Abstract
Background COVID-19is currentlya global health threat.Healthcare workers are on the front-lineof the COVID-19 outbreak response andthereforeat heightened risk of infection.There is a dearth of evidence from Sub-Saharan Africa abouthealthcareworkerexperiencesinmanaging COVID-19.Wehavereportedon healthcareworkerresponses, experiences, and perspectives on epidemic response strategies at Queen Elizabeth CentralHospital, Malawi's largest referral hospital. Methods We conducted39 face-to-facein-depthinterviewswith a purposively selected sample of healthcare workers duringthe first wave of COVID-19 in Malawi (March 2020 toOctober2020).The study includedhealthcare workerswho provided direct and indirect patient care. Results During the early phase ofthe firstwave (March to May 2020), healthcare workers expressed concernswithinadequateworkingspace, unconducive infrastructure, delayedandrushed trainingonthemanagement of COVID-19,andlack of incentives.Additionally, thehospitalhadstaff shortagesandlimited essential resourcessuch as piped oxygen and personal protective equipment. This increased healthcareworkerfears ofcontractingCOVID-19and theywere less willingto volunteeratCOVID-19isolationunits.Resource constraints and limitedpreparednesscompromised the carepathwayparticularly withincreasednumbersof COVID-19 patients.By the peak ofthe first wave(June to August 2020) many of these issues had been resolved. The hospital provided refresher trainingcourses, personal protective equipmentbecameavailable, incentives were offeredto healthcare workers working in COVID-19 units andpiped oxygen was installed. Staff morale wasboosted,andmore staff were willing to work at the COVID-19 isolation centres. Conclusion Experiences of healthcare workersduring the first wave of COVID-19 are critical forimprovingcarein futureCOVID-19 waves. Responsestrategiesinresource-constrainedareas shouldprioritisetimely training of staff,creationof adequateisolationareas,provision ofadequatemedical supplies and strengthening leadership.
Highlights
Background COVID19 is currently a global health threat
The hospital provided refresher training courses, personal protective equipment became available, incentives were offered to healthcare workers working in COVID-19 units and piped oxygen was installed
Experiences of healthcare workers during the first wave of COVID-19 are critical for improving care in future COVID-19 waves
Summary
Background COVID19 is currently a global health threat. Healthcare workers are on the front-line of the COVID-19 outbreak response and at heightened risk of infection. We have reported on healthcare worker responses, experiences, and perspectives on epidemic response strategies at Queen Elizabeth Central Hospital, Malawi’s largest referral hospital. More than a year into the pandemic, COVID-19 remains a health concern worldwide with over 200 million confirmed cases and more than four million deaths. A low-income country in Southern Africa, registered 61,800 cases and 2,302 deaths, as of the 1st November 20212. After Malawi’s first confirmed case of COVID-19 (2nd April 2020), Blantyre became the epicenter of the national epidemic. Queen Elizabeth Central Hospital (QECH), the largest referral hospital in Malawi based in Blantyre, was reorganised to respond to this need[3]. As COVID-19 cases spread throughout the country, the need for informed context-specific initial experiences of healthcare workers (HCWs) became essential
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