Community health worker knowledge, attitudes and practices towards COVID-19: Learnings from an online cross-sectional survey using a digital health platform, UpSCALE, in Mozambique

Abstract

Healthcare workers (HCWs) are at the frontline of the Coronavirus Disease 2019 (COVID-19) pandemic response, yet there is a paucity of literature on their knowledge, attitudes and practices (KAP) in relation to the pandemic. Community Health Workers (CHWs) in Mozambique are known locally as agentes polivalentes elementares (APEs). While technical guidance surrounding COVID-19 is available to support APEs, communicating this information has been challenging due to restrictions on travel, face-to-face group meetings and training, imposed from May to August 2020. A digital health platform, upSCALE, that already supports 1,213 APEs and 299 supervisors across three provinces, is being used to support APEs on effective COVID-19 management by delivering COVID-19 sensitive SMS messages, training modules and a COVID-19 KAP survey. The KAP survey, conducted from June 2020 to August 2020, consisted of 10 questions. Of 1,065 active upSCALE APEs, 28% completed the survey. Results indicate that only a small proportion of APEs listed the correct COVID-19 symptoms, transmission routes and appropriate prevention measures (n = (25%), n = (16%) and n = (39%), respectively) specifically included in national health education materials. Misconceptions were mainly related to transmission routes, high risk individuals and asymptomatic patients. 84% said they followed all government prevention guidelines. The results from the KAP survey were used to support the rapid development and deployment of targeted COVID-19 awareness and education materials for the APEs. A follow-up KAP survey is planned for November 2020. Adapting the existing upSCALE platform enabled a better understanding, in real time, of the KAP of APEs around COVID-19 management. Subsequently, supporting delivery of tailored messages and education, vital for ensuring a successful COVID-19 response.

A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden

“…One study limitation is the relatively low survey response rate from PHCWs, something that was in-line with similar studies conducted during the same period (5,(34)(35)(36). This may be partly explained by the idea that some employees who did not work directly with COVID-19 patients perhaps did not believe that the survey was aimed toward them, and thus refrained from responding.…”

Utility of telemedicine in sub‐Saharan Africa during the COVID ‐19 pandemic. A rapid review

“…All these studies were reported in 2020 during the COVID 19 outbreak. Two articles were cross‐sectional surveys (Armand et al, 2021 ; Feldman et al, 2021 ), one was a randomized controlled trial (Owolabi et al, 2020 ), one was a news article (Adebayo et al, 2020 ), one was a narrative review from Kenya (Jaguga & Kwobah, 2020 ), two were observational studies (Adebayo et al, 2021 ; Nlemadim et al, 2021 ), two were letters (Balme et al, 2020 ; Moolla et al, 2020 ), one was a commentary (Kamulegeya et al, 2020 ) and the other one was a retrospective and prospective analysis (Moyo & Madziyire, 2020 ).…”

“…The review showed the utilization of telemedicine in Zimbabwe, Cameroon, Uganda, South Africa, Nigeria, Mozambique, Tanzania, and Kenya. The most utilized mode of engaging patients was the telephones (P. Adebayo et al, 2020 ; Armand et al, 2021 ; Balme et al, 2020 ; Kamulegeya et al, 2020 ) and (Feldman et al, 2021 ). Two studies made use of the social media platform Whatsapp (Armand et al, 2021 ; Moyo & Madziyire, 2020 ) while some employed virtual platforms and video calls such as Skype (Armand et al, 2021 ; Moolla et al, 2020 ).…”

“…Two studies made use of the social media platform Whatsapp (Armand et al, 2021 ; Moyo & Madziyire, 2020 ) while some employed virtual platforms and video calls such as Skype (Armand et al, 2021 ; Moolla et al, 2020 ). Telehealth in SSA was not limited to consultation but also extended to education with two studies making use of the virtual digital platform to increase awareness and engage patients (Feldman et al, 2021 ; Jaguga & Kwobah, 2020 ).…”

“…The video call visits allowed for patients dignity while maintaining closeness with relatives (Moolla et al, 2020 ). Telemedicine aided in the ease of access to training and information while slowing down the transmission in Mozambique through the use of mobile phones (SMS) (Feldman et al, 2021 ). Uganda reported successful maintenance of mental health services, referrals, and refills by employing teleconsultations (Kamulegeya et al, 2020 ).…”