Frontline Healthcare Workers' Knowledge and Perception of COVID-19, and Willingness to Work during the Pandemic in Nepal.

Dipak Prasad Upadhyaya,Ji-Hyuk Park,Brij Kumar Das,Seok-Ju Yoo,Binaya Chalise,Sabin Bhandari,Mukesh Adhikari,Kwan Lee,Chetan Nidhi Wagle,Ramesh Kunwar,Ashish Timalsina,Kaveh Khoshnood,Bom Bc,Ramgyan Yadav,Archana Shrestha,Deepak Raj Bhatta,Dilaram Acharya,Rajan Paudel

doi:10.3390/healthcare8040554

Abstract

This study investigated the contextual factors associated with the knowledge, perceptions, and the willingness of frontline healthcare workers (FHWs) to work during the COVID-19 pandemic in Nepal among a total of 1051 FHWs. Multivariable logistic regression analysis was applied to identify independent associations between predictors and outcome variables. Of the total study subjects, 17.2% reported inadequate knowledge on COVID-19, 63.6% reported that they perceived the government response as unsatisfactory, and 35.9% showed an unwillingness to work during the pandemic. Our analyses demonstrated that FHWs at local public health facilities, pharmacists, Ayurvedic health workers (HWs), and those with chronic diseases were less likely, and male FHWs were more likely, to have adequate knowledge of COVID-19. Likewise, nurses/midwives, public health workers, FHWs from Karnali and Far-West provinces, and those who had adequate knowledge of COVID-19 were more likely to have satisfactory perceptions towards the government response. Further, FHWs—paramedics, nurse/midwives, public health workers, laboratory workers—FHWs from Karnali Province and Far-West Province, and those with satisfactory perceptions of government responses to COVID-19 were predictors of willingness to work during the COVID-19 pandemic. These results suggest that prompt actions are required to improve FHWs’ knowledge of COVID-19, address negative perceptions of government responses, and motivate them through specific measures to provide healthcare services during the pandemic.

Highlights

In December 2019, an outbreak of a pneumonia-like illness was first detected in Wuhan, Hubei Province of China [1], and subsequently, faced with an escalating number of cases beyondChina, the World Health Organization (WHO) declared the outbreak a pandemic [2]
All participating frontline healthcare workers (FHWs) were aged 18 to 60 years old and ranged from high-level officials of the Ministry of Health and Population to paramedics working at the grassroots level in all seven provinces of Nepal, and excluded those subjects who were had mentally ill or unwilling to participate in the study
Odds Ratios were obtained by multivariate logistic regression adjusted for caste/ethnicity, Professional category, Province, Presence of Chronic Disease, health workers with family members requiring care, perceived knowledge of COVID-19, and perception of government response. * p-value < 0.05 at the 5% level of significance ** p-value < 0.01 at the 5% level of significance *** p-value < 0.001 at the 5% level of significance. This is the first nationwide study on knowledge and perception of COVID-19 among FHWs, and their willingness to work during the COVID-19 pandemic situation in Nepal despite several other studies have been conducted in Nepal related to COVID-19

Summary

Introduction

In December 2019, an outbreak of a pneumonia-like illness was first detected in Wuhan, Hubei Province of China [1], and subsequently, faced with an escalating number of cases beyond. The World Health Organization (WHO) declared the outbreak a pandemic [2]. The infection is transmitted between individuals via nasopharyngeal droplets or saliva [3]. No vaccine or effective treatment for COVID-19 is currently available [3]. Nepal is a small country in South Asia that shares a border with China and observed its first case of COVID-19 on 25 January 2020 [4]. In the first half of May 2020, Nepal experienced an explosive increase in cases; more than three-fourths of all cases recorded to date occurred during this period.

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Conclusion