HSRC Responds to the COVID - 19 Outbreak Communities are at the - PowerPoint PPT Presentation

HSRC Responds to the COVID - 19 Outbreak “Communities are at the heart of any disease outbreak and health emergency response” The HSRC launched the project “Street talk-Asikulume” at the end of March 2020 to gather crucial behavioural data to provide insights into the social dynamics of the South African population’s response to the COVID-19 outbreak. The HSRC’s rapid assessment of social and behavioural factors is crucial to assist government mitigate the effects of the spreading epidemic. Engaging communities regarding their knowledge, beliefs, practices and attitudes in response to the COVID-19 outbreak in South Africa

INTRODUCTION  We acknowledge and appreciate the excellent work that has been done with respect to the epidemiology and health care aspects of this disease  We also appreciate the extensive work undertaken on the economic impact of the pandemic  This survey provides a starting point to balance the country’s response at this tipping point in the fight against the pandemic: the socio-behavioural insights from South Africans

HEALTH PROMOTION AND WELL-BEING FRAMEWORK FOR OUTBREAK RESPONSE ACTION GUIDELINES Health behaviour, health information and health literacy

STUDY METHODS Study design and population  The HSRC’s research response to the COVID-19 outbreak employed a mixed methods approach with a  Quantitative studies – panel surveys conducted online and telephonically  General population survey 1: Socio-behavioural survey  General population survey 2: Lockdown survey Key Informant  Healthcare workers survey – www.hsrc.ac.za/heroes Interviews  Youth survey  Data from surveys is benchmarked using the general population Community Informant Interviews demographics based on Stats SA’s mid-year estimates allowing for generalisability of findings Cape Flats Case Study Photovoice  Qualitative studies  Key informant interviews  Photovoice case studies  Social media studies  Study sample  Sample of all South Africans aged 18 years and older communities, including healthcare workers  Qualitative studies included interviews with informants including teachers, shebeen owners and sex workers • Partnerships with UKZN, SAPRIN (Agincourt), Walter Sisulu University, NIHSS and Acumen Media were crucial for expansion into these communities

ANALYSING THE DATA The data was benchmarked (weighted) to the distribution of South Africa’s adult population. The mid-year adult population estimates from Statistics South Africa by age, sex, race, and province is used in this process. This allows the data to be generalizable to the country. Source: https://www.healthcatalyst.com/in-pursuit-of-the-patient- stratification-gold-standard 5

PRELIMINARY RESULTS OF LOCKDOWN SURVEY: 8 – 24 APRIL 2020 MOVING FROM LOCKDOWN TO COMMUNITY PARTICIPATION, MOTIVATION AND ENABLEMENT

DEMOGRAPHIC PROFILE BY RACE, SEX AND AGE Out of a total of 19330 participants, the majority (70%) were 25-59 years of age 48% Female 6% 52% 16% Male 8% Slightly more than half of the participants were females Age groups (years) Population group % 18 - 24 African 78.4% 25 - 59 70% White 9.6% 60 - 69 Coloured 9.0% 70+ Indian/Other 3.0% 7

DEMOGRAPHIC PROFILE BY TYPE OF EMPLOYMENT Student 8% Self employed 9% Employed informal/part time Unemployed 37% Employed full time 10% • 36% of participants are unemployed • 10% had informal/part time work • 9% were self employed 36% 8

DEMOGRAPHIC PROFILE BY PROVINCE Majority of participants were from Gauteng (28%) & KwaZulu-Natal (18.3%) 9

DEMOGRAPHIC PROFILE BY COMMUNITY TYPE Approximately one third of participants stated their community type was a township (35.1%) and 1 in 5 indicated they were from a rural community type

KNOWLEDGE ABOUT COVID-19 PREVENTION Staying 2 meters away from another person 95.5 3.1 1.5 Wearing a mask 85.6 11.3 3.1 Staying away from people who are infected 96.8 1.5 1.8 Not touching my nose, eyes and face 92.7 5.3 2 Washing my hands frequently for 20 seconds 97.4 1.8 0.8 75 80 85 90 95 100 105 Percentages (%) Yes No Dont know 11

