Implementation barriers and facilitators to a COVID-19 intervention in Bangladesh: The benefits of engaging the community for the delivery of the programme

BMC Health Services Research

Research Article

Fahmida Akter¹  Mohiuddin Ahsanul Kabir Chowdhury¹  Malika Tamim¹  Avijit Saha¹  Omor Faruque¹  Animesh Talukder¹  Malabika Sarker²  Albaab-Ur Rahman³  Monzur Morshed Patwary³  Morseda Chowdhury³  Imran Ahmed Chowdhury³ 

[1] BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh;BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh;Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany;Health, Nutrition, and Population Program, BRAC, Dhaka, Bangladesh;

关键词: COVID-19;    Community resilience;    Community engagement;    Implementation fidelity;    Facilitators;    And Barriers;   

DOI  :  10.1186/s12913-022-08939-7

 received in 2022-06-24, accepted in 2022-12-06,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundBRAC (Bangladesh Rural Advancement Committee), the largest NGO globally, implemented a community-based comprehensive social behavior communication intervention to increase community resilience through prevention, protection, and care for COVID-19. We conducted implementation research to assess fidelity and explore the barriers and facilitators of this intervention implementation.MethodsWe adopted a concurrent mixed-method triangulation design. We interviewed 666 members of 60 Community Corona Protection Committees (CCPCs) and 80 members of 60 Community Support Teams (CSTs) through multi-stage cluster sampling using a structured questionnaire. The qualitative components relied on 54 key informant interviews with BRAC implementers and government providers.ResultsThe knowledge about wearing mask, keeping social distance, washing hands and COVID-19 symptoms were high (on average more than 70%) among CCPC and CST members. While 422 (63.4%) CCPC members reported they ‘always’ wear a mask while going out, 69 (86.3%) CST members reported the same practice. Only 247 (37.1%) CCPC members distributed masks, and 229 (34.4%) donated soap to the underprivileged population during the last two weeks preceding the survey. The key facilitators included influential community members in the CCPC, greater acceptability of the front-line health workers, free-of-cost materials, and telemedicine services. The important barriers identified were insufficient training, irregular participation of the CCPC members, favouritism of CCPC members in distributing essential COVID-19 preventive materials, disruption in supply and shortage of the COVID-19 preventative materials, improper use of handwashing station, the non-compliant attitude of the community people, challenges to ensure home quarantine, challenges regarding telemedicine with network interruptions, lack of coordination among stakeholders, the short duration of the project.ConclusionsEngaging the community in combination with health services through a Government-NGO partnership is a sustainable strategy for implementing the COVID-19 prevention program. Engaging the community should be promoted as an integral component of any public health intervention for sustainability. Engagement structures should incorporate a systems perspective to facilitate the relationships, ensure the quality of the delivery program, and be mindful of the heterogeneity of different community members concerning capacity building. Finally, reaching out to the underprivileged through community engagement is also an effective mechanism to progress through universal health coverage.

【 授权许可】

CC BY   
© The Author(s) 2022

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