivers of children <5 years. Respondents were purposefully selected to represent both genders and to fit into two education groups (i) below primary-education (ii) above primary-education. Qualitative inquiry explored the socio-economic impact of the pandemic, perceptions and practices for PMs and self-reported usage of Arogya Setu^® (contact tracing app) recommended by the government. Data was managed using Atlast Ti software. Thematic analysis was conducted.

Results:  From August-Sep 2020, we conducted 60 IDIs of which 36.6% (22/60) were females and 26.6% (16/60) had either no schooling or <5 years of schooling. Most of respondents concurred that most people in their society did not comply with recommended PMs. The reason for non-complying with PMs were: poor susceptibility to illness, less perceived severity of COVID-19, low perceived benefits of non-complying outweighed by high outcomes and false beliefs that COVID-19 is less in rural areas and more prevalent among the un-educated population. Most respondents were aware of the recommended PMs and intended that PMs must be followed, subjective norms, social norms and behavioural intentions negatively impacted the intention to follow it. There was low self-reported usage of Arogya Setu app.

Conclusions:  There is a need to deploy appropriate risk communication and health promotion strategy to encourage community support and involvement in COVID-19 pandemic response.   Moreover, one size fits all approach does not contribute to effective containment of the pandemic like COVID-19 that is novel and has lots of uncertainty involved. Customized plans tailored to local community’s needs are required to address the rural-urban and less educated-more educated divide