Community health workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria - A qualitative study

Zahra Olateju , Tolulope Olufunlayo, Christine MacArthur, Charlotte Leung , Beck Taylor

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Abstract

Background
Community Health Workers are globally recognised as crucial members of healthcare systems in low and middle-income countries, but their role and experience during COVID-19 is not well-understood. This study aimed to explore factors that influence CHWs’ ability and willingness to work in the COVID-19 pandemic in Lagos.

Design
A generic qualitative study exploring Community Health Workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria.

Methods
15 semi-structured, in-depth, video interviews were conducted with Community Health Workers purposively sampled across seven of Lagos’ Local Government Areas with the highest COVID-19 burden. Interviews explored Community Health Workers’ attitudes towards COVID-19, its management, and their experiences working in Lagos. Data was analysed thematically using the framework method.

Results
Three main themes were identified. 1. Influences on ability to undertake COVID-19 Role: Trust and COVID-19 knowledge were found to aid Community Health Workers in their work. However, challenges included exhaustion due to an increased workload, public misconceptions about COVID-19, stigmatisation of COVID-19 patients, delayed access to care and lack of transportation. 2. Influences on willingness to work in COVID-19 Role: Community Health Workers’ perceptions of COVID-19, attitudes towards responsibility for COVID-19 risk at work, commitment and faith appeared to increase willingness to work. 3. Suggested Improvements: Financial incentives, provision of adequate personal protective equipment, transportation, and increasing staff numbers were seen as potential strategies to address many of the challenges faced.

Conclusion
Despite Community Health Workers being committed to their role, they have faced many challenges during the COVID-19 pandemic in Nigeria. Changes to their working environment may make their role during disease outbreaks more fulfilling and sustainable. International input is required to enhance Nigeria’s policies and infrastructure to better support Community Health Workers during both current and future outbreaks.
Original languageEnglish
Article numbere0265092
Number of pages18
JournalPLOS One
Volume17
Issue number3
DOIs
Publication statusPublished - 8 Mar 2022

Bibliographical note

Funding Information:
The author(s) received no specific funding for this work.

Publisher Copyright:
Copyright: © 2022 Olateju et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

  • Adult
  • Attitude
  • COVID-19
  • Community Health Workers
  • Female
  • Humans
  • Interviews as Topic
  • Knowledge
  • Male
  • Middle Aged
  • Nigeria
  • Pandemics
  • Perception
  • Personal Protective Equipment
  • SARS-CoV-2
  • Stereotyping
  • Surveys and Questionnaires
  • Transportation
  • Workload
  • Young Adult

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