Limbani Felix, Kapumba Blessings M, Mzinganjira Henry, Phiri Tamara, Mwandumba Henry C, Rylance Jamie, Morton Ben, Desmond Nicola
Malawi Liverpool Wellcome Trust Clinical Research Programme, Kamuzu University of Health Sciences, PO Box 30096, Chichiri, Blantyre, BT3, Malawi.
Queen Elizabeth Central Hospital, Blantyre, BT3, Malawi.
Wellcome Open Res. 2022 Feb 4;7:40. doi: 10.12688/wellcomeopenres.17368.1. eCollection 2022.
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.
新型冠状病毒肺炎（COVID-19）目前是全球健康威胁。医护人员处于应对COVID-19疫情的前线，因此感染风险更高。撒哈拉以南非洲地区缺乏关于医护人员管理COVID-19经验的证据。我们报告了马拉维最大的转诊医院——伊丽莎白女王中央医院医护人员对疫情应对策略的反应、经验和看法。
在马拉维COVID-19第一波疫情期间（2020年3月至2020年10月），我们对经过有目的抽样选取的医护人员进行了39次面对面深入访谈。该研究纳入了提供直接和间接患者护理的医护人员。
在第一波疫情的早期阶段（2020年3月至5月），医护人员对工作空间不足、基础设施不利于工作、COVID-19管理培训延迟且仓促以及缺乏激励措施表示担忧。此外，医院人员短缺，管道氧气和个人防护装备等基本资源有限。这增加了医护人员感染COVID-19的恐惧，他们不太愿意在COVID-19隔离病房志愿服务。资源限制和准备不足损害了护理途径，尤其是随着COVID-19患者数量增加。到第一波疫情高峰期（2020年6月至8月），许多这些问题得到了解决。医院提供了进修培训课程，个人防护装备变得可用，为在COVID-19病房工作的医护人员提供了激励措施，并且安装了管道氧气。员工士气得到提升，更多员工愿意在COVID-19隔离中心工作。
COVID-19第一波疫情期间医护人员的经验对于改善未来COVID-19疫情期间的护理至关重要。资源有限地区的应对策略应优先考虑及时培训员工、创建足够的隔离区域、提供充足的医疗用品以及加强领导。
