Background
Methods
Study setting, design, and period
Sampling
Data collection method
Topics in the interview script | |
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What do you think about COVID-19? | |
How health professionals prevent themselves and patients from COVID-19? | |
What do you think about precautionary measures? | |
What are the perceived barriers to the practice of precautionary measures? | |
What activities done in the health facility to prevent the spread of COVID-19? | |
What do you suggest to improve the practice of health care providers to tackle the COVID-19 pandemic? |
Trustworthiness
Data analysis
Results
Main themes | Sub-themes |
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Theme 1:Overview | Origin |
Causes | |
Mode of transmission | |
Sign and symptoms | |
Treatment | |
Preventive measures | |
Theme 2:Consequences | Stress on the HCPs |
The socio-cultural and economic crisis | |
Theme 3:Perceived practice of preventive measures | Using PPEs |
Handwashing and using alcohol and sanitizer | |
Avoid contact | |
Appropriate waste disposal | |
Theme 4: Perceived barriers | Community influence |
Health care provider related barriers | |
Institutional barriers | |
Lack of communication and support | |
Theme 5:Newfangled activities | Launching testing center and other services |
Controlling patients, visitors, and staffs | |
Taskforce organization and surveillance | |
Theme 6: Suggestions for improvement by HCPs | Conduct outreach services and involve community leaders |
Control transportation | |
Strengthen multidisciplinary teamwork | |
Motivation and capacity building for staffs | |
Fulfill necessary supplies | |
Monitor activities continuously | |
Mass screening and campaign |
Overview of COVID-19
“Coronavirus disease-2019 (COVID-19) originated from Wuhan province, China after eating bat meat” (Participant 10).
“The name of disease given by the virus name and year of occurrence, which called Coronavirus Disease-2019” (Participant 14).
“The mode of transmissions are physical contact, air, droplets, handshaking, and different body fluids” (Participant 15).
“The sign and symptoms of COVID-19 are fever, the difficulty of breathing/shortness of breathing, and sore throat” (Participant 16).
“The sign and symptoms of COVID-19 are fever, back pain, sneezing, and dry cough” (Participant 12).
“There is no vaccine and treatment for Coronavirus Disease-2019. But, the best prevention way is homestay; others are not got to a public gathering, physical distancing, washing hands with soap and water, using alcohol or sanitizer, and using facemask at market or place where so many individuals gathered”. Besides, to above-stated prevention ways, social or physical distancing at least 2 m or 6 ft. Reducing transport, not got to “Lekiso” or burial places, “Ikub” and Edir” places” (Participant 4).
“The prevention ways are social distancing, frequent washing with water and soap by rubbing hands for 20 seconds, using alcohol and sanitizer in areas where water is not available. Two staffs from our sectors trained on COVID-19 prevention and treatment, and they stated that we could treat COVID-19 by antibiotics by increasing the dose (at least by Amoxicillin) and by taking cooked hot food and fluids” (Participant 3).
Consequences of COVID-19 pandemic
“COVID-19 is the most severe and resulted in tension on HCPs and economic crisis. It is possible to control the transmission but challenged with the societal culture and the way of living” (Participant 7).
The perceived practice of preventive measures of the COVID-19 pandemic in health professionals
“Health care professional prevent themselves and patients or any person who visits the health facility by using different kinds of masks (surgical mask, N-95 facemask, and locally produced masks), frequently washing hands with soap and water, and by using hand sanitizers” (Participant 1).
“Health care workers, preventing themselves and others by using a facemask, which produced locally, and some bought their N-95 facemask and hand sanitizer. They wash hands with soap and water in the main get and emergency room only due to a shortage of handwashing facilities. The entrance of patients and visitors controlled in the main get. One person or supporter for severely ill patients and only patient if stand-alone can get into the facility. All individuals who enter the facility must apply a facemask and wash hand in the main get” (Participant 8).
“In the case of the pediatric ward, the patient came after passing pre-triage, and all the staff practice standard precautionary measures such as using a facemask, donning gloves, frequently washing hands, and use sanitizers. If the patients with cough came to the ward, there is isolation room until diagnosis and if we suspected COVID-19 sample sent to the testing center” (Participant 11).
“All health professionals have a facemask and maintain physical distancing. However, it is difficult in case of maternal, child health services, family planning, delivery, and postnatal care because there is direct physical contact” (Participant 7).
“The health care workers preventing the pandemic by infection prevention practice such as avoiding or stored contaminated materials in specified places and follow the adequate waste disposal mechanisms, using PPEs (facemask, gloves, and gowns)” (Participant 15).