RISK PERCEPTION Most participants perceived themselves to be at moderate or low risk

KEY MESSAGE 1 What the findings tell us Logic for change Health promotion strategy: from data to action health behavior change , health literacy, information, policy • Being in the situation of lockdown • • If the burden of disease is high As we lift the lockdown, preventive could have given 1 in 2 people a and generalised, and mortality is behaviour change has to be sense of security and so they high, most people will perceive intensified perceived themselves to be at low themselves at high risk. • All people of South Africa need to risk • When the curve is flattened and take responsibility for their own • Only 1 in 5 people believe that the burden of disease appears behavior they are at high risk of infection to be relatively low and • Targeted messages have to promote mortality low, then most people voluntary behavior actions (hand will perceive themselves to be at washing, social distancing and low risk (complacency due to masks) lockdown success) • The tipping point is between the • We may becomes victims of the epidemiologic, the economic, and successes gained during the the social/individual behaviors lockdown if preventive behaviours are not intensified

ADHERENCE TO LOCKDOWN REGULATIONS: STAYING AT HOME BY AGE AND COMMUNITY TYPE Community type 100 I have been at home since the start of lockdown, and have not left I have had to leave to get food and medicine 80 73 I had to leave to collect a social grant 67 65 I spend a lot of my time visiting my friends and neighbours and Percentage (%) 60 57 socialising 60 49 100 38 40 80 32 29 27 65 64 26 25 62 60 54 51 20 13 11 10 Percentage (%) 0 39 5 3 3 3 2 2 34 2 40 0 30 28 0 23 City Suburb Township Informal Rural Farm 20 12 12 settlement (Traditional 7 6 6 3 1 1 0 tribal area) 0 0 30% had not left home since the start of lock All ages 18 - 24 25 - 59 60 - 69 70+ down and 62% had left to get food/medicine 14

KEY MESSAGE 2 What the findings tell us Logic for change Health promotion strategy: from data to action health behavior change , health literacy, information The majority of people adhered This is important to build upon. The message is South Africa you to the regulations: The country needs to move can do it to save lives. Take control from a situation of being in lock of your lives to prevent you, your The results show that 99% down to appealing for family and your neighbours from either left their homes for food, community participation and contracting the Corona virus. medicine and social grants or invoking the spirit of Ubuntu. stayed home.

ADHERENCE TO LOCKDOWN REGULATIONS: CONTACT WITH PEOPLE DURING LOCKDOWN (While you were away from home, how many people did you come into close contact with? (within 2 metres) Only 20% indicated that they had not left home, 20% 8% had met with more than 50 people 29% 8% 9% 12% 23% 1 to 3 people 4 to 10 11 to 20 21 to 50 More than 50 people Have not left home 16

KEY MESSAGE 3 What the findings tell us Logic of change Health promotion strategy: from data to action health behavior change, health literacy, information, policy and economic interventions 29% of people reported that It is important to use the psychosocial The message is that South Africans have to they came into close contact and behavioural determinants to build disrupt their social relations and activities with 10 or more people during a targeted culturally appropriate in order to save lives, by adopting social the past 7 days when out of behaviour change approach regarding distancing. Anyone can be infectious with their homes. social distancing and its meaning in or without symptoms, so everyone needs the local context. To deconstruct our to have a duty to protect others by normal lives so as to break the chain wearing a mask whenever out of one’s 15% had to use public of transmission. home. The message is for public transport transport to get to the shops. to disinfect the taxis and ensure the use of masks and social distancing inside the taxis and at taxi ranks. (Enabling messages about what you can do rather than what you cannot do).

ACCESS TO ESSENTIALS DURING LOCKDOWN: FOOD Just under a quarter (24%) of residents had no money to buy food We can buy from a shop 25% More than half (55%) of 24% within walking distance from informal settlement my house residents had no money We can buy from a shop, which I reach using a taxi/bus for food (public transport) We can buy from a shop, About two-thirds of which I reach using my car residents from townships 15% also had no money for We do not have enough food money to buy food during the lockdown 36% 18