Health-Care Workers’ Perspectives on Preparedness of Health-Care Facilities for Outbreak of Communicable Diseases in Nigeria: A Qualitative Study

Abstract

A high probability of another outbreak of communicable disease exists in sub-Saharan African countries, after the Ebola virus disease outbreak of 2014. Thus, health-care facility (HCF) preparedness for a prompt and effective response to disease outbreaks needs to be ascertained. In this study, Nigerian health-care workers' (HCWs) knowledge of preparedness, perception of the level of preparedness existing in these HCFs, militating factors, and possible ways to improve, were evaluated through qualitative data collection, using focus group discussion and in-depth interview. Among the 193 HCWs which participated in the study, the perception of 190 (98.4%) was that their HCFs were insufficiently equipped to respond to disease outbreaks. None of the facilities had an emergency operation unit (EOU). Most HCWs perceived preparedness as observation of universal precautions. Other aspects of preparedness, such as training, routine emergency drills, disease surveillance, waste management, and design and location of HCFs were minimally mentioned. None of the participants had undergone any form of emergency drill training. Among the suggestions of how to improve on preparedness were immunization of staff, improved interdepartmental communication within the HCF, and routine training. The overall poor level of preparedness which exists in the HCFs means that they cannot prevent or contain a communicable disease outbreak. There is a need to improve universal precautions, communication within the HCFs, and routine interpretation of surveillance data by epidemiologists. There is also a need for the establishment of EOU in every HCF, a system that responds to, and manages emergency response to disease outbreaks, which also must be functional during non-outbreak periods.

Evaluating the Preparedness of Child Health Facilities and Health Care Providers to COVID 19 Pandemic

“…The reason why most of the health care facilities have an IDU with relatively good health care policy is that they are secondary and tertiary levels of care. This is in contrast to earlier reports of poor preparedness of health care facilities (Ugaharo et al [16] in Nigeria, Yayi et al [17] in Uganda, and Daugherty et al [18]) in previous disease outbreaks in the past. The report of fair ratings despite the existence of policy however is in concordance with previous works [16,19,20].…”

“…This is in contrast to earlier reports of poor preparedness of health care facilities (Ugaharo et al [16] in Nigeria, Yayi et al [17] in Uganda, and Daugherty et al [18]) in previous disease outbreaks in the past. The report of fair ratings despite the existence of policy however is in concordance with previous works [16,19,20]. This further buttress the fact that a standard IDU is not only about policy, but the availability of resources and training of health care workers [HCW] to operationalize the policy.…”

“…This could be alluded to the years of medical experience, in addition to the facilities predominantly tertiary and secondary healthcare facilities. This finding is similar to reports by previous works demonstrating the knowledge competence of HCWs on IPC [16,21,22]. The value of a good overall knowledge of HCWs is of significant importance in all spheres of disease identification, control, and management.…”

Assessment of Healthcare Workers’ Levels of Preparedness and Awareness Regarding COVID-19 Infection in Low-Resource Settings

“…Some of the questions were based on a framework similar to that of previous studies on infectious disease outbreaks. 20 – 22 The structured questionnaire was validated to address questions about healthcare workers’ level of preparedness and knowledge of COVID-19 (Supplemental files I–II).…”

“…Therefore, critical preparedness, readiness, and knowledge regarding COVID-19 are needed for physicians and nurses on the front line. 16,19 Few researchers have addressed the overall issues of preparedness of healthcare systems for COVID-19, especially in developing countries, where resources and facilities are limited. Considerable concerns have been raised regarding countries' preparedness for COVID-19 and their ability to maintain control.…”