Perceptions of COVID-19 risks and protective actions: a qualitative study in six Sudanese communities

Nada Abdelmagid,Salma A.E. Ahmed,Nazik Nurelhuda, Israa Zainalabdeen,Aljaile Ahmed, Omama Abdalla, Ahmed Dawd,Ahmed Eldirdiri, O.I. Sallam, Drij Ismail, Rahaf AbuKoura, Reem Gaafar,Maysoon Dahab

Research Square (Research Square)(2023)

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Abstract Background Risk communication is an essential strategy in outbreak response. Understanding perceptions of health risks and protective behaviours is critical for informing effective risk communication during outbreaks. This study aimed to explore Coronavirus disease (COVID-19) knowledge, risk perception and precautionary behaviours during the early weeks of the COVID-19 epidemic in Sudan. Methods In-depth telephone interviews were conducted with 59 adults from six of urban, rural and forcibly displaced communities in Sudan. Participants were from households with members at higher risk of severe COVID-19 outcomes. We analysed data using participatory group analysis followed by a thematic inductive and deductive analysis of interview transcripts. We used the Health Belief Model to analyse, present and discuss the findings. Results Most participants perceived a high susceptibility to COVID-19, especially among older people, due to novelty and transmission characteristics of the disease. However, a few were mainly concerned about the livelihood implications of the government’s response. Our respondents had good knowledge about COVID-19 although there were a few misconceptions. Most participants viewed COVID-19 as a highly infectious, dangerous and fatal disease. Most participants understood the benefits of protective measures and reported complying with hand hygiene. A few reported complying with social and physical distancing, including stay-at-home orders. Compliance was generally poorer among older adults. Many participants reported substantial financial and social barriers to compliance and resistance to compliance in their communities fuelled by COVID-19 denialism, rumours, misinformation, and poorly enforced government restrictions. Conclusion High levels of knowledge and a high perceived susceptibility and severity of disease were not enough to motivate high levels of compliance with the protective measures in the study communities. Financial and social obligations to protective measures, coupled with COVID-19 denialism and rumours, were significant barriers to compliance. Early risk communication interventions should promote contextually appropriate, high-impact, low-cost interventions and tackle emerging rumours and misinformation.
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sudanese communities,risks,protective actions,qualitative study
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