Abstract

Background: To this date, there is no national estimate about healthcare providers’ Knowledge, Attitude and Practice (KAP) towards the preventive measures of COVID 19 in Ethiopia. A comprehensive national review on this topic is important to highlight the areas for improvement and further prevention of the pandemic in the country. Therefore, this meta-analysis was aimed at addressing the pooled estimate of health care providers’ KAP towards the precautionary health measures of COVID 19 in Ethiopia.

Methods: Primary studies were accessed through Google scholar, HINARI, SCOPUS and PubMed databases. From eligible studies, two authors extracted author/year, study region, study design, sample size, health care providers’ knowledge, attitude and practice towards the precautionary health measures of COVID 19 on an excel spreadsheet. The extracted data were then exported to stata version 14. Effect sizes were pooled using the random inverse varience -effects model due to significant heterogeneity (I²=99.2%). Sensitivity analyses were performed.

Results: In this meta-analysis, a total of 9 studies with a sample of 3802 health care providers were included. Of the total health care providers, 79.21% (95% CI: 73.08%, 85.35%; I²=92.7%) had good knowledge; 69.82% (95% CI: 52.18%, 87.47%; I²=98.9%) had positive attitude; and 58.09% (95% CI: 42.12%, 74.05%; I²=97.5%) had good practice towards the precautionary health measures of COVID 19. Among the different precautionary health measures, hand hygiene with soap/sanitizer 65.11% (95%CI: 30.78%, 99.43%; I²= 99.8%), using facemask 61.63% (95%CI: 15.52%,107.73%; I²=99.9%) and avoiding touching eyes, nose and mouth 70.81% (95%CI: 31.12%, 110.50%; I²=99.6%) were better practiced whereas staying at home during off working hours 18.45% (95%CI: 8.18%, 45.08%; I²=98.2%] was least practiced. Concerning associated factors, age <34 years (AOR=2.14; 95%CI: 1.25, 3.62), access to infection prevention (IP) training (AOR=2.4; 95%CI: 1.36, 4.21) and using social media (AOR=2.85; 95%CI: 2.00, 3.70) were significantly associated with good knowledge of the precautionary health measures. Good knowledge of the precautionary health measures (AOR=3.17; 95% CI: 1.97, 5.06) and suffering from chronic medical illnesses (AOR=2.17; 95%CI: 1.69, 6.95) were significant predictors of health care workers’ positive attitude about the precautionary health measures of COVID 19. Regarding factors associated with practice, lack of protective equipment in the facility (AOR=0.42; 95%CI: 0.3, 0.74), high workload (AOR=0.4; 95% CI: 0.36, 0.87), good knowledge (AOR=2.47; 95%CI: 1.53, 3.41) and positive attitude (AOR=3.29; 95%CI: 2.09, 5.19) towards the precautionary measures were significantly associated with good practice of the precautionary measures.

Conclusion: In Ethiopia, health care workers’ knowledge, attitude and mainly their practice towards the precautionary health measures of COVID-19 was relatively low as compared to other countries. Most importantly, good practice of the precautionary health measures was significantly associated with accessibility of protective equipment; reasonable workload, good knowledge and positive attitude towards the precautionary measures. Therefore, evidence-based practices on risk communication, raising awareness, accessibility of protective equipment and staff workload should be strategized and implemented by all governmental and nongovernmental organizations in collaboration with healthcare institutions in Ethiopia.

Keywords: COVID-19; systematic review; Ethiopia; knowledge, attitude; practice