Knowledge and practice of COVID-19 prevention among community health workers in rural Cross River State, Nigeria: implications for disease control in Africa

Abstract

Introduction in developing countries, community health workers (CHWs) are essential, for provision of behaviour change communication towards prevention of coronavirus 2019 (COVID-19) infection at rural grassroots level. We aimed at assessing their level of knowledge and practice of preventive measures in a developing country setting. Methods total enumeration of all CHWs in a rural local government area in southern Nigeria was carried out, using cross-sectional descriptive study design. Pretested self-administered 15-item questionnaire was used to assess knowledge of COVID-19 including basic epidemiology, virology, preventive measures and use of personal protective equipment (PPE). Practice of preventive measures was also assessed. Each correct response to knowledge question contributed one unit to the total score which was converted to percentage. Total knowledge score of 50% or greater was considered satisfactory. Results complete data was obtained from eighty-six (86) respondents with mean age of 36.3±8.9 years (18-54 years). Mean total knowledge score was 28.14±12.8% (6.7 to 53.3%), and 9.3% (n=8) had score of at least 50%. Correct responses to appropriate sequence of putting on and removing personal protective equipment (PPE) were 5.8% (n=5) and 8.1% (n=7), respectively. Regular practice of use of face masks, goggles, gloves, and hand hygiene was found to be 50% (n=43), 12.8% (n=11), 30.2% (n=26), and 56.4% (n=48), respectively. Conclusion community health workers are grossly underprepared for provision of health education on COVID-19, due to their poor level of knowledge. Their capacity building through workshops and effective continuing education program are urgently needed.

Caregivers’ Perception and Practice of Infection Prevention and Control for COVID-19 at a Tertiary Centre, Southern Nigeria

“…Furthermore, the proper wearing of the mask was not ascertained in those online series. Yet, the figure in the present series is higher than what was recorded amongst heads of households in Enugu metropolis (33.8%) and among CHWs in Cross Rivers State (50%) which was attributed among others, to inadequate provision of the necessary materials [8,22]. Nevertheless, it is worrisome that only 28.5% of participants wore their masks properly, covering both the nose and mouth.…”

“…The steps of hand washing were however, not explored in this series. On the other hand, hand hygiene practice was reported to be poor (56.4%) in the Cross Rivers state study, which is worrisome as failure to effectively practice preventive measures among CHWs may expose them to the risk of getting infected and spreading the virus in their community [22].…”

“…In Sierra Leone also, when there was yet no confirmed case, 91% of participants indicated they had heard of COVID-19, which may have been prompted by their previous experience with the devastating West African Ebola epidemic [20]. On the contrary, awareness of COVID-19 was low in a study in Ethiopia (49.4%), and unacceptably low among Community Health Workers (CHWs) in a rural setting in Cross Rivers State, as 9.3% of respondents had total knowledge score of at least 50% [21,22]. This was attributed to the novel nature of the virus, and possibly the relative neglect in building capacity of CHWs, who constitute an essential group of grassrootsoriented healthcare professionals [22].…”

Knowledge of COVID-19 and Compliance with the Use of Facemask among Undergraduate Students in a University in South-South Nigeria

“…Only 11% of respondents in this study wear facemask at all the times when they are outdoor and in the public. In other related studies nearly half of the respondents used facemask regularly when outdoor [19,26,27]. Furthermore 18% and 24% of the respondents in this study respectively wear and remove their facemask appropriately in accordance with the protocols on wearing and removal of facemask.…”

Responding to COVID-19 by building health workforce capacity across eleven countries in Sub-Saharan Africa

“…While the 2019 Global Health Security Index found that no country was fully prepared for a pandemic, the African region had the lowest scores. 20 Recent studies from South Africa 21 , Nigeria 22 , Ethiopia 23 and Libya 24 illustrate the need for improved coverage of basic IPC training amongst frontline HCW of all cadres, an initiative which should ideally be built into both pre-service education and in-service training in all countries. Training alone is insufficient to close the IPC performance gap -enabling policies, guidelines, systems, supplies, and infrastructure are also essential.…”