Abstract:
BACKGROUND: Health workers are crucial to the successful implementation of infection prevention and control
strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine
SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces
of South Africa as well as explore some elements of health worker and health facility infection prevention and
control practices.
METHODS: A cross-sectional study design was utilised. The study population comprised both clinical and nonclinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A
structured self-administered questionnaire was developed using the World Health Organization guidance as the
basis for the knowledge questions. COVID-19 protocols were observed during data collection.
RESULTS: A total of 286 health workers from 47 health facilities at different levels of care participated in the survey.
The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%)
answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score
eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being
either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants
(50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers
displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had
received infection prevention and control training. Some participants indicated they did not have access to medical
masks (11.8%) and gloves (9.9%) in their departments.
CONCLUSIONS: The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection
prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring
adequate infection prevention and control training for all staff and universal access to appropriate PPE were
identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings
that needed to be addressed were provided to the relevant provincial departments of health.
