Ignorance has been identified as a key factor in the spread of the deadly COVID-19 pandemic, as many people are yet to believe in the existence of the infection, causing them to move about without adherence to safety protocols.
Mrs Christianah Olusola Ayeni, director of nursing services (DNS), Lagos State Primary Healthcare Board (LSPHCB), made this disclosure in a recent interview with Pharmanews, noting that in spite of various community sensitisation programmes embarked upon by the Board and even the Lagos State Government, most community members have shunned routine visits to the primary healthcare centres for the treatment of their ailments.
She added that many people now resort to self-medication, which usually leads to late presentation when they visit the hospital.
While acknowledging the efforts of government in training nurses and health workers on infection prevention, she asked that this be intensified, as well as the provision of more personal protective equipment. Below are the excerpts:
With nurses at the frontline of the battle against COVID- 19, how has it been for nurses at the Primary Healthcare Centres (PHCs)?
Professionally speaking, anyone with the knowledge of healthcare service delivery can explain the intricacies involved, and the hazards of the profession. There’s the need for health service providers to be passionate about their jobs, whether it is on the high or low side and no matter the intensity involved. This is why, during any challenge, pandemic or epidemic, nurses are always prepared.
Nurses at the primary healthcare level have been rising to the occasion. For instance, we have been doing all our best to face the challenges as they arise, starting from training of nurses and all health workers on COVID-19 and to strict adherence to infection prevention protocols in all our facilities.
Furthermore, the Lagos State Primary Healthcare Board (LSPHCB) has put in place, mobilisation, sensitisation and health education in the communities for awareness creation about the infection.
We also give daily health talks in all our PHCs on COVID- 19 symptoms, most importantly the prevention and strict adherence to its safety protocols.
Hand washing sites in all our PHCs were created towards ensuring clients and patients perform hand washing procedure before entering the PHC. We also ensure that all patients put on face mask.
In what ways has the pandemic affected nursing care at the health centres?
Despite the fact that all nursing services were put in place during the pandemic, we experience low turnout of patients, resulting in drastic reduction in earlier recorded statistics.
Ignorance on the part of some community members also contributed to the low effects of nursing care. This is because despite all the noise and sensitisation by the agencies of government (including Primary Healthcare Board mobilisation) and even by our governor, the incident commander, many people do not still believe that COVID- 19 exists. So, instead of coming to the health facility for treatment, they take to traditional therapies at home, thereby reporting at the health facility when the case becomes worse.
Doctors and pharmacists have been updating the public about infected members but much has not been heard about infected nurses. Does it mean that nurses are not infected?
No, that assertion can be wrong. This is because we have had cases of nurses being infected with COVID- 19 during the course of discharging their duties. For instance, some cases of infected nurses were reported during the first wave of the pandemic by the National Association of Nigeria Nurses and Midwives, Lagos State Branch, at the level of primary, secondary and tertiary healthcare facilities.
Has the PHCB recorded any fatality among nurses?
No, there hasn’t been any record of such at the PHC level. Those affected are always going to the isolation unit and come back recovered.
With 9,856 active cases of COVID-19 currently in the community as stated by the Lagos State Government, how does the Board ensure that majority of them receive nursing care?
In collaboration with the state government, PHCB has trained health workers, including nurses in preparation for home-based care of COVID-19 mild/ asymptomatic cases.
So, let me assure you that the Lagos State government with the PHCB has put in place a robust plan with high efficacy and efficiency that will take care of asymptomatic/mild cases that have been screened for either isolation unit or home-based-community care.
On the part of the Board, what are the strategies put in place to mitigate spread of infection among nurses?
All nurses and health workers have been adequately trained on COVID- 19 signs and symptoms and the various aspects of prevention.
In addition, the use of PPEs, hand washing procedures, social distancing at the PHC, avoiding crowds by giving staggered appointment procedure to clients have all been put in place.
Triaging protocols are also in place at the general outpatient department as patients are coming in. Strict adherence to infection prevention protocols by nurses and all health workers is also enforced.
Going forward, how can nurses be strengthened to overcome the pandemic?
In addition to all that has been mentioned above, there’s need for continuous training and retraining of nurses on infection prevention protocols. Also, supervision and monitoring by the PHCB to ensure strict compliance to COVID-19 prevention protocols at the facility level is required.
Moreover, governments need to provide adequate PPEs in all our Primary Health Care facilities for proper protection of nurses and health workers.
Nurses should be adequately informed by encouraging them to be aware of what is going around them through news update and government directives on COVID- 19.
They can also be strengthened through motivation and empowerment by the government and partner agencies.