Abstract

Reusable respiratory protective devices called elastomeric respirators have demonstrated their effectiveness and acceptability in well-resourced healthcare settings. Using standard qualitative research methods, we explored the feasibility of elastomeric respirator use in low- and middle-income countries (LMIC). We conducted interviews and focus groups with a convenience sample of health workers at one clinical center in Mali. Participants were users of elastomeric and/or traditional N95 respirators, their supervisors, and program leaders. Interview transcripts of participants were analyzed using a priori constructs from the Health Belief Model (HBM) and a previous study about healthcare respirator use. In addition to HBM constructs, the team identified two additional constructs impacting uptake of respirator use (system-level factors and cultural factors). Together, these framed the perceptions of Malian health workers and highlighted both facilitators of and barriers to respirator use uptake. As needs for respiratory protection from airborne infectious hazards become more commonly recognized, elastomeric respirators may be a sustainable and economic solution for health worker protection in LMIC.

Highlights

  • Publisher’s Note: MDPI stays neutralWith each global infectious disease outbreak, shortages in the supply of single-use disposable N95 filtering facepiece respirators (N95 FFRs) become evident

  • A total of 35 individuals participated in five focus groups (Table 1), representing all individuals participating in the respiratory protection program (RPP) at the time

  • 30 respirator users involved with the childhood mortality study,; the supervisor group included directors of three laboratories, and the RPP Champions included two respiratory protection leaders

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Summary

Introduction

With each global infectious disease outbreak, shortages in the supply of single-use disposable N95 filtering facepiece respirators (N95 FFRs) become evident. During the COVID-19 pandemic, global respiratory protection device (RPD) shortages occurred again and resulted in the re-use of single-use N95 FFRs or the use of non-medical grade masks and face-shields by medical staff, potentially leaving health workers exposed to infectious pathogens and vulnerable to deadly illness [5]. This vulnerability highlights the need for innovative, sustainable, and cost-effective solutions for assuring ready access to respiratory protective equipment during shortages.

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