ABSTRACT
A 30 de Janeiro de 2020, o Director-geral da Organização Mundial de Saúde determinou que a COVID-19 constitui uma preocupação de saúde pública de emergência internacional. Objectivo: Identificar as barreiras e facilitadores para o cumprimento da quarentena e do isolamento obrigatório em pessoas expostas e diagnosticadas com COVID-19 em Maputo. Material e Métodos: Foram realizadas entrevistas em profundidade durante os meses de Maio a Julho de 2020 com 30 pessoas expostas e diagnosticadas com COVID-19. Os participantes foram selecionados usando uma amostragem aleatória sistemática. Resultados: A maioria dos participantes mencionaram a redução de salário mensal/horas extras, a interdição de bens e serviços e, o apoio familiar e dos profissionais de saúde como factores condicionantes para o cumprimento adequado da quarentena e isolamento. Conclusão: As condições sócio-económicas jogam um papel fundamental para que as pessoas cumpram a quarentena ou isolamento.
Introduction: On January 30, 2020, the Director-General of the World Health Organization determined that COVID-19 is an international emergency public health concern. Objective: To identify barriers and facilitators for non-compliance with quarantine and mandatory isolation in people exposed and diagnosed with COVID-19 in Maputo. Material and Methods: In-depth interviews were conducted from May to July 2020 with 30 people exposed and diagnosed with COVID-19. Participants were selected using systematic random sampling. Results: Most participants mentioned the reduction of monthly wages/extra hours, the ban on goods and services and the support of family and health professionals as conditioning factors for the proper compliance with quarantine and isolation. Conclusion: Socio-economic conditions play a fundamental role for people to comply with quarantine or isolation.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Patient Isolation/methods , Diagnosis , SARS-CoV-2/isolation & purification , COVID-19/drug therapy , COVID-19/transmission , Socioeconomic Factors , Quarantine/methods , Sampling Studies , MozambiqueABSTRACT
INTRODUCTION: While planning an immunization campaign in settings where public health interventions are subject to politically motivated resistance, designing context-based social mobilization strategies is critical to ensure community acceptability. In preparation for an Oral Cholera Vaccine campaign implemented in Nampula, Mozambique, in November 2016, we assessed potential barriers and levers for vaccine acceptability. METHODS: Questionnaires, in-depth interviews, and focus group discussions, as well as observations, were conducted before the campaign. The participants included central and district level government informants (national immunization program, logistics officers, public health directors, and others), community leaders and representatives, and community members. RESULTS: During previous well chlorination interventions, some government representatives and health agents were attacked, because they were believed to be responsible for spreading cholera instead of purifying the wells. Politically motivated resistance to cholera interventions resurfaced when an OCV campaign was considered. Respondents also reported vaccine hesitancy related to experiences of problems during school-based vaccine introduction, rumors related to vaccine safety, and negative experiences following routine childhood immunization. Despite major suspicions associated with the OCV campaign, respondents' perceived vulnerability to cholera and its perceived severity seem to override potential anticipated OCV vaccine hesitancy. DISCUSSION: Potential hesitancy towards the OCV campaign is grounded in global insecurity, social disequilibrium, and perceived institutional negligence, which reinforces a representation of estrangement from the central government, triggering suspicions on its intentions in implementing the OCV campaign. Recommendations include a strong involvement of community leaders, which is important for successful social mobilization; representatives of different political parties should be equally involved in social mobilization efforts, before and during campaigns; and public health officials should promote other planned interventions to mitigate the lack of trust associated with perceived institutional negligence. Successful past initiatives include public intake of purified water or newly introduced medication by social mobilizers, teachers or credible leaders.
