Acceptability and feasibility of strategies to shield the vulnerable during the COVID-19 outbreak: a qualitative study in six Sudanese communities

BMC Public Health

Maysoon Dahab¹  Nada Abdelmagid¹  Mahmoud Ali Fadlallah²  Salma A. E. Ahmed³  Nazik Nurelhuda⁴  Israa Zainalabdeen⁵  Aljaile Ahmed⁵ 

[1]Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK

[2]Sudan COVID-19 Research Group, Khartoum, Sudan

[3]Sudan COVID-19 Research Group, Khartoum, Sudan

[4]Asian Institute of Technology, Bangkok, Thailand

[5]Public Health Institute (PHI), Khartoum, Sudan

[6]Sudan COVID-19 Research Group, Khartoum, Sudan

[7]Independent public health researcher, Khartoum, Sudan

[8]Sudan COVID-19 Research Group, Khartoum, Sudan

[9]University of Khartoum, Faculty of Dentistry, Khartoum, Sudan

[10]Sudan COVID-19 Research Group, Khartoum, Sudan

[11]Y-PEER Sudan, Khartoum, Sudan

关键词: Shielding;    COVID-19;    Sudan;    High-risk;    Resource-poor;    Acceptability;    Feasibility;    Participatory analysis;   

DOI  :  10.1186/s12889-021-11187-9

来源: Springer

【 摘 要 】

BackgroundShielding of high-risk groups from coronavirus disease (COVID-19) has been suggested as a realistic alternative to severe movement restrictions during the COVID-19 epidemic in low-income countries. The intervention entails the establishment of ‘green zones’ for high-risk persons to live in, either within their homes or in communal structures, in a safe and dignified manner, for extended periods of time during the epidemic. To our knowledge, this concept has not been tested or evaluated in resource-poor settings. This study aimed to explore the acceptability and feasibility of strategies to shield persons at higher risk of severe COVID-19 outcomes, during the COVID-19 epidemic in six communities in Sudan.MethodsWe purposively sampled participants from six communities, illustrative of urban, rural and forcibly-displaced settings. In-depth telephone interviews were held with 59 members of households with one or more members at higher risk of severe COVID-19 outcomes. Follow-up interviews were held with 30 community members after movement restrictions were eased across the country. All interviews were audio-recorded, transcribed verbatim, and analysed using a two-stage deductive and inductive thematic analysis.ResultsMost participants were aware that some people are at higher risk of severe COVID-19 outcomes but were unaware of the concept of shielding. Most participants found shielding acceptable and consistent with cultural inclinations to respect elders and protect the vulnerable. However, extra-household shielding arrangements were mostly seen as socially unacceptable. Participants reported feasibility concerns related to the reduced socialisation of shielded persons and loss of income for shielding families. The acceptability and feasibility of shielding strategies were reduced after movement restrictions were eased, as participants reported lower perception of risk in their communities and increased pressure to comply with social commitments outside the house.ConclusionShielding is generally acceptable in the study communities. Acceptability is influenced by feasibility, and by contextual changes in the epidemic and associated policy response. The promotion of shielding should capitalise on the cultural and moral sense of duty towards elders and vulnerable groups. Communities and households should be provided with practical guidance to implement feasible shielding options. Households must be socially, psychologically and financially supported to adopt and sustain shielding effectively.

【 授权许可】

CC BY