Socio-Demographic Characteristics of the respondents
A total of 330 HCWs were included in the study making the response rate 95.7%. More than half (56.1%) were between 25–34 years of age. Two hundred and three (61.5%) were male participants. More than two-thirds (69.4%) of the respondents were married. Nearly half (47.6%) were protestant by religion and Oromo is the dominant ethnic group (87.9%). More than half (53.7%) of the respondents were degree holders. One hundred eighty-four (55.8%) of the HCW were nurses and 108(40.3%) had less than five years of experience (Table.1).
Training and availability of hygiene facilities
The study revealed that more than half (59.1%) of the study participants did not receive training related to infection prevention. One hundred seventy-seven (53.6%) of the study participants reported that the institution does not have an infection prevention program and 201(60.9%) did not have an active infection prevention team. More than half (54.5%) reported that the institution does not have an emerging infectious disease taskforce (dealing with outbreaks). One hundred eighty (54.5%) of the health workers reported that they do not have infection prevention and control guidelines at their work unit. Nearly two-thirds (65.8%) and 180(54.5%) of the health workers reported the availability of water and soap at their work unit respectively. Three-fourth (75.2%) of the respondents reported the availability of alcohol and hand sanitizer. Two-third of the respondents reported adequate availability of the necessary personal protective equipment (PPE) at their facility. One hundred ninety (42.4%) of the respondents reported the availability of colored dust bin to segregate medical wastes at their work unit. One hundred twenty-eight (38.8%) of the health workers reported that their place of assignment at the time of data collection was at the outpatient department (Table 2.
Table 1
Socio-demographic characteristics of the Healthcare workers in Illu Aba Bor and Buno Bedelle Zones, Southwest Ethiopia, 2020.
Variables | Category | Frequency | Percent |
Age in years | < 25 25–35 > 35 | 84 185 61 | 25.5 56.1 18.4 |
Sex | Male Female | 203 127 | 61.5 38.5 |
Marital status | Single Married Others* | 96 229 5 | 29.1 69.4 1.5 |
Religion | Orthodox Muslim protestant Others | 109 57 157 7 | 33.0 17.3 47.6 2.1 |
Ethnicity | Oromo Amhara Tigray Others** | 290 26 6 8 | 87.9 7.9 1.8 2.4 |
Educational status | Diploma Degree Masters | 144 176 10 | 43.6 53.3 3.03 |
Profession | Physician Nurse Midwife Nurse Health officer Lab.Technicians Pharmacy professional | 29 184 57 20 22 18 | 8.8 55.8 17.3 6.1 6.7 5.5 |
Years of service | < 5 years 5– 10 years > 10 years | 133 108 89 | 40.3 32.7 27.0 |
* Divorced/Widowed **Wakefata |
Table 2
Training and availability of hygiene facilities at Health care facilities of Illu Aba Bor and Bunno Bedelle Zones, Southwest Ethiopia, 2020
Variables | Category | Frequency | Percent |
Ever had training on infection prevention | Yes No | 135 195 | 40.9 59.1 |
Infection control program at the institution | Yes No | 153 177 | 46.4 53.6 |
Infection control team at facility | Yes No | 139 201 | 39.1 60.9 |
Emerging infectious diseases taskforce (dealing with outbreaks) available | Yes No | 154 180 | 46.5 54.5 |
IPC policies and guidelines available | Yes No | 150 180 | 45.5 54.5 |
Water facility available | Yes No | 217 113 | 65.8 34.2 |
Alcohol/hand sanitizer available at facility | Yes No | 248 82 | 75.2 24.8 |
Adequate soap at work unit | Yes No | 150 180 | 45.5 54.5 |
Adequate disinfectants available at work unit | Yes No | 145 185 | 43.9 56.1 |
Sufficient PPE available | Yes No | 109 221 | 33.0 67.0 |
Have safety box for sharp disposal | Yes No | 243 87 | 73.6 26.4 |
Working unit has colored dust bin to segregate medical wastes | Yes No | 140 190 | 42.4 57.6 |
Currently assigned place(ward) | OPD Laboratory Pharmacy Medical ward Surgical ward Paediatric ward TB and ART MCH GYN & OBS | 128 35 23 22 13 12 12 43 42 | 38.8 10.6 7.0 6.7 3.9 3.6 3.6 13.0 12.7 |
IPC- Infection prevention and control TB - Tuberculosis |
OPD – Out patient department ART – Anti retro viral therapy |
MCH – Mother and child Health PPE – Personal protective equipment |
Knowledge towards COVID-19
Greater part (93.3%) of the respondent demonstrated self-reported good knowledge towards COVID-19 and the mean (± SD) knowledge score was 9.0 4 ± 1.06. Three hundred twenty-two (97.6%) correctly answered the mode of transmission of the virus. Greater part (97%) of the respondents correctly answered that COVID- 19 is a viral infection. Two hundred twenty-three (97.9%) of the respondents correctly answered that fever, cough, sore throats, and shortness of breath are common symptoms of COVID-19. More than 90% of HCPs were well aware of the route of transmission of the virus, frequent hands wash with soap and water or alcohol-based hand rub, and using face masks can help in the prevention of disease transmission, and healthcare workers are at a higher risk of infection. Two hundred ninety-one (88.2%) correctly identified that the isolation period is 2 weeks, 263(79.7%), 251(76.1%), and 232(70.3) correctly answered that COVID-19 vaccine is not available in markets, COVID-19 could be fatal and antibiotics are not a first-line treatment, respectively (Table 3).
