Acceptability of contact management and care of simple cases of COVID-19 at home: a mixed-method study in Senegal

Abstract

Introduction: In mid-2020, due to the health system challenges from increased COVID-19 cases, the Ministry of Health and Social Action in Senegal opted for contact management and care of simple cases at home. The objective of the study was to determine the acceptability of contact management, home care of simple cases of COVID-19, and its associated factors. Method: This was a sequential mixed-method study. We collected data from June 11, 2020, to July 10, 2020, for the quantitative survey (N=813) and from August 24 to September 16, 2020, for the qualitative survey (N=30). We carried out a sampling strategy using marginal quotas at the national level. We collected data using a structured questionnaire in a telephone interview for the quantitative survey and using an interview guide formulated from the initial results of the quantitative survey for the qualitative data. We assessed acceptability using binomial logistic regression combined with content analysis. Results: The care of simple cases of COVID-19 at home was well accepted (78.5%). This result was justified for some (saturation of the health system) but not for others (risk of contamination). The use of home contact management was less accepted (51.4%), with risk limitation as the main reason given. The acceptability of home-based care for simple cases was positively associated with knowledge of the modes of transmission of the virus (ORaj: 1.55 [95%CI: 1.04,2.28]), regular research into COVID-19 (ORaj: 2.12 [95%CI: 1.45,3.12]), belief in the existence of treatment (ORaj: 1.82 [95%CI: 1.19,2.83]), and confidence in institutional information (ORaj: 2.10 [95%CI: 1.43,3.10]). The acceptability of home-based contact management was positively associated with knowledge of the modes of transmission of the virus (ORaj: 1.77 [95%CI: 1.27,2.48]), regular research for information on COVID-19 (ORaj: 2.39 [95%CI: 1.76,3.26]), and confidence in the government in the fight against the epidemic (ORaj: 1.51 [95%CI: 1.10,2.08]). Conclusion: Regular information on the disease, knowledge of its mode of transmission and trust in institutions are factors in accepting COVID-19 management at the community level. Authorities should take these factors into account for better communication to improve the acceptability of home-based care. Keywords: COVID-19, Acceptability, Simple cases, Contacts, Mixed method, Senegal

Evaluation of the Performance of the Routine Epidemiological Surveillance System in the Health District of Tambacounda (Senegal) in 2020

“…This health system is based on six pillars: (i) health care service delivery, (ii) information - monitoring and evaluation - operational research, (iii) governance - leadership, (iv) human resources, (v) drug products - technology - vaccines and (vi) health financing [3,4]. In Senegal, the health system is pyramidal with three levels: (i) an operational level, the base of the pyramid consisting of health boxes, health posts, health centers and health districts, (ii) an intermediate level made by regional hospitals and the 14 medical regions, (iii) a central level, top of the pyramid with national hospitals, the various divisions and directorates of the Ministry of Health and Social Action [5]. At all levels of the health pyramid, routine ES is required and includes communicable diseases which are the most frequent causes of death and disability in the African region [6].…”