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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 7  |  Issue : 2  |  Page : 107-112

Knowledge, attitude, and practices regarding COVID-19 outbreak among the personnel providing emergency services in India


1 Private Practitioner, MDS, Orthodontics and Maxillofacial Orthopaedics, Munger, Bihar, India
2 Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India

Date of Submission05-Jan-2021
Date of Acceptance26-Feb-2021
Date of Web Publication29-Jun-2021

Correspondence Address:
Dr. Vidya Bhushan
MDS, Orthodontics and Dentofacial Orthopaedics, Munger - 811 201, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJAM.IJAM_2_21

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  Abstract 


Introduction: The threat of contracting coronavirus persists among individuals constantly coming in direct or indirect contact with positive cases. Therefore, this study was conducted to assess the knowledge, attitude, and practices (KAPs) regarding the COVID19 outbreak among the personnel providing emergency services in India and also assess their perception toward government measures during this pandemic.
Materials and Methods: An online survey was conducted among individuals providing services during the period of COVID-19 outbreak. A total of 234 people consented to continue with the survey. Data collection was carried out from April 2020 to June 2020. Data analysis was carried out using Chi-square statistics and Fisher-Freeman-Halton test. The level of statistical significance was set at 0.05 with a confidence interval of 95%.
Results: Majority of the participants were male and belonged to the age group of 18–54 years. Almost all were aware that COVID-19 is a virus and had knowledge regarding its mode of spread and modes of prevention. Precautions such as covering face with mask, avoiding shaking hands, and washing hands before touching the eyes, nose, and mouth were undertaken by 34.6% of the total participants. Around 70.5% of the males, 53.7% of the females, and 33.3% of the participants from the others' category felt that the funds released by the government to combat corona were efficiently reaching the poor or the needy. Some of the barriers preventing the fair distribution of funds/services to the poor and needy as reported by the participants were corruption, lack of knowledge, delay in delivery and lack of personal protective kits, limited workforce, and no bank account of poor people.
Conclusion: KAP of personnel providing emergency services is crucial to the containment of this disease. Understanding of the barriers shall aid policymakers to assess the impact of their preventive programs and also take crucial decisions toward its management.
The following core competencies are addressed in this article: Medical knowledge, practice-based learning and improvement, and systems-based practice.

Keywords: Attitude, barriers, COVID-19, knowledge, outbreak, practice


How to cite this article:
Bhushan V, Rai S. Knowledge, attitude, and practices regarding COVID-19 outbreak among the personnel providing emergency services in India. Int J Acad Med 2021;7:107-12

How to cite this URL:
Bhushan V, Rai S. Knowledge, attitude, and practices regarding COVID-19 outbreak among the personnel providing emergency services in India. Int J Acad Med [serial online] 2021 [cited 2021 Oct 26];7:107-12. Available from: https://www.ijam-web.org/text.asp?2021/7/2/107/319802




  Introduction Top


The world is witnessing a pandemic post the influenza pandemic (H1N1) of 2009.[1] Various countries have been tackling this issue in different ways with the sole aim being safety of their citizens. With active support from its citizens, India has been able to contain the spread of the virus. The most important factor in preventing the spread of the virus locally is to empower the citizens with the right information and taking precautions as per the advisories being issued by the Ministry of Health and Family Welfare.[2] From nationwide lockdown to practising and promoting social distancing, the government has taken all possible measures to protect its citizens. Public representatives, government officials, and medical professionals have played a major role in this pandemic by providing selfless service to the humankind. Although the availability of personal protective equipments has encouraged our frontline warriors to render services even during the pandemic, there exist lacunae in the system that prevents the timely and unbiased distribution of these essentials in all the districts and remote areas. Delivery of valid information on prevention to each and every citizen is very necessary and even a minor negligence is sufficient to invite the virus into our homes. Hence, we conducted this study to assess the knowledge, attitude, and practices (KAPs) regarding the COVID19 outbreak among the personnel providing emergency services in India. We also intended to assess the precautions that are being undertaken by this group during this period and their perception regarding government measures to curb this pandemic. This shall aid the government to assess the impact of its preventive measures among its citizens and take future decisions.


  Methodology Top


An online survey was conducted among individuals providing services during the period of COVID-19 outbreak. It contained 24 questions which included both open- and close-ended questions on demographic profile of the participants, their knowledge regarding COVID-19, their attitude toward the pandemic, and the government actions along with the measures taken to protect themselves from the disease. The questionnaire was checked for its content validity and face validity by medical practitioners as well as nonmedical practitioners. The survey questionnaire was pilot tested on 25 individuals which further added onto the face validity and content validity. The time taken to fill the questionnaire was about 8–10 min. Item analysis was carried out to test for the internal consistency and reliability and the Cronbach's alpha was found to be 0.76 which depicted acceptable reliability. Convenience sampling was performed and the survey link was shared among around 250 individuals from all over India. These individuals belonged to different occupational groups and were providing essential as well as emergency services during the period of lockdown. A brief message providing information on the topic and aim of the survey was attached along with the survey form. A total of 234 people consented to continue with the survey. Data collection was carried out from April 2020 to June 2020.

