“An increase in COVID-19 patients would be overwhelming”: A qualitative description of healthcare workers’ experiences during the first wave of COVID-19 (March 2020 to October 2020) at Malawi’s largest referral hospital.

Limbani, Felix, Kapumba, Blessings M, Mzinganjira, Henry, Phiri, Tamara, Mwandumba, Henry ORCID: https://orcid.org/0000-0003-4470-3608, Rylance, Jamie ORCID: https://orcid.org/0000-0002-2323-3611, Morton, Ben ORCID: https://orcid.org/0000-0002-6164-2854 and Desmond, Nicola ORCID: https://orcid.org/0000-0002-2874-8569 (2022) '“An increase in COVID-19 patients would be overwhelming”: A qualitative description of healthcare workers’ experiences during the first wave of COVID-19 (March 2020 to October 2020) at Malawi’s largest referral hospital.'. Wellcome Open Research, Vol 7, p. 40.

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Abstract

Background
COVID-19 is currently a global health threat. Healthcare workers are on the front-line of the COVID-19 outbreak response and therefore at heightened risk of infection. There is a dearth of evidence from Sub-Saharan Africa about healthcare worker experiences in managing COVID-19. We have reported on healthcare worker responses, experiences, and perspectives on epidemic response strategies at Queen Elizabeth Central Hospital, Malawi’s largest referral hospital.

Methods
We conducted 39 face-to-face in-depth interviews with a purposively selected sample of healthcare workers during the first wave of COVID-19 in Malawi (March 2020 to October 2020). The study included healthcare workers who provided direct and indirect patient care.

Results
During the early phase of the first wave (March to May 2020), healthcare workers expressed concerns with inadequate working space, unconducive infrastructure, delayed and rushed training on the management of COVID-19, and lack of incentives. Additionally, the hospital had staff shortages and limited essential resources such as piped oxygen and personal protective equipment. This increased healthcare worker fears of contracting COVID-19 and they were less willing to volunteer at COVID-19 isolation units. Resource constraints and limited preparedness compromised the care pathway particularly with increased numbers of COVID-19 patients. By the peak of the first wave (June to August 2020) many of these issues had been resolved. The hospital provided refresher training courses, personal protective equipment became available, incentives were offered to healthcare workers working in COVID-19 units and piped oxygen was installed. Staff morale was boosted, and more staff were willing to work at the COVID-19 isolation centres.

Conclusion
Experiences of healthcare workers during the first wave of COVID-19 are critical for improving care in future COVID-19 waves. Response strategies in resource-constrained areas should prioritise timely training of staff, creation of adequate isolation areas, provision of adequate medical supplies and strengthening leadership.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > W 21.5 Allied health personnel. Allied health professions W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care WA Public Health > WA 30 Socioeconomic factors in public health (General) WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 506 COVID-19
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.12688/wellcomeopenres.17368.1
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	29 Jun 2022 13:10
Last Modified:	14 Jun 2023 12:58
URI:	https://archive.lstmed.ac.uk/id/eprint/19959

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