Abstract
Background
Although several training courses for Health Care Workers (HCWs) on COVID-19 were conducted in Yemen, no evaluation has been done to assess the effectiveness of such training on the Knowledge, Attitude and Practice (KAP) of HCWs. Therefore, this study aimed to assess the effectiveness of training on the KAP of HCWs toward infection prevention and control (IPC) for COVID-19, determine the relationship between the change in the KAP of HCWs, and identify the associated factors with the change in KAP.
Methodology
A cross-sectional study was conducted from April to December 2021. It was conducted among 186 HCWs working at COVID-19 isolation centers and caring for COVID-19 patients, in all Yemen’s governorates. The data were collected one week before and immediately after the training session. SPSS version 26 was used for data entry and analysis. The median, interquartile range (IQR) and median difference were calculated. The Wilcoxon Signed Ranks Test was used to estimate the significant difference between KAP pre- and post-training scores. Kurskal-Wallis and Mann-Whitney U tests were used to assess the associated factors. Spearman’s correlation coefficient test was used to assess the statistical relationship between the change in KAP. A P value < 0.05 was considered statistically significant.
Results
Out of 186 HCWs, 181 HCWs filled the pre- and post-assessment, with a response rate of 97.3%. The median difference (IQR) in the KAP scores were 3.0 (1.0 and 6.0), 1.0 (-1.0 and 4.0) and 2.0 (-1.0 and 5.0), respectively. However, there are statistical difference in the KAP scores between the pre- and post-training (p value = 0.000, 0.004 and 0.000, respectively). There are significant positive correlations between the change in knowledge, attitude and practice (all p values < 0.01). A significantly change in knowledge was found among those working in epidemiological surveillance (p value = 0.031).
Conclusions
This evaluation concludes that the training program is effective in improving the KAP of HCWs toward IPC for COVID-19. It provides scientific evidence about the importance of training courses for HCWs during the COVID-19 pandemic. Further study is recommended to evaluate the retention of the KAP after a period of training.
Supplementary Information
The online version contains supplementary material available at 10.1186/s12913-024-11927-8.
Keywords: Effectiveness, Training, KAP, IPC, COVID-19, Healthcare workers
Background
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a newly discovered coronavirus, firstly named 2019-nCoV and then renamed severe acute respiratory syndrome coronavirus 2 [1, 2]. It emerged in Wuhan, China at the end of 2019 [2–4]. On 30 January 2020, the World Health Organization (WHO) declared the novel coronavirus outbreak a Public Health Emergency of International Concern, and on March 11, 2020, the WHO named it a pandemic [5]. As of June 16, 2024, about 775,645,882 cases of COVID-19, including 7,051,876 deaths reported to WHO [6]. The United States of America is the most affected region with over 103 million cases and 1.2 million deaths [6]. Eastern Mediterranean region has 23.4 million cases, including 351 thousand deaths June 15, 2024 [6].
As a result of the blockade imposed on Yemen by the Saudi-led Coalition and most of the points of entry have little or no technical capacity to deal effectively with suspected cases among travelers, the pandemic eventually reached Yemen, with the first confirmed case of COVID-19 announced on April 10, 2020 in Hadramaut government [7]. After that, the virus is circulating widely across the whole of Yemen. Governmental measures have started to be implemented, such as introducing quarantine, closing airports, and restricting public gatherings [7]. Also, a few hospitals and medical wards have been designated to receive cases [7]. As of June 16, 2022, almost 11,945 confirmed cases of COVID-19 including 2,159 deaths were reported [6]. However, this number is smaller than the actual number of cases in Yemen [8].
Anxiety, fear, and transmission of this disease are increasing among Health care workers (HCWs) due to the lack or inadequate of personal protective equipment (PPE), and the shortage of equipment and medicines [7]. Moreover, numbers from unofficial reports (e.g. health sources and social media) indicate that deaths are rising among HCWs during the epidemic of COVID − 19 in Yemen. Therefore, adequate knowledge about COVID-19 and infection control practices among the HCWs could lead to positive changes in attitudes and practices of HCWs and consequently reduce morbidity and mortality [1, 9].
Environmental hygiene, true work practices and appropriate use of PPE, and early detection and isolation of COVID–19 patients are important infection prevention and control (IPC) measures to protect HCWs and visitors at the health facilities [10]. Improving Knowledge, Attitude, and Practice (KAP) among HCWs through training is a crucial step toward protecting the health workforce and ensuring their safety.