Table 3
Knowledge towards COVID-19 among healthcare workers of Illu Aba Bor and Buno Bedelle Zones, Southwest Ethiopia, 2020
Knowledge questions | Category | Number | Percent |
COVID-19 is a virus infection | Yes No | 320 10 | 97 3.0 |
COVID-19 is transmitted by close contact with the infected person | Yes No | 300 30 | 90.9 9.1 |
Know common modes of transmission | Yes No | 322 8 | 97.6 2.4 |
The incubation period is 14 days | Yes No | 253 77 | 76.7 23.3 |
Fever, cough, sore throats and shortness breath are common symptoms of COVID-19 | Yes No | 323 7 | 97.9 2.1 |
The isolation period is two weeks | Yes No | 291 39 | 88.2 11.8 |
COVID-19 vaccine is available on markets | Yes No | 67 263 | 20.3 79.7 |
Antibiotics are the first-line treatment | Yes No | 98 232 | 29.7 70.3 |
Frequent hands wash with soap and water or alcohol-based hand rub and using face masks can help in the prevention of disease transmission | Yes No | 306 24 | 92.7 7.3 |
Patients with underlying chronic diseases are at a higher risk of infection and death | Yes No | 302 28 | 91.5 8.5 |
Healthcare workers are at a higher risk of infection | Yes No | 311 19 | 94.2 5.8 |
COVID-19 could be fatal | Yes No | 251 79 | 76.1 23.9 |
Knowledge | Poor Good | 22 308 | 6.7 93.3 |
Mean ± SD knowledge score |
Mean ± SD | 9.0 4 ± 1.06 |
SD – Standard deviation |
Infection prevention practice
A summary score was developed from continuous data of the practice of healthcare workers regarding infection prevention towards COVID-19. The mean (± SD) self-reported infection prevention practice was 10.05 ± 4.81. The overall self-reported good infection practice score towards COVID-19 among the healthcare workers was 64.2% (Fig. 1).
Perceived barriers to infection prevention and control practices
A mixed perception was reported by HCWs regarding barriers to infection prevention and control practice. Of the total participants, 29.7% presumed that overcrowding in the emergency room is a barrier, and 26.7% strongly agreed that insufficient training on infection control is also a barrier towards infection prevention and control practice. A quarter (25.8%) of the participants strongly agreed that the limitation of infection material is a barrier to infection prevention practices (Figure. 2).
Differences in knowledge among HCPs towards COVID-19
Independent sample t-test and one-way ANOVA analysis were done to assess the mean difference between groups regarding socio-demographic characteristics. In both tests, knowledge did not differ significantly (P > 0.05) with age, gender, education, experience, or profession (Table 4).
Table 4
Test of significance of variation (Independent sample t-test and one way ANOVA) in knowledge score by socio-demographic characteristics, Illu Aba Bor and Buno Bedelle Zones, Southwest Ethiopian, 2020.