Perceived barriers for the practice of preventive measures for COVID-19
Community influence
“There is ignorance and negligence in the community to accept the practice of prevention ways or to avoid the previous culture while came to our facility” (Participant 13).
“Most community members who came to institution perceived that there are no any COVID-19 and it is false and politics, not a disease. It is a common cold, which is cured easily. Because no one is infected and no one is dead in our surrounding” (Participant 3).
“There is a lack of awareness in the community who came to the institution even if awareness created by different stakeholders by using montarbo and microphones. They came without a facemask, and some apply facemask inappropriately” (Participant 7).
Health care provider related barriers
“The main challenge in this facility to practice precautionary measures in line with standards and emergency operation is that pregnant and breastfeeding staffs, aged staffs, and staffs with chronic diseases like asthma and diabetes mellitus were obligated to work and not allowed to stay at home” (Participant 3).
“Regarding the practice precautionary measures to prevent COVID-19, most staffs practice the measures even if there are some negligent and ignorant staffs due to no occurrence of the case around the town” (Participant 16).
Institutional barriers
“The barriers are the absence of hand sanitizer, shortage of alcohol, facemasks, and other PPE since our district is new, and the majority of the thinks are limited. There is no screening in our institution as well as in our district even with infrared thermometer” (Participant 5).
“The barriers that affect the practice of precautionary measures in our institution are … , shortage of supplies (facemask, gloves, etc.), inadequate OPD, and emergency rooms to maintain the recommended physical distance. The other factors are..., unavailability of guidelines to orient the staffs” (Participant 15).
“There is no training and psychological support for HCP to avoid stress and to stabilize the situation. The budget issue is the main concern to fulfill the necessary materials and training all the health care providers. As our health facility, there is no water, we buy 20 litter/ 10 birr per day water from surrounding, and we use rainwater, which strode in the tanker, there is also a shortage of alcohol and sanitizer, and district health office gave two litter alcohol and sanitizer” (Participant 4).
“The barriers that affect the practice of precautionary measures in our institution are inadequate duty rooms for staffs that many staffs exchangeable used a single room for a period and if one individual from those infected the risk contamination is most likely. The other challenge is the shortage of hand sanitizer and facemask. The recommended duration of use of single facemask is 8 hour, but most staffs use more than a week” (Participant 6).
“The main problem in this health facility is that as different teams or stakeholders, commented there is no triage. However, we simply isolated patients with cough and gave priority for those individuals” (Participant 3).
Lack of communication and support
“The barriers that affect the practice of precautionary measures are attention and recognition not given for health care professionals …. There is no support from the town health office, zonal health department, and task force in the zone rather than taking the suspected or confirmed cases to the treatment center. Staffs in other government organization apply standard and recommended facemask, but we struggled to serve the community by locally produced and below standard facemasks” (Participant 8).
“The other factors are lack of communication of our institution with supporting organization or universities to train the staffs and unavailability of guidelines to orient the staffs” (Participant 15).
Newfangled activities in the health facility after the occurrence of the pandemic
“Activities that conducted after the occurrence of the pandemic are an organization of fever clinic that provided by trained staffs with an infrared thermometer, pre-triage service, and COVID-19 testing center launched. Handwashing facilities organized in a different place and all persons are obligated to apply facemask” (Participant 12).
“The activities conducted in the facility after the occurrence of the pandemic were a team (taskforce) created and a team of health professionals trained in the zonal level. There is integration with health extension workers at the health post, and those health extension workers conducted surveillance at least 20 households per day to identify the suspected cases” (Participant 3).
“The activities conducted in our facility after the pandemic was the construction of new handwashing station, screening in the get, distancing patient bed in the ward, reducing the number participates in meeting” (Participant 2).
Suggestions by health professionals for the improvement
“ … the community leader must intervene on this to save the community from this pandemic. The community practicing already an existing culture in “Eder” “Ekub“ and “Lekiso“ places, that the task force, the town health office, and the zonal health department must support the health professionals or team to create awareness in the community … “ (Participant 8).
“… awareness creation must continue in the community … transport access must arrange … for the staffs who came far from the health facility” (Participant 7).
“ … task force activities are key roles to prevent the spread of infection in the community. Therefore, those activities must strengthen and frequently monitored rather than one session or one-week activity” (Participant 1).
“ … the leaders in the facility must train on COVID-19 prevention aspects before anyone that the leaders are the main responsible person or individual to orient or to facilitate the health professionals or staffs to practice prevention measures” (Participant 2).
“ … mass screening needed to identify the case, staffs and all the community must apply a facemask and use hand sanitizer … “ (Participant 12).