Barriers and facilitators of compliance with infection prevention and control measures during the COVID-19 pandemic in health facilities in Kampala city, Uganda

Abstract

During the COVID-19 pandemic, Infection Prevention and Control (IPC) was crucial to reduce the spread of the virus in health facilities. This study explored the barriers and facilitators of IPC compliance among healthcare workers (HCWs) during the COVID-19 pandemic in Kampala City, Uganda. Key informant interviews were conducted with 14 participants in 12 health facilities located in Nakawa division, Kampala City. Of these facilities, 3 were government-owned, and 9 were private not-for-profit. Each health facility's participant was either the IPC focal person or a HCW knowledgeable about the IPC measures implemented there. Transcripts were coded using a newly generated codebook in Atlas.ti version 9, and thematic analysis was carried out to analyze the study findings. Participants identified the fear of contracting the virus as one of the primary facilitators for IPC compliance among HCWs during the COVID-19 pandemic. They explained that the sustainability of IPC measures in health facilities was partly due to HCWs' belief that they served as role models in the community for observing and implementing health-related behaviors, especially regarding COVID-19. Among the barriers, participants mentioned that not all HCWs got the opportunity to be trained on COVID-19 IPC. Only HCWs working in high-risk departments for COVID-19 such as triage or Intensive Care Units were prioritized. However, regardless of the department, all HCWs were exposed to potential COVID-19 patients, and the high workload led them to sometimes skip the required IPC measures. This study found that addressing the spread of COVID-19 among HCWs necessitated a comprehensive approach to IPC in health facilities. This approach should encompass capacity building, as well as provision of necessary supplies. In addition, HCWs, the hospital management and government have a role to play to ensure that IPC is fully implemented in the case of future related outbreaks.