Abstract
Background: The first entry to any level of care within the health setting in the Eastern Cape is the Primary health care (PHC). At this level of care, screening, diagnosis, treatment for chronic illnesses, treatment for minor ailments, promotion of health, prevention of diseases and rehabilitation services are offered. In King Sabatha Dalindyebo (KSD) district, Eastern Cape Province, most PHC facilities do not have a doctor onsite, as such seeing and managing patients is the responsibility of the nurses for both acute and chronic diseases. KSD was declared by the Eastern Cape Department of Health (ECDOH) as one of the COVID-19 hotspots from May 2020 to August 2020. The cumulative number of COVID-19 cases sat at 13947 and the number of cases per day averaged 18 in July 2021. Approximately 321 health workers were affected by COVID-19 and PHC workers were among those affected, including workers in Community Health Centres (CHCs). Understanding the risks of PHC workers may assist in risk mitigation. According to the Ministry of Health in South Africa, of the total number of confirmed COVID-19 cases in the healthcare sector, 21,333 (78%) cases were reported in the public sector, while 6,027 (22%) were from the private sector (NDOH, 2020).
Aim: The aim of the was to determine the risk of contracting COVID-19 amongst Primary Health Care Workers in the KSD health sub-district.
Methods: A quantitative descriptive and correlational design to determine primary health care workers’ risks of contracting COVID-19 was used in this study. The systematic investigation of the nature of relationships, or associations between and among variables, rather than direct cause-effect relationships between COVID-19 and identified risk factors was used for the study. Collection of data was over three months in primary health care facilities and community health centres in King Sabatha Dalindyebo sub-district, which is a part of OR Tambo District. The number of PHC workers who participated in the study was 268. The study was conducted between the period of September 2021 and April 2022 (8 month period).
Data collection tool used was a self-reporting questionnaire containing three sections to measure primary care workers’ risks of contracting COVID-19. After collection, data was entered in the Statistical Programme for the Social Sciences (SPSS) version 27, analysed and reported by descriptive and inferential statistics. The researcher obtained ethical approval from the Health Research Ethics Committee of the University of Johannesburg. The Eastern Cape Department of Health Ethics committee and the OR Tambo District manager provided the researcher with permission to conduct the study. Individual informed consent was then provided by the participants.
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Results: Participants’ risks of contracting COVID-19 were high as the number of PHC workers diagnosed with COVID-19 was 104 (38.8%) out of the 268 participants. Availability of PPE was fairly adequate, with most participants responding that there were adequate PPE supplies in their facilities. There was inconsistency in the use of PPE and implementation of COVID-19 policies and Standard Operating Procedures (SOPs). Mitigation strategies to counter the risk of contracting COVID-19 were in place but were not implemented consistently by PHC workers in the KSD sub-district. There were other challenges outside of the control of PHC workers that exposed them to the risk of contracting COVID-19. These included infrastructural challenges within the facilities. Also, external factors might have contributed to the risk of contacting COVID-19 amongst PHC workers as many of them used public transport to go to work and attended gatherings outside of their work environment.
Conclusion: PHC workers in KSD sub-district are generally exposed to the risk of contracting COVID-19 due to environmental and occupational factors. Although PPE and strategies to mitigate risks were available, there was inconsistency in the use and implementation of these.
Keywords: Protective Equipment, COVID-19, risk factors.