Data were analyzed using SPSS (Statistical Package for the Social Sciences) version 26 and the results were depicted in the form of tables and graphs. Chi-square statistics were employed to analyze the differences in the baseline characteristics of the participants. The level of statistical significance was set at 0.05 with a confidence interval of 95%. Fisher-Freeman-Halton test was used to assess the difference in the knowledge, attitude, practices, and perception regarding the pandemic situation among males, females, and personnel in the others' category.


  Results Top


A total of 234 participants participated in the survey. Majority of the participants were males and belonged to the age group 18–54. The baseline characteristics of the participants are depicted in [Table 1].
Table 1: Baseline characteristics of the participants

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Around 81.5% of the males, 91.1% of the females, and 95.2% of the others' category were aware of COVID-19 being a virus. Among males, females, and others, 36.9%, 35.8%, and 23.8%, respectively, believed that COVID-19 had multiple modes of spread. Around 34.9% of the males, 29.8% of the females, and 23.8% of the others believed the mode of prevention to be covering the face while coughing, washing hands regularly, and using alcohol-based sanitizer. Majority (85.5%) of the total participants were scared of COVID-19. News from social media and television sources was considered to be the most trusted source of information during the pandemic. About 40.4% of the males and 46.2% of the females had to undertake their regular full-time duties from either offices, hospitals, banks, essential shops, or other departments. Precautions such as covering face with mask, avoiding shaking hands, and washing hands before touching the eyes, nose, and mouth were undertaken by 34.6% of the total participants. Around 15.1% of males reported that their family members maintained social distancing, while around 26.8% of females reported that their families maintained social distancing once they returned back from work. All the participants in the others' category reported that their family members cleaned their clothes as a precautionary measure [Table 2].
Table 2: Knowledge, attitude, and practices among personnel providing emergency services during COVID-19 pandemic

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Majority of the participants (44.5% of the males, 29.8% of the females, and 38.2% of the others) were unsure if the public was abiding by the precautionary actions taken by the government to stop this virus from spreading. Around 69.2% of the males, 59.7% of the females, and all the participants in the others' category did not have a health insurance. Around 53.4% of males and 43.2% of females reported having financial resources to pay for the medical treatment if they fell ill due to corona. None of the participants in the others' category had financial resources to pay for their medical treatment. Around 70.5% of the males, 53.7% of the females, and 33.3% of the participants from the others' category felt that the funds released by the government to combat corona were efficiently reaching the poor or the needy [Table 3].
Table 3: Perception of personnel providing emergency services toward the pandemic situation

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Some of the barriers preventing the fair distribution of funds/services to the poor and needy as reported by the participants were corruption, politics, lack of co-operation, lack of knowledge, delay in delivery of personal protective kits, lack of personal protective kits, limited workforce, and no bank account of poor people [Figure 1].
Figure 1: Barriers that are preventing the fair distribution of funds/ services to the poor and needy

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  Discussion Top


COVID-19 is an emerging, rapidly changing global health challenge affecting all sectors of society. Those providing emergency services are not only at the forefront of the fight against this highly contagious infectious disease but are also directly or indirectly affected by it and the likelihood of acquiring this disease is higher among them in comparison to the general population. It is therefore of paramount importance that this group has adequate knowledge about all aspects of the disease.

Majority of the participants were males, belonged to the working age group, were health-care workers, and belonged to the eastern zone of India. In a study done by Olum et al., a vast majority of the participants were male (n = 64%) with a median age of 32 years and 62% of the participants were medical doctors.[3] Zhong et al. reported that among the survey completers, 65.7% were women, 63.5% held a bachelor degree or above, and 56.2% engaged in mental labor.[4]

Majority of the participants were aware of COVID-19 being a virus and also about its mode of spread. Majority of the participants in each group knew the basic preventive measures for this disease. The difference in knowledge regarding COVID-19 among the three groups was found to be statistically insignificant. Azlan et al. reported that about 77.2% of the participants in their study had an acceptable level of knowledge on COVID-19, but there was noticeable confusion among participants regarding transmission of the virus.[5] Most participants in their study knew that isolating infected persons for a period of 14 days was an effective way to reduce the spread of the virus.[5] In a similar study, it was reported that 78.7% of the respondents knew that the causative agent was a virus and more than 80% knew that the disease could be prevented through washing hands and avoiding touching and contacting infected people.[6]

