ABSTRACT
Background: Although many studies were conducted on COVID-19 knowledge, attitude, and practice among the general population in many countries, very little is known about refugees, particularly Rohingya refugees in Cox's Bazar. A vast array of Risk Communication and Community Engagement (RCCE) interventions were implemented in Coxs Bazar with the intent of reducing disease transmission by empowering the community to adopt public health measures. Objectives: The study aimed to evaluate the current state of knowledge, attitude, and practice among Rohingya refugees as a result of RCCE initiatives. Materials and Methods: A cross-sectional study was conducted with 500 Rohingya individuals. Participants in the study were Rohingya refugees residing in five randomly selected camps where IOM health was operating. Using a structured questionnaire, skilled community health workers surveyed the Rohingya population. In addition to the survey on knowledge, attitude, and practice, the study gathered information on the perspectives and relevance of sociodemographic factors that influence KAP. Results: The study findings indicate that the mean scores for knowledge, attitude, and practice were 9.93 (out of 14), 7.55 (out of 11), and 2.71 (out of 7) respectively. Association was found between knowledge and practice level and age group - elderly age group (>/= 61 years) had less level of knowledge (AOR 0.42, P value= 0.05) and the late mid age group (46 - 60 years) had better practice level (AOR 2.67, P value <0.001). A significant association was also found between good knowledge level and medium family size (5 - 6 members) (P value= 0.02). Conclusions: The study reveals that the Cox's Bazar Rohingya refugee community has a low knowledge and attitude score about COVID-19 prevention measures. Especially the KAP scores were found significantly low in elderly population. Despite RCCE interventions, the practice level of these measures exhibited a considerably low score. Poor implementation of preventive measures must be identified and remedied, involving the community in future outbreaks of a similar nature.
Subject(s)
COVID-19ABSTRACT
Introduction: Infection Prevention and Control (IPC) is key in the control of COVID-19 pandemic and one of the pillars considered in the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to COVID-19 pandemic in Rohingya refugee camps in Cox’s Bazar, Bangladesh to identify best practices, challenges, and recommendations for improvement of the current and future responses.Methods: Two meetings were conducted with a total of 54 participants purposively selected from different organizations and agencies that had been involved in frontline implementation of IPC in Cox’s Bazar district. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meetings notes and transcripts were analysed manually using content analysis and results presented in text and quotes.Results: Best practices included: assessments, response plan, working group, trainings, early case identification and isolation, hand hygiene in HFs, monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centres (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of working uniforms and lack of culture- and gender adapted work uniforms and Personal Protective Equipment (PPE). Recommendations were: institutionalization of IPC, establishment of IPC monitoring mechanisms in all HCFs, strengthening IPC education and training and public health and social measures in communities. Conclusion: IPC monitoring and continuous training provides critical support in promoting consistent and adaptive IPC implementation. Response to pandemic crisis combined with concurrent emergencies, like a protracted displacement with many, diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization and close supervision.