Assessment of knowledge, attitude and practices among Accredited Social Health Activists (ASHAs) towards COVID-19: a descriptive cross-sectional study in Tripura, India

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Abstract

With the surge in COVID-19 cases, community healthcare workers (CHW) remain pivotal for proper dissemination of awareness of disease transmission and infection control measures among the communities in low- and middle-income countries. In this context, lack of adequate knowledge and appropriate attitude among the CHW can directly influence the COVID-19 management programme. Therefore, the present study was designed to assess the knowledge, attitude and practices towards COVID-19 among the CHW of India known as Accredited Social Health Activists (ASHAs). A descriptive cross-sectional was conducted in the state of Tripura, Northeast India, among ASHAs with 14-, 4- and 3-item self-administered questionnaire for knowledge, attitude and practice. Around 61.2% of participants had the mean correct answer rate and the mean score of knowledge was 8.57± 2.25 (±SD). As per Bloom’s cut-off, it was observed that only 10% of the ASHAs had adequate knowledge, 30.9% showed positive attitude and 88% adhered to the good practices. It was observed that the indigenous ASHAs were 1.79 times more likely to adhere to the good practice of wearing masks during filed visits in the community (OR: 1.791, 95% CI: 1.059-3.028, p=0.030). Multinomial regression analysis showed that practice was significantly associated with fear of getting infected during service and the community’s fearfulness of ASHAs spreading the disease. Urgent addressing of the provisions of support, guidance and training of grassroot level healthcare workers in rural tough terrains can ensure robust output from the existing community healthcare workers in future pandemic-like emergencies.

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  1. SciScore for 10.1101/2021.02.17.21251725: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: Ethical Clearance: The study has been reviewed and cleared by the Institutional Ethical Committee of the Agartala Government Medical College, Tripura (Ref. No. F (5-234)/AGMC/Academic/IEC Meeting/2020/13149).
    RandomizationTherefore, four Community healthcare centres under West Tripura district were randomly selected for the study.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: Data was coded and analysed using SPSS v25
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    5(IBM Corp., Armonk, NY, USA) and GraphPad Prism5.
    GraphPad
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.