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06 Aug 2020

HSRC and UKZN’s School of Medicine release results of Healthworkers survey

Human Sciences Research Council (HSRC)
Press Release

Pretoria, Thursday 6 August 2020 – The Human Sciences Research Council (HSRC), in partnership with the University of KwaZulu-Natal’s Nelson R. Mandela School of Medicine, today released the results of the survey looking at the impact of COVID-19 on healthworkers.  The survey was conducted from 11 April 2020 – 7 May 2020 and aimed to ascertain the impact COVID-19 on South African health workers – both physically and emotionally. 

Healthcare workers have been at the forefront of fighting the pandemic and are at high risk of contracting the virus.  This is addition to already strenuous conditions under which they work including long working hours, psychological distress, fatigue, occupational burnout, stigma and physical and psychological violence.

Globally, more than 90 000 healthcare workers are thought to be infected with COVID-19 and more than 600 deaths have been recorded.  According to the Department of Health, at least 24000 health workers have been infected with at least 100 losing their lives to the COVID-19 disease. 

Due to the impact of the virus on frontline workers, HSRC and UKZN conducted “Front line talk”: A national survey of South African health care workers’ response to Covid-19, which reached at least 7607  health care workers over the age of 18 years in all nine provinces of South Africa.

Conducted on the datafree online platform, Moya Messaging, the survey looked at some of the following issues:
•    Training received to respond to COVID-19
•    Levels of knowledge, awareness and attitudes to COVID 19
•    The use and access to Personal Protective Equipment in the workplace
•    Perceptions of risk in the workplace
•    Concerns in relation to COVID-19
•    Health and psychosocial wellbeing of the respondent

Demographic profile of the respondents
•    A total of 7 607 healthcare professionals participated in the survey.
•    4 in 5 participants were female
•    3 in 5 participants were black African
•    3 in 5 participants came from urban formal areas
•    Half of the participants came from the 4 most affected provinces (GP, WC, KZN, EC)
•    Nurse practitioners comprised 2 in 5 of the participants
•    Half of the participants worked in the public health sector whilst a third worked in the private sector
•    About a quarter of participants worked in either the NGO, civil society or academic sector –designated as neither public nor private
•    1 in 10 participants were over 60

Findings

Knowledge
•    2 in 5 participants did not know the correct COVID-19 incubation period
•    3 in 4 of all professional categories correctly identified contact with contaminated surfaces as a mode of transmission.
•    2 in 5 of all professional categories incorrectly identified COVID-19 as being airborne.
•    Knowledge of the correct symptoms is high at the time of data collection
•    Overall, half of the healthcare professionals were confident on their knowledge about COVID-19
•    Nurse practitioners lacked confidence in their knowledge about COVID-19 more than the other categories

Sources of information
•    Overall, two-thirds of health professionals consulted sources of information on COVID-19 from the National Department of Health, from WHO, CDC
•    Compared to health professionals in rural areas, health professionals in urban formal areas relied more on  WHO/CDC websites and scientific journals. 
•    Similarly, medical practitioners vs. all other health professionals relied on WHO/CDC websites (3 in 4 vs 3 in 5) and scientific journals (2 in 5 vs 1 in 5) as sources of information
•    Other health professionals used social media (1 in 4 vs 1 in 5) and news websites (3 in 5 vs 2 in 5) more than medical practitioners

Training
•    About two thirds of health professionals received some form of COVID-19 related training
•    Only 1 in 2 were trained in treatment guidelines and 1 in 4 in declaring patients as recovered
•    There is a large difference in training received between medical vs nurse practitioners on treatment guidelines, case definitions as well as tests that should be done to confirm diagnosis
•    The fields in which health professionals were least frequently trained in, i.e. treatment guidelines and declaring patients as recovered,  were also the fields in which confidence in training received was lowest

Perception of Risk
•    Risk perception is lowest in GP and WC. These are the provinces with the highest proportions of health professionals who work in urban formal settings. i.e. 84% of Gauteng participants worked in urban formal areas, 78% of WC participants worked in urban formal areas.
•    Risk perception is highest in NW and FS

Risk Factors
•    Three quarters of health professionals felt that their occupation placed them at higher risk. 
•    A third of health professionals felt that where they worked put them at greater risk
•    Two thirds felt that the general population are not following the transmission guidelines and therefore putting health professionals at risk
•    Over half of health professionals felt they did not have adequate PPE which put them at risk
•    A quarter of health professionals felt that their underlying health conditions put them at risk of contracting COVID-19

Need for Personal Protective Equipment (PPE)
•    Overall over two thirds of participants expressed the need for all forms of PPE
•    The data suggests incorrect knowledge of the use of PPE in some clinical situations, e.g. N95 mask for use in triaging patients, use of surgical mask in critical and intensive care of COVID-19 patients 
•    4 in 5 health professionals expressed the need for environmental controls, eye shields/goggles, gloves and N95 masks
•    Overall confidence in the use of PPE was low.
•    1 in 2 health professionals were confident in their personal ability in the correct use of PPE including donning and doffing
•    Health professionals indicated their lack of confidence in the availability and accessibility of PPE
•    Self perceived risk of contracting COVID-19 was high when confidence in the correct use of PPE was low

Health and Wellbeing
•    The level of concern for health and wellbeing was significantly different by profession
•    Nearly half of nurse practitioners were extremely concerned about family members and personal health.
•    2 in 5 health professionals have extreme concern for their family wellbeing, whilst 1 in 5 health professionals have extreme concern for their own personal wellbeing
•    3 in 5 nurse practitioners were concerned about passing infection to family members.
•    A quarter of nurse practitioners experienced severe psychological distress with health professionals working in the public sector experiencing higher psychological distress than those working in the private sector
•    Nurses reported the lowest general health and well-being compared to medical practitioners and other health care professionals
•    Health professionals who reported high psychological distress reported low levels of general health and well-being whilst health professionals who reported high general well-being reported low levels of psychological distress.

The HSRC was established in 1968 as South Africa’s statutory research agency and has grown to become the largest dedicated research institute in the social sciences and humanities on the African continent, doing cutting-edge public research in areas that are crucial to development.

Our mandate is to inform the effective formulation and monitoring of government policy; to evaluate policy implementation; to stimulate public debate through the effective dissemination of research-based data and fact-based research results; to foster research collaboration; and to help build research capacity and infrastructure for the human sciences.

The Council conducts large-scale, policy-relevant, social-scientific research for public sector users, non-governmental organizations and international development agencies. Research activities and structures are closely aligned with South Africa’s national development priorities.

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For more information or to set up interviews, please contact:
Manusha Pillai
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Email: MPillai@hsrc.ac.za

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