Health care provider perspectives on the treatment of patients with COVID-19 during the first wave at the Aga Khan Hospital in Dar es Salaam, Tanzania: A qualitative study.

Abstract

Background

The COVID-19 pandemic, as characterized by the World Health Organization, led to the widespread use of various treatment regimens, including off-label and herbal medications. However, in resource-limited settings, healthcare providers face additional challenges, such as psychological and infrastructural, which may affect patient care. Understanding the perspectives of these frontline providers can offer insights into the clinical benefits of these treatment approaches and inform strategies for pandemic preparedness.

Methods

A phenomenological qualitative study using Focus Group Discussions was employed with 24 health care providers caring for patients with COVID-19. An FGD guide was utilised to extract in-depth data. Topics covered were challenges and fears associated with treatment of COVID-19, views on off-label drug use and herbal treatment, and providers’ experiences of patient management. FGDs were transcribed verbatim and deductive thematic analysis was used to develop meaningful themes.

Findings

Provider perspectives were summarized into 3 themes. First, negative emotional responses, especially in the first wave, consisted of fear and anxiety caused by working in the COVID-19 Unit, perceived risk of getting infected and concern for patients and their relatives. Second, COVID-19 health care delivery was multidisciplinary and consisted of rapidly evolving treatment protocols, symptomatic and supportive care. Third, we found several patient-related challenges which included stress, and community responses towards COVID-19.

Conclusion

Health care providers perceived fear and anxiety as initial responses. Flexibility and multidisciplinary team involvement played a great role in ensuring patient care as well as provider wellness. Therefore, important policy measures such as mental health support for providers, multidisciplinary team training and collaboration, clear risk communication and standardized protocols, and community engagement measures should be kept in place to ensure pandemic preparedness to help providers carry out their duties.