Community health workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria—A qualitative study

Abstract

Background Community Health Workers are globally recognised as crucial members of healthcare systems in low and middle-income countries, but their role and experience during COVID-19 is not well-understood. This study aimed to explore factors that influence CHWs’ ability and willingness to work in the COVID-19 pandemic in Lagos. Design A generic qualitative study exploring Community Health Workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria. Methods 15 semi-structured, in-depth, video interviews were conducted with Community Health Workers purposively sampled across seven of Lagos’ Local Government Areas with the highest COVID-19 burden. Interviews explored Community Health Workers’ attitudes towards COVID-19, its management, and their experiences working in Lagos. Data was analysed thematically using the framework method. Results Three main themes were identified. 1. Influences on ability to undertake COVID-19 Role: Trust and COVID-19 knowledge were found to aid Community Health Workers in their work. However, challenges included exhaustion due to an increased workload, public misconceptions about COVID-19, stigmatisation of COVID-19 patients, delayed access to care and lack of transportation. 2. Influences on willingness to work in COVID-19 Role: Community Health Workers’ perceptions of COVID-19, attitudes towards responsibility for COVID-19 risk at work, commitment and faith appeared to increase willingness to work. 3. Suggested Improvements: Financial incentives, provision of adequate personal protective equipment, transportation, and increasing staff numbers were seen as potential strategies to address many of the challenges faced. Conclusion Despite Community Health Workers being committed to their role, they have faced many challenges during the COVID-19 pandemic in Nigeria. Changes to their working environment may make their role during disease outbreaks more fulfilling and sustainable. International input is required to enhance Nigeria’s policies and infrastructure to better support Community Health Workers during both current and future outbreaks.

Risk Perception Related to COVID-19 and Future Affective Responses Among Healthcare Workers in Switzerland: A Mixed-Methods Longitudinal Study

“…Consistently, we found that higher levels of worry and unprotect perceptions were associated with higher burnout scores over time among frontline HCWs. Participants stated that they were in constant crisis process, working overtime, with multiple changes in their work context, a situation described as insecure and overwhelming [24,36,37]. They also evoked a tendency to adopt a "savior" posture, sacrificing their "basic needs," which could undermine their health at work.…”

“…Stakeholders and mental health professionals are called upon to provide HCWs with interventions to deal with their emerging affective reactions, considering their worries and internal ambivalences. As the pandemic continues, tailored individual and structural interventions should be offered [36], such as group or individual discussion sessions, promoting mutual support among HCWs and counteracting social isolation [37].…”

Community health workers and Covid-19: Cross-country evidence on their roles, experiences, challenges and adaptive strategies

“…For example, CHWs played multiple roles in the 2014 Ebola outbreak in West Africa [11][12][13][14][15]. Most recently, CHWs have been active in the COVID-19 response [16][17][18][19][20][21][22][23]. Research has documented the roles played by CHWs in controlling COVID-19, and the challenges they have experienced [16][17][18][19][20][21][22][23][24].…”

When one door closes: a qualitative exploration of women’s experiences of access to sexual and reproductive health services during the COVID-19 lockdown in Nigeria

“…The need for quality and accessible SRH services further increases in the lockdown period as researchers have documented an increased rate of sexual and gender-based violence (SGBV) in that context [14,15]. Yet, research ndings from Nigeria [16][17][18] and elsewhere [19][20][21][22][23] indicate that COVID-19 and the associated lockdown negatively affected access to SRH services. The reported impact varied considerably by geographies, social and health services contexts, and population settings.…”

“…Furthermore, while Nigeria is a multi-ethnic country with signi cant regional differences in health-related behaviours and associated factors, studies regarding COVID-19 and healthcare access have been very limited in their geographic focus. Except for the quantitative study by Adelekan and colleagues [16], studies on COVID-19 and access to healthcare in Nigeria have generally been limited to only one of the country's 36 states [17][18].…”