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探索埃塞俄比亚南部加莫地区有效实施预防和控制新冠疫情公共卫生措施的障碍:运用改良的田桥模型

Exploring Barriers to Effective Implementation of Public Health Measures for Prevention and Control of COVID-19 Pandemic in Gamo Zone of Southern Ethiopia: Using a Modified Tanahashi Model.

作者信息

Boti Sidamo Negussie, Hussen Sultan, Shibiru Tamiru, Girma Meseret, Shegaze Mulugeta, Mersha Abera, Fikadu Teshale, Gebru Zeleke, Andarge Eshetu, Glagn Mustefa, Gebeyehu Selamawit, Oumer Bilcha, Temesgen Gebremaryam

机构信息

School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

出版信息

Risk Manag Healthc Policy. 2021 Mar 19;14:1219-1232. doi: 10.2147/RMHP.S297114. eCollection 2021.

Abstract

BACKGROUND

Since the occurrence of the COVID-19 pandemic, different public health measures have been implemented to prevent and control the further spread of the disease. However, barriers that influence the effective implementation of public health measures were not explore in Ethiopia especially in study Area. Therefore, this study tried to fill this gap by exploring the barriers to effective implementation of public health measures for prevention and control of the COVID-19 pandemic in the Gamo Zone of southern Ethiopia.

METHODS

The study employed a qualitative study with a phenomenology approach among purposely selected 30 individuals in the community and selected institutions. Key informant interview was used to collect the data. The data were transcribed verbatim and translated into the English language. The transcribed data were read several times to clearly understand the content for further analysis. The analysis of the data was conducted based on the modified Tanahashi framework.

RESULTS

The study identified different barriers under five main themes: accessibility, acceptability, availability, contact and use, and effective implementation of public health measures related to barriers. The main barriers to effective implementation of public health measures were resistance to change, negligence, lack of community engagement, insufficient training for front line workers, poor supportive supervision, poor law enforcement, and lack of continuous community awareness creation. Beside, acceptability related barriers like cultural and religious norms and availability related barriers like shortage of personal protective equipment and shortage of skilled health professional have also lion share barriers for implementation of the public health measures.

CONCLUSION

The study identified different personal, institutional, and societal level barriers for effective implementation of public health measures for the COVID-19 pandemic. Therefore, proper and targeted continuous community awareness creation with further mandatory law enforcement activities should be implemented by the concerned bodies to mitigate individual and societal level barriers. In addition, the government with relevant stakeholders should give due attention to equip and protect the frontline professionals by availing the necessary logistic and provision of continuous capacity-building activities.

摘要

背景

自新冠疫情爆发以来,已实施了不同的公共卫生措施以预防和控制该疾病的进一步传播。然而,埃塞俄比亚,特别是在研究区域,尚未探讨影响公共卫生措施有效实施的障碍。因此,本研究试图通过探索埃塞俄比亚南部加莫地区预防和控制新冠疫情的公共卫生措施有效实施的障碍来填补这一空白。

方法

本研究采用定性研究方法,采用现象学方法,在社区和选定机构中特意挑选了30个人。通过关键信息人访谈收集数据。数据逐字转录并翻译成英语。转录的数据被多次阅读以清楚理解内容以便进一步分析。基于修改后的田中框架对数据进行分析。

结果

该研究在五个主要主题下确定了不同的障碍:可及性、可接受性、可用性、接触与使用以及与障碍相关的公共卫生措施的有效实施。公共卫生措施有效实施的主要障碍是抵制变革、疏忽、缺乏社区参与、一线工作人员培训不足、支持性监督不力、执法不力以及缺乏持续的社区意识培养。此外,文化和宗教规范等与可接受性相关的障碍以及个人防护设备短缺和熟练卫生专业人员短缺等与可用性相关的障碍也是公共卫生措施实施的主要障碍。

结论

该研究确定了新冠疫情公共卫生措施有效实施在个人、机构和社会层面的不同障碍。因此,有关机构应实施适当且有针对性的持续社区意识培养以及进一步的强制性执法活动,以减轻个人和社会层面的障碍。此外,政府与相关利益攸关方应给予应有关注,通过提供必要的后勤保障和开展持续的能力建设活动来装备和保护一线专业人员。

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