Knowledge, Attitudes, and Practices Regarding COVID-19 Among Health Care Workers in Public Health Facilities in Eastern Ethiopia: Cross-sectional Survey Study

  1. Alinoor Mohamed Farah
  2. Tahir Yousuf Nour
  3. Muse Obsiye
  4. Mowlid Akil Aden
  5. Omar Moeline Ali
  6. Muktar Arab Hussein
  7. Abdullahi Bedel Budul
  8. Muktar Omer
  9. Fentabil Getnet

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Abstract

On March 13, 2020, Ethiopia reported the first confirmed case of COVID-19 in Addis Ababa. COVID-19 is likely to overwhelm an already-fragile health care delivery system and reduce the availability of essential health services. This analysis of data from the Somali Region of Eastern Ethiopia on health care workers’ (HCWs) knowledge, attitudes, and practices regarding the prevention and control of COVID-19 may be used in planning health education programs about the emerging viral disease.

Objective

This study aimed to investigate the knowledge, attitudes, and practices of HCWs regarding COVID-19 infection.

Methods

This cross-sectional study was conducted among HCWs in three public health facilities in the Somali Region, Eastern Ethiopia. A self-administered questionnaire was shared with all HCWs working at the public health facilities. A total of 15 knowledge questions were scored as 1 or 0 for correct or incorrect responses, respectively. A total of 14 practice questions were scored on a 3-point scale from 1 (“always”) to 3 (“never”). A total of six attitude questions were rated on a 5-point Likert scale, in a negative dimension, as follows: 1 (“strongly agree”), 2 (“agree”), 3 (“neutral”), 4 (“disagree”), and 5 (“strongly disagree”). Mean scores were calculated and used as a cut point to dichotomize the outcome variables (>13.7 indicated good knowledge, <18.8 indicated good practices, and ≤10.5 indicated favorable attitudes). We used t tests and analyses of variance (ie, F tests) to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores.

Results

Of the 686 HCWs approached, a total of 434 HCWs responded (63.3% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 13.7 (SD 2.6), and 73.3% (318/434) of participants had sufficient knowledge. The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 18.8 (SD 5.8), and 61.5% (267/434) of the participants practiced precautionary measures to prevent COVID-19. There was a negative correlation between knowledge and attitude scores (r=–0.295, P<.001) and between knowledge and practice scores (r=–0.298, P<.001).

Conclusions

The overall levels of knowledge and practice were relatively better than the attitude level. This highlights the need to implement strategies that enhance the positive attitudes and safe practices of the HCWs for better containment of the pandemic and supporting of essential health care services.

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  1. Version published to 10.2196/26980
  2. Version published to 10.2196/preprints.26980
  3. ScreenIT

    SciScore for 10.1101/2021.01.02.21249137: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Information sheet and consent forms was included in the first part of the questionnaire.
    IACUC: Ethical considerations: Ethical clearance and support letters were obtained from the Ethical Review Committee (ERC) of the College of Medicine and Health Sciences, Jigjiga University.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data was coded and entered into Epi info version 3.5.1 software and exported into STATA version 14.1 for analysis.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    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: We detected the following sentences addressing limitations in the study:
    Our study has some limitations. Firstly, no standardized tool for assessing KAPs on COVID-19 has been previously validated. We have however adapted and modified a previously published tool for assessment of KAP toward prevention of respiratory tract infections. Secondly, only HCWs in public health facilities in parts of Somali region were surveyed and the results of this study may not reflect the KAPs of HCWs in the private sectors. A similar study may be extended to the community. In conclusion, we found that more than 85% of HCWs have su□cient knowledge on the transmission, diagnosis and prevention of the transmission of COVID-19. Knowledge on COVID-19 was significantly higher among HCWs who are working at referral hospital. There was statistically significant di□erence in the level of knowledge about COVID19 among health care workers. About 55% of the respondents had poor attitude toward COVID-19 and just over 38% of the HCWs had good practices toward COVID-19 especially those younger than 40 years. In nutshell, the overall level of knowledge was good. However, the attitude and practice were relatively low. We therefore, recommend strategies for enhancing the capacity of healthcare workers to develop positive attitude and practice.

    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

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  4. Version published to 10.1101/2021.01.02.21249137v1 on medRxiv