In our study, almost all the participants reported of being scared of the virus and no statistically significant difference was found between the groups. Television and social media were the trusted sources of information for all the three groups similar to a study done in Saudi Arabia.[5] Olum et al. reported that most of the participants used information from international and governmental media (websites and verified social media pages).[3] A statistically significant difference was found between the mode of work of the participants in the three groups during the pandemic. No statistically significant difference in the precautionary measures taken by the participants was found between the groups. This could be due to the fact that all the television channels and social media networks were advertising the need to wear a mask, sanitizing hands, maintaining social distancing, and covering the face while coughing and majority of the participants relied on television and social media networks for information. In our study, females and people in the third category reported that their families preferred washing clothes as a protective measure when compared with their male counterparts and this difference was found to be statistically significant. Precautions such as washing hands, avoiding touching the eyes, nose, and mouth, throwing the used tissue in the trash, and using the mask to cover their nose in crowded places were some of the precautions taken by majority of the participants in a study done by ALdowyan et al.[6]

There was a statistically significant difference in the perceptions of males, females, and people in the others' category regarding government efforts toward combating the pandemic, efficiency of health-care system in our country, and also the extent to which the citizens were abiding by the government instructions. ALdowyan et al. reported that around 40% of females and 52% of males agreed that governmental institutions can control and prevent the disease in Saudi Arabia.[6] In a study conducted in Malaysia, it was found that a majority of participants had confidence that Malaysia would be able to win the battle against COVID-19 and a large percentage of participants also agreed that the Malaysian government was performing well in handling the COVID-19 crisis.[5] Zhong et al. reported that nearly all of the respondents in their study had confidence that China could win the battle against COVID-19.[4] However, a statistically insignificant difference was observed for perceptions regarding financial security to fight the disease. A statistically insignificant difference was found among the three groups in relation to the perception toward equitable distribution of the funds released by the government or private bodies.

The barriers in the fair distribution of funds to the poor and needy, as reported by the participants, were local politics, corruption, lack of transportation facilities, lack of volunteers, prevailing problem of illiteracy, lack of adequate production and supply of personal protective kits, and also no substantial knowledge of the exact number of migrant workers in different states. These were some of the discrepancies listed by the participants which need to be taken care of by the government bodies so as to maintain a continuous, steady, and transparent flow of services to the citizens of our nation during the pandemic.

The study had both strengths and limitations. As self-administered questionnaire was used, the chances of interviewer's bias were minimal.

Limitations of the study:

  • More questions on knowledge and practices could have been incorporated in the questionnaire
  • Due to the limited accessibility to Internet in remote areas of India, the questionnaires could not be circulated among the COVID-19 warriors working in those areas.



  Conclusion Top


KAP of the personnel providing emergency services during COVID-19 outbreak is crucial to the containment of this disease. An understanding of the barriers faced by these people shall aid the policymakers and public health managers to assess the impact of their preventive programs on the citizens and also help in taking crucial decisions toward management of the pandemic in our country.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Research quality and ethics statement

Appropriate approval was obtained from institutional research committee (number KIDS/RES/013/2020). Clinical trials registration was not done as it was an observational study. The authors declare that they followed applicable EQUATOR Network (http://www. equator-network. org/) research reporting guidelines.



 
  References Top

1.
Khanna M, Kumar B, Gupta A, Kumar P. Pandemic influenza A H1N1 (2009) virus: Lessons from the past and implications for the future. Indian J Virol 2012;23:12-7.  Back to cited text no. 1
    
2.
COVID-19 Dashboard. Government of India. Available from: https://www.mygov.in/covid-19. [Last accessed on 2020 Jul 24].  Back to cited text no. 2
    
3.
Olum R, Chekwech G, Wekha G, Nassozi DR, Bongomin F. Coronavirus disease-2019: Knowledge, attitude, and practices of health care workers at Makerere University Teaching Hospitals, Uganda. Front Public Health 2020;8:181.  Back to cited text no. 3
    
4.
Zhong BL, Luo W, Li HM, Zhang QQ, Liu XG, Li WT, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: A quick online cross-sectional survey. Int J Biol Sci 2020;16:1745-52.  Back to cited text no. 4
    
5.
Azlan AA, Hamzah MR, Sern TJ, Ayub SH, Mohamad E (2020) Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia. PLoS ONE 15(5): e0233668. Accessed from: https://doi.org/10.1371/journal.pone.0233668.  Back to cited text no. 5
    
6.
ALdowyan NM, Ahmed AS, El-Gharabawy RM. Knowledge, attitude and practice (KAP) study about Middle East respiratory syndrome coronavirus (MERS-CoV) among population in Saudi Arabia. Int Arch Med 2017;10.doi: 10.3823/2524  Back to cited text no. 6
    


    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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