Availability of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Ethiopia

Abstract

Healthcare professionals (HCPs) are at the frontline in the fight against COVID-19 and are at an increased risk of becoming infected with coronavirus. Risk of infection can be minimized by use of proper personal protective equipment (PPE). This study assessed the availability of PPE and satisfaction of HCPs in six public hospitals in Addis Ababa, Ethiopia. A cross-sectional study was conducted from 9th to 26th June 2020. The study hospitals included: Tikur Anbessa Specialized Hospital, Zewditu Memorial Hospital, Ghandi Memorial Hospital, Menelik II Hospital, Yekatit 12 Hospital Medical College and St. Paul Hospital Millennium Medical College. Data were collected using a self-administered questionnaire. Descriptive statistics were used to describe the data and Chi-square test was used to assess the association between the groups. Bivariate and multivariable logistic regression models were used to assess factors associated with the satisfaction level of healthcare workers with regard to the availability and use of proper PPE during the current COVID-19 pandemic. A total of 1,134 (92.3%) valid questionnaires from a possible 1,228 were included in the analysis. The mean (SD) age of the participants was 30.26 (6.43) year and 52.6% were females. Nurses constituted about 40% of the overall sample, followed by physicians (22.2%), interns (10.8%), midwives (10.3%) and others (16.7%). An overall shortage of PPE was reported in all study hospitals. The majority (77%) of the healthcare professionals reported that their hospital did not have adequate PPE. A critical shortage of N95 respirator was particularly reported, the self-reported availability of N95 increased from 13% to 24% before and during COVID-19, respectively. The self-reported use of N95 increased from 9% to 21% before and during COVID-19, respectively. Almost 72% of the respondents were dissatisfied with the availability of PPE in their hospital. The independent predictors of the respondents satisfaction level about PPE were male gender (adjusted OR=1.39, 95% CI:1.05-1.85), healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR=7.53, 95% CI:5.08-11.16), and preparedness to provide care to COVID-19 cases (adjusted OR=1.65, 95% CI:1.22-2.12). A critical shortage of appropriate PPE both before and during COVID-19 was identified. The high level of dissatisfaction with the availability of PPE might potentially lead to a lower level of preparedness and readiness to fight against COVID-19. Therefore, urgent efforts are needed to adequately supply the healthcare facilities with appropriate PPE to alleviate the challenges.

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“…About two-third of the respondents were dissatisfied with the low level of availability of PPDs in their hospital. This finding corroborates with the study in Ethiopia which reported an overall low level of satisfaction of healthcare practitioners with the availability and use of appropriate PPDs in their hospital [20].…”

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“…35 In this study, there was no significant difference between case and control regarding PPE availability this result is different than reported in a cross-sectional study in Ethiopia the study included 1228 HCWs that reported an overall shortage of PPE the majority (77%) of HCWs reported that their hospital did not have adequate PPE. 36 In survey study that was conducted in 33 hospitals in Sudan among workers in all radiology department reported that 75% of all workers had sufficient knowledge about hand hygiene and hand hygiene is embedded in their routine clinical practice. 37 Also, in a cross-sectional study in 13 regions of Saudi Arabia among HCWs in radiology department reported that the majority of radiographic technologists reported wearing the recommended PPE regardless the patient infectious states during this pandemic and 80% of participant received frequent training about infection prevention and control at their health institutions while in this study only 50.8% of participant received training about infection prevention and control practice.…”

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“…74,76,77 Lack of proper training and guidelines, critical shortage of PPE, lack of scientific evidence at hand, low local support, lack of proper communication and collaboration between stakeholders, and fear of contracting the infection were reported by the HCWs to be the major limiting factors. 39,[74][75][76] Though limited, the studies have clearly depicted that the collateral damage was felt more than the direct impacts of the outbreak during the first few months. Maternal health service utilization declined significantly compared with the previous months.…”

“…Major reasons mentioned by HCWs were lack of training, critical shortage of PPE, lack of scientific evidence at hand, inability to access guidelines and recommendations, limited access for literature, low local support, poor communication and collaboration between stakeholders, and fear of contracting the infection. 39,[74][75][76]…”