Assessing the knowledge, attitude and practice of hand hygiene as a covid-19 preventive measure: a case Study of Nakivale Refugee Settlement, Isingiro District

Abstract

Handwashing with soap and water remains among the most effective methods of Hand Hygiene that help prevent Corona Virus Disease 2019 (COVID-19) pandemic and also critical to prevent the possible spread of other infectious diseases. This study aims to examine the factors influencing the KAP factors of refugees towards HH in Nakivale Refugee Settlement, Isingiro District. A study using data from a cross-sectional survey with 786 responses from new arrival refugees in the settlement was conducted. The study included demographic characteristics, individual practices, risk perceptions, attitude, norm factors and ability factors related to hand hygiene during the COVID-19 pandemic. The specific objectives were to establish the handwashing practices of refugees, to find out the attitudes towards handwashing and to determine the knowledge of refugees about handwashing. Descriptive analysis, chi square and multiple logistic regression tests were used to analyse the data. We re-classified categories of hand hygiene frequencies; never and rarely as poor hygiene practice and sometimes and always as good Hand hygiene practice. The results showed that, 75.2% of female respondents and 79.5% male respondents reported good handwashing behaviour during COVID-19 pandemic. Respondents who perceived themselves at low risk of contracting COVID-19 when they washed their hands (OR 11.36, 2.68 - 48.14), perceived risk of death from COVID-19 not possible when washing hands with soap (OR 1.55, 0.33 - 7.31), did not face any challenges in accessing soap for handwashing (OR 1.03, 0.62 - 1.03), perceived a more supportive norm (OR 1.68, 1.15–2.44) were more likely to engage in good hand hygiene practice more frequently during the pandemic. Perceived susceptibility, perceived effectiveness, religion and soap availability are important predictors of hand hygiene practices, which are similar to findings from previous studies in other pandemic contexts. Designing behavioural change strategies targeting mind-set change of refugees with regard to handwashing behavioural practices and attitudes and installing rain water harvesting systems in communities so as to supplement water supply for hand washing in the settlement can significantly improve the HH behaviour in the settlement.