Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study.

BACKGROUND: Practicing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic. METHODS: A qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis. RESULTS: Two themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices). CONCLUSION: During public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.

Understanding facilitators and barriers to COVID-19 vaccination in the Zimbabwean population: a qualitative analysis.

BACKGROUND: Vaccines are effective biological interventions that reduce health burdens. However, during the COVID-19 pandemic, there were concerns about varying levels of COVID-19 vaccination coverage in the Zimbabwean population. This study aimed to understand facilitators and barriers to COVID-19 vaccine uptake in the Zimbabwean population. METHODS: In September-October 2023, key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with a sample comprising health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected across the country. At each site, the participant sample was homogeneous. Data were collected using audiotapes, transcribed verbatim, and translated into English. Data were analysed manually using thematic analysis. RESULTS: Ten FGDs and 30 KIIs were conducted across the country. Among the facilitators of COVID-19 vaccine uptake were the perceived benefits of COVID-19 vaccination, such as protection from infection, severe disease and death. People also complied with COVID-19 vaccination because of the government's call for mandatory vaccination, travel restrictions, restrictions when entering some premises for services, visiting, working, learning and functions. Barriers to COVID-19 vaccine uptake included low-risk perception, negative attitudes emanating from concerns about the origins of the vaccines, COVID-19 cases or death of vaccinated people, negative peer influence, religious doctrines, cultural beliefs and misconceptions circulating through social media. Other barriers included knowledge gaps on COVID-19 vaccines, safety, effectiveness, side effects, access-related challenges to COVID-19 services and concerns over the changing policy on COVID-19 vaccination. CONCLUSIONS: The study has shown the importance of community engagement and data-driven public health communication strategies to facilitate behaviour change for increased uptake of a vaccine. In future epidemics, public health campaigns should focus on the timely provision of information explaining the benefits of an intervention, addressing safety concerns more effectively. To build trust and hence improve vaccine uptake by the public, there is a need for continuous engagement with people and to provide platforms for dialogue to address issues contributing to low vaccine uptake.

Women's knowledge, attitudes and practices (KAP) relating to breast and cervical cancers in rural Zimbabwe: a cross sectional study in Mudzi District, Mashonaland East Province.

BACKGROUND: Breast and cervical cancers constitute the most common cancers among women in sub-Saharan Africa. In Zimbabwe, cervical cancer accounts for more than a third of all cancers among women of African descent. Cancer knowledge levels, attitudes and practices of people in different sections of society should be assessed in order to guide current cancer interventions. This study aimed to assess breast and cervical cancer knowledge, attitudes and practices of women of reproductive age, in Mudzi District, Republic of Zimbabwe. METHODS: A cross-sectional community-based survey was conducted. A total of 409 survey household questionnaires were administered to women of reproductive age (15-49 years) in 2014. RESULTS: A total of 409 respondents were interviewed. Nearly 85% of respondents had heard of cancer. 34.2% did not know of any cervical cancer risk factors and 51% were not familiar with the signs and symptoms of cervical cancer. Fifty five percent (55%) had not discussed cancer issues with partners in the past 12 months, and only 27.4% had discussed cancer issues with partners at all. Most of the respondents (96.2%) had never undergone cervical cancer screening. The majority of the respondents (70.8%) had never discussed breast cancer issues with community members. About 70% had never discussed cervical cancer issues with community members. CONCLUSIONS: This study revealed a lack of awareness and comprehensive knowledge about breast and cervical cancer. It also revealed low self-risk perception, low uptake of cancer early detection services and low capacity of the local health institution in offering cancer services. It is recommended that the scaling-up of cancer information, dissemination, and early detection services must be prioritised, including training of local health institutions.