A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.

We performed two cross-sectional surveys across three informal settlements in Kenya (within Kisii county, Nairobi, and Nakuru county) to study the effectiveness of public health interventions during the COVID-19 pandemic. A total of 720 participants were surveyed from 120 randomly selected geographi...

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Main Authors: Steven Scholfield, Geraldine D Kavembe, Rodney R Duncan, Bernhards O Ragama, Jared Mecha, Albert Orwa, Geoffrey Otomu, Erick Wanga, James Astleford, John Gutto, Isaac Kibwage, Julius Ogato, Arpana Verma, Keith Brennan, Jonathan Huck, Diana Mitlin, Mahesh Nirmalan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0294202
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author Steven Scholfield
Geraldine D Kavembe
Rodney R Duncan
Bernhards O Ragama
Jared Mecha
Albert Orwa
Geoffrey Otomu
Erick Wanga
James Astleford
John Gutto
Isaac Kibwage
Julius Ogato
Arpana Verma
Keith Brennan
Jonathan Huck
Diana Mitlin
Mahesh Nirmalan
author_facet Steven Scholfield
Geraldine D Kavembe
Rodney R Duncan
Bernhards O Ragama
Jared Mecha
Albert Orwa
Geoffrey Otomu
Erick Wanga
James Astleford
John Gutto
Isaac Kibwage
Julius Ogato
Arpana Verma
Keith Brennan
Jonathan Huck
Diana Mitlin
Mahesh Nirmalan
author_sort Steven Scholfield
collection DOAJ
description We performed two cross-sectional surveys across three informal settlements in Kenya (within Kisii county, Nairobi, and Nakuru county) to study the effectiveness of public health interventions during the COVID-19 pandemic. A total of 720 participants were surveyed from 120 randomly selected geographical locations (240 participants/settlement/survey), and a coordinated health promotion campaign was delivered between the two surveys by trained staff. Information relating to knowledge, attitudes, and practices (KAP) were collected by trained field workers using a validated questionnaire. The main outcomes showed improvements in: (i) mask-wearing (% of participants 'Always' using their mask increased from 71 to 74%, and the percentage using their masks 'Sometimes' decreased from 15% to 6%; p<0.001); (ii) practices related to face mask usage (% of subjects covering the mouth and nose increased from 91 to 95%, and those covering only part of their face decreased from around 2.5% to <1%; p<0.001). Significant improvements were also seen in the attitudes and expectations relating to mask wearing, and in the understanding of government directives. Over 50% of subjects in the post-campaign survey reported that social distancing was not possible in their communities and fears associated with COVID-19 testing were resistant to change (unchanged at 10%). Access to COVID-19 testing facilities was limited, leaving a large proportion of people unable to test. As willingness to take a COVID-19 test did not change between surveys (69 vs 70%; p = 0.57), despite increased availability, we recommend that policy level interventions are needed, aimed at mitigating adverse consequences of a positive test. Improvements of KAPs in the more crowded urban environment (Nairobi) were less than at settlements in rural or semi-urban settings (Nakuru and Kisii). We conclude that coordinated public health campaigns are effective in facilitating the change of KAPs amongst people living amidst challenging socio-economic conditions in informal settlements.
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spelling doaj-art-26d861750bba4bcf87f496281fa992902025-08-20T02:17:34ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011812e029420210.1371/journal.pone.0294202A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.Steven ScholfieldGeraldine D KavembeRodney R DuncanBernhards O RagamaJared MechaAlbert OrwaGeoffrey OtomuErick WangaJames AstlefordJohn GuttoIsaac KibwageJulius OgatoArpana VermaKeith BrennanJonathan HuckDiana MitlinMahesh NirmalanWe performed two cross-sectional surveys across three informal settlements in Kenya (within Kisii county, Nairobi, and Nakuru county) to study the effectiveness of public health interventions during the COVID-19 pandemic. A total of 720 participants were surveyed from 120 randomly selected geographical locations (240 participants/settlement/survey), and a coordinated health promotion campaign was delivered between the two surveys by trained staff. Information relating to knowledge, attitudes, and practices (KAP) were collected by trained field workers using a validated questionnaire. The main outcomes showed improvements in: (i) mask-wearing (% of participants 'Always' using their mask increased from 71 to 74%, and the percentage using their masks 'Sometimes' decreased from 15% to 6%; p<0.001); (ii) practices related to face mask usage (% of subjects covering the mouth and nose increased from 91 to 95%, and those covering only part of their face decreased from around 2.5% to <1%; p<0.001). Significant improvements were also seen in the attitudes and expectations relating to mask wearing, and in the understanding of government directives. Over 50% of subjects in the post-campaign survey reported that social distancing was not possible in their communities and fears associated with COVID-19 testing were resistant to change (unchanged at 10%). Access to COVID-19 testing facilities was limited, leaving a large proportion of people unable to test. As willingness to take a COVID-19 test did not change between surveys (69 vs 70%; p = 0.57), despite increased availability, we recommend that policy level interventions are needed, aimed at mitigating adverse consequences of a positive test. Improvements of KAPs in the more crowded urban environment (Nairobi) were less than at settlements in rural or semi-urban settings (Nakuru and Kisii). We conclude that coordinated public health campaigns are effective in facilitating the change of KAPs amongst people living amidst challenging socio-economic conditions in informal settlements.https://doi.org/10.1371/journal.pone.0294202
spellingShingle Steven Scholfield
Geraldine D Kavembe
Rodney R Duncan
Bernhards O Ragama
Jared Mecha
Albert Orwa
Geoffrey Otomu
Erick Wanga
James Astleford
John Gutto
Isaac Kibwage
Julius Ogato
Arpana Verma
Keith Brennan
Jonathan Huck
Diana Mitlin
Mahesh Nirmalan
A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.
PLoS ONE
title A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.
title_full A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.
title_fullStr A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.
title_full_unstemmed A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.
title_short A cross-sectional survey on the effectiveness of public health campaigns for changing knowledge, attitudes, and practices in Kenyan informal settlements during the COVID-19 pandemic.
title_sort cross sectional survey on the effectiveness of public health campaigns for changing knowledge attitudes and practices in kenyan informal settlements during the covid 19 pandemic
url https://doi.org/10.1371/journal.pone.0294202
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