An Ethnographic Study of Multiple Factors Influencing Perceptions, Attitudes, and Observance of COVID-19 Preventive Measures among Rural and Urban Slum Dwellers in Ghana

Abstract

Background. The COVID-19 pandemic and government-led interventions to tackle it have had life-changing effects on vulnerable populations, especially rural and urban slum dwellers in developing countries. This ethnographic study explored how the Ghanaian government’s management of COVID-19, socio-cultural factors, infrastructural challenges, and poverty influenced community perceptions, attitudes, and observance of COVID-19 prevention measures in Ghana. Methods. The study employed focused ethnography using in-depth interviews (IDIs), focus group discussions (FGDs), and nonparticipant observations to collect data from an urban slum and a rural community as well as from government officials, from October 2020 to January 2021. The data were triangulated and analyzed thematically with the support of qualitative software NVivo 12. All ethical procedures were followed. Results. The Ghanaian government’s strategy of communicating COVID-19-related information to the public, health-related factors such as health facilities failing to follow standard procedures in testing and tracing persons who came into contact with COVID-19-positive cases, poverty, and lack of social amenities contributed to the poor observance of COVID-19 preventive measures. In addition, the government’s relaxation of COVID-19 restrictions, community and family values, beliefs, and misconceptions contributed to the poor observance of COVID-19 preventive measures. Nevertheless, some aspects of the government’s intervention measures and support to communities with COVID-19 prevention items, support from nongovernmental organizations (NGOs), and high knowledge of COVID-19 and its devastating effects contributed to positive attitudes and observance of COVID-19 preventive measures. Conclusion. There is a need for the government to use the existing community structures to engage vulnerable communities so that their concerns are factored into interventions to ensure that appropriate interventions are designed to suit the context. Moreover, the government needs to invest in social amenities in deprived communities. Finally, the government has to be consistent with the information it shares with the public to enhance trust relations.

Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study

“…As was indicated in some settings in this study, the household was supposed to have at least one tippy tap. A similar approach has also been noted in Ghana [ 22 , 31 ], and these tippy taps have been noted to improve hand washing. While this mitigatory measure is welcome, such vulnerable communities should be considered for the provision of long-term mitigatory measures, as the tippy tap does not carry much water and thus would require frequent refilling.…”

“…Those with these resources mentioned that hand hygiene was not a challenge, while the absence of these hand washing facilities, soap and/or sanitizer were cited as barriers to hand hygiene. These environmental determinants have also been noted as barriers to hand washing in Ghana among rural and urban slum dwellers [ 22 , 31 ], among slum dwellers in Kenya [ 32 ], young adult students in Canada [ 27 ] and in poor settlements in Accra and Johannesburg [ 33 ]. A previous study in Zimbabwe also identified a lack of hand hygiene facilities as one of the challenges driving SARS-CoV-2 transmission in the country [ 24 ].…”

“…Hand shaking at funerals is a cultural way of consoling the loved ones of the deceased. In Ghana [ 22 ], Pakistan [ 35 ], and Iran [ 36 , 37 ], it was also reported that community members lifted COVID-19 restrictions, favouring continuing with sociocultural factors such as attending funerals, churches and family functions. Thus, it is important to engage the community when engaging in public health interventions so that people are aware that their cultural, religious or social diversity is taken into consideration in intervention measures.…”

“…In another study, people with access to hand washing facilities with soap and water were more likely to wash their hands with soap and water than those without access to these resources [ 21 ]. In Ghana, a lack of resources such as pipe-borne water and soap has resulted in people not being able to adhere to hand washing for the control of COVID-19 [ 22 ].…”

Evaluating the ergonomic deficiencies in computer workstations and investigating their correlation with reported musculoskeletal disorders and visual symptoms among computer users in Bangladeshi university

“…However, females experience more shoulder, and hand/wrist symptoms compared to males [ 38 ]. Therefore, due to gender differences, repetitive upper-limb tasking for prolonged periods of time may increase the chance of developing MSDs [ 9 , 46 ]. Similarly, other variables such as job type, age, working experience, and OSHA scores of different workstation components were also significant predictors of the development of MSDs.…”