PERCEPTION OF DISEASE OUTBREAK BY HEALTH WORKERS AND LEVEL OF EPIDEMIC PREPAREDNESS OF PUBLIC HEALTH FACILITIES IN ALIMOSHO LOCAL GOVERNMENT AREA, LAGOS

Abstract

Epidemic preparedness has been influenced by top-down approaches that emphasize the need for commitment and expertise in addressing severe situations. Studies have shown that responses to managing disease outbreak have been reactive rather than pro-active, with limited understanding of key action steps to be taken during the outbreak. There is little documentation on the level of epidemic preparedness of public health facilities in Nigeria. This study was carried out to assess the perception of disease outbreak by health workers and level of epidemic preparedness of public health facilities in Alimosho Local Government Area, Lagos State. This study adopted a cross-sectional survey design. A total sampling technique was used to recruit all 290 health workers in the public health facilities in Alimosho LGA. A semi-structured, interviewer-administered questionnaire was used for data collection. The instrument included information on socio-demographic characteristics, knowledge of health workers and perception towards epidemic preparedness. A workplace checklist was used to assess the adequacy of epidemic preparedness in Alimosho LGA. From a total obtainable knowledge score of 27, a knowledge score of ≥12 was classified as good and from a total obtainable perception score of 55, a perception score of ≥30 was classified as good. Data were analysed using descriptive statistics and logistic regression at p < 0.05. Age of the health care workers was 35.9±8.4 years, 87.6% were Yoruba and 81.4% were married. Nine percent had post-graduate degrees, 79.2% were graduates while 12.1% were non-graduates. About 79.0% of the workers had permanent employment. Clinical staff and support staff were 79.0% and 12.8%, respectively. Only 12.1% of the respondents had received training on epidemic preparedness in the past 12 months; 68.6% of those trained and 57.3% of those not trained had significant understanding of baseline response to disease outbreak. Of the clinical staff, 61.6% also had an understanding of baseline response to disease outbreak. Only 11.3 % of the respondents were knowledgeable about epidemic preparedness. The high occurring epidemic prone diseases were measles (33 .0%) and cholera (26.7%). Of those who were not knowledgeable about epidemic preparedness, 94.8% lack understanding of disease outbreak. Across the healthcare facilities visited, infrastructures for disease containment was not available. Health workers :S 35 years of age were about 3 times less likely to be knowledgeable about epidemic preparedness (OR = 0.33, CI = 0.132 - 0.825) compared with those >35 years of age. Workers with no understanding of disease outbreak were also twice less likely to be knowledgeable about epidemic preparedness compared to those who had an understanding of disease outbreak (OR= 0.34, CI= 0.131 - 0.894). The understanding of disease outbreak by health workers was inadequate; also, the level of preparedness for epidemic outbreak in Alimosho local government was not satisfactory. The provision of infrastructure and training of health workers should be encouraged in Alimosho Local Government Area in order to avert and control disease outbreaks.