Background: Three million internally displaced Somalis live in overcrowded settlements with weakened infrastructure, insufficient access to WASH facilities, and inaccessible health services. This vulnerable population is especially susceptible to COVID-19, which is expected to have worsened health outcomes and exacerbate existing structural challenges in the implementation of public health measures. This study examines knowledge of COVID-19, self-reported prevalence of preexisting conditions, and access to essential health services among residents of internally displaced persons (IDP) camps in Somalia.
Methods: A descriptive, cross-sectional survey design assessing demographics, current health profiles, knowledge and perceptions of COVID-19, and access to resources was used. 401 Somali IDP camp residents completed the survey.
Results: Though 77% of respondents reported taking at least one COVID-19 preventative public health measure, respondents reported a severe lack of access to adequate sanitation, an inability to practice social distancing, and nearly universal inability to receive a COVID-19 screening exam. Questions assessing knowledge surrounding COVID-19 prevention and treatment yielded answers of "I don't know" for roughly 50% of responses. The majority were not familiar with basic information about the virus or confident that they could receive medical services if infected. Those who perceived their health status to be "fair," as opposed to "good," showed 5.69 times higher odds of being concerned about contracting COVID-19. Respondents who felt more anxious or nervous and those who introduced one behavioral change to protect against COVID-19 transmission showed 10.16 and 5.20 times increased odds of being concerned about disease contraction, respectively.
Conclusion: This study highlights immense gaps in the knowledge and perceptions of COVID-19 and access to treatment and preventative services among individuals living in Somali IDP camps. A massive influx of additional resources is required to adequately address COVID-19 in Somalia, starting with educating those individuals most vulnerable to infection.