Variables | Mean(± SD) Knowledge | t-test | F-test | P-value |
Age in years <25 25–35 >35 | 8.79 ± 1.27 9.13 ± 0.96 9.08 ± 0.94 | | 3.013 | 0.050 |
Sex Male Female | 9.05 ± 1.13 8.93 ± 1.34 | 1.073 | | 0.284 |
Educational status Diploma Degree Masters | 8.96 ± 1.22 9.09 ± 0.90 9.20 ± 1.03 | | 0.679 | 0.508 |
Profession Nurse Physician Midwife Nurse Health officer Lab.Technicians Pharmacy professional | 9.01 ± 1.08 8.96 ± 1.45 9.11 ± 0.84 9.25 ± 0.72 8.83 ± 1.42 9.03 ± 1.05 | | 0.543 | 0.744 |
Years of service < 5 years 5– 10 years >10 years | 8.89 ± 1.19 9.18 ± 0.89 9.04 ± 1.05 | | 2.361 | 0.096 |
SD - Standard deviation |
Factors associated with infection prevention practice
On multivariable logistic regression analysis, gender, educational status, profession, years of service, knowledge towards COVID-19, and availability of personal protective equipment were significantly associated with good infection prevention practices. Accordingly, male HCWS were 3.65 times more likely to have good infection prevention practices than female health care workers (AOR = 3.65, 95% CI: (1.96, 6.80)). Bachelor degree holders were 1.82 times more likely to have good infection prevention practice compared to diploma holders (AOR = 1.82, 95% CI (1.02, 3.22)). Physicians were 3.17 times more likely to practice infection prevention than nurses (AOR = 3.17, 95% CI (1.08, 9.33)). Service year was another factor significantly associated with infection prevention practice. Healthcare workers having service year of 5–10 years were 2 times more likely to have good infection prevention practice (AOR = 2.00 (1.02, 3.92)) and those who have served for more than 10 years were 3.14 times more likely to have good infection prevention practice (AOR = 3.14 (1.51, 6.52)) compared to those who have served for less than five years. Health care workers who had the personal protective equipment at their work unit were 2 times more likely to have good infection prevention practices compared to those who did not have enough supply of the PPE(AOR = 1.96 (1.06, 3.61)). Knowledge level of health care workers was significantly associated with good infection prevention practices. Health care workers who had a good knowledge score were 2.28 times more likely to have good infection prevention practices compared to those who had poor knowledge scores (AOR = 2.61 (1.48, 4.62)) (Table 5).
Table 5
Multivariable logistic regression analysis of factors associated with infection prevention practice among HCWs in Illu Aba Bor and Bunno Bedelle Zones, Southwest Ethiopia, 2020.
Characteristics | Category | IPC Practice | COR(95%CI) | AOR(95%CI) |
Good N (%) | Poor N (%) |
Sex | Male Female | 148(72.9) 64(50.4) | 55(27.1) 63(49.6) | 3.28(1.83,5.87) 1.00 | 3.65(1.96,6.80)** 1.00 |
Educational status | Diploma Degree Masters | 82(56.9) 124(70.5) 6(60.0) | 62(43.1) 52(29.5) 4(40.0) | 1.00 1.80(1.14, 2.86) 1.13(0.31,4.19) | 1.00 1.82(1.02,3.22)* 1.42(0.31,6.39) |
Profession | Nurse Physician Midwife nurse Health officer Lab Technicians Pharmacy professional | 109(59.2) 23(79.3) 39(68.4) 16(80.0) 16(72.7) 9(50.0) | 75(40.8) 6(20.7) 18(31.6) 4(20.0) 6(27.3) 9(50.0) | 1.00 0.38(0.15.0.98) 0.57(0.19,1.63) 1.04(0.25,4.30) 0.69(0.19,2.55) 0.26(0.07,0.95) | 1.00 3.17(1.08,9.33)* 1.64(0.77,3.49) 2.42(0.70,8.37) 0.83(0.27,2.60) 0.52(0.17,1.59) |
Years of service | < 5 5–10 > 10 | 77(57.9) 75(69.4) 60(67.4) | 56(42.1) 33(30.6) 29(32.6) | 1.00 1.65(0.972.82) 1.51(0.86,2.64) | 1.00 2.00(1.02,3.92)* 3.14(1.51,6.52)* |
Knowledge | Poor Good | 10(45.5) 202(54.5) | 12(65.6) 106(34.4) | 1.00 2.29(0.96,5.47) | 2.35(1.56,4.98)* |
Training on IPC | Yes No | 95(70.4) 117(60.0) | 40(29.6) 78(40.0) | 1.58(0.99,2.53) 1.00 | 1.54(0.87,2.72) 1.00 |
Active IPC team | Yes No | 93(72.1) 119(59.2) | 36(27.9) 82(40.8) | 1.78(1.11,2.87) 1.00 | 0.98(0.52,1.84) 1.00 |
IPC policy | Yes No | 108(72.0) 104(57.8) | 42(28.0) 76(42.2) | 1.88(1.18,2.99) 1.00 | 1.21(0.66,2.35) 1.00 |
Availability of Water | Yes No | 149(68.7) 63(55.8) | 68(31.3) 50(44.2) | 1.74(1.09,2.78) 1.00 | 1.26(0.72,2.20) 1.00 |
Availability of hand sanitizer | Yes No | 168(67.7) 44(53.7) | 80(32.3) 38(46.3) | 1.81(1.09,3.02) 1.00 | 0.99(0.54,1.81) 1.00 |
Availability of PPE | Yes No | 85(78.7) 127(57.2) | 23(21.3) 95(42.8) | 2.76(1.62,4.71) 1.00 | 1.96(1.06,3.61)* 1.00 |
**Significant at < 0.01. *Significant at < 0.05. IPC – Infection prevention practice |
COR: crude odds ratio; AOR: adjusted odds ratio; CI: confidence intervals |
HCW – Health care worker PPE: Personal protective equipment |