Several training courses for HCWs during the COVID-19 epidemic were conducted by the Ministry of Public Health and Population (MoPHP) and its partners. However, no evaluation has been done to assess the effectiveness of such training on the KAP of HCWs. Through this evaluation, such a gap will be crossed and evidence-based data will be provided to MoPHP officials and partners to scale up HCWs training regarding COVID-19 IPC in Yemen. Therefore, this study aimed to assess the effectiveness of training on the KAP of HCWs toward IPC for COVID-19 in Yemen, 2021, determine the relationship between the change in the KAP of HCWs, and identify the associated factors with the change in KAP.
Methodology
Study design
A quasi-experimental design study was conducted to evaluate the effectiveness of the training program on HCWs’ KAP regarding IPC for COVID-19. It was carried out during the period of conducting training courses, from April to December 2021.
Study setting and population
The study was carried out among HCWs working at COVID-19 isolation centers and caring for COVID-19 patients, in all of Yemen’s governorates.
Sample size
Census sampling was used. All nominated HCWs by Governorates’ Health and Population Offices for participating in the training program were considered as sample size. The nominated HCWs for participation were 65 HCWs in the first phase and 120 HCWs in the second phase of the training program. Therefore, 186 HCWs were considered as the sample size.
Inclusion and exclusion criteria
The nominated HCWs by Governorates’ Health and Population Offices who participated in the first and second phases of the training program, and those who are working at COVID-19 isolation centers and caring for COVID-19 patients were recruited. As well as those who agree to engage in the pre- and post-assessment. However, the HCWs who disagree to engage in the pre- and/or post-assessment were excluded from this assessment.
Training package
The training program aimed to develop the KAP for the HCWs regarding IPC for COVID-19. Before starting the training program, the link to the pre-test questionnaire was sent by WhatsApp to all participants. The findings from the pre-test questionnaire were used to determine the gaps in COVID-19 KAP. The training materials are designed and developed by experts and according to WHO guidelines and National Training Manual for IPC. They are adapted to address the specific needs and context of healthcare settings in Yemen. Beyond translation into the Arabic language. The training courses were designed according to the interactive adult-learning theory and covered all topics related to COVID-19 and its IPC measures, such as hand hygiene and washing policy and procedures, PPE, cleaning, disinfection and sterilization, waste management, isolation protocols, environmental hygiene. Different tools were used to deliver the above training package e.g. PowerPoint presentations, case studies, group works, role-plays etc. The materials were provided to the participants.
Training program
The training program is carried out through two phases. The first phase is conducted to train the trainers, while the second phase is conducted to train the remaining HCWs working at COVID-19 isolation centers and caring for COVID-19 patients. During the first phase, a three-day training of trainers on IPC for COVID-19 was conducted for each hub and governorate.
Assessment tools
A predesigned structured questionnaire has been adopted from previous literature [8, 10–13] (see supplementary file 1). It was translated from English into Arabic language. The questionnaire was reviewed by three experts, to assess the validity and ensure simplicity and clarity. A pilot study was conducted among a convenience sample of 10 health workers to assess the reliability. The results of Cronbach’s alpha were 0.63 for the knowledge and attitude sections, and 0.72 for the practice section. Then the questionnaire was designed according to the results of the pilot study. The data were collected one week before and immediately after the training session.
The questionnaire contains questions regarding COVID-19’s causes, signs and symptoms, incubation period, mode of transmission, preventive measures, and measures of IPC. It consists of four sections: Section I included questions related to the sociodemographic characteristics of HCWs. Section II included 16 items to assess the knowledge of HCWs. Section III contained 10 items to assess the attitude of HCWs. Section IV included 10 items to assess the practice of HCWs.
Data analysis and interpretation
The knowledge was assessed by sixteen multiple-choice questions. Eight questions with only one correct answer (8 maximum points) and eight yes/no questions, each question has four points (32 maximum points). Each correct answer scored 1 and 0 for incorrect and don’t know answers. Therefore, the maximum total score for knowledge is 40 points. The attitude was evaluated through 10 questions (with a maximum score of 50), and it was based on 5 Likert scores, in which the score of 1 to 5 was given from strongly disagree to strongly agree. The practice of HCWs was assessed through 10 questions (with a maximum score of 50) and it was based on 5 Likert scores, in which the score of 1 to 5 was given from never to always [11, 12].
The statistical software for the social sciences (SPSS) version 26 (Armonk, NY: IBM Corp.) was used for data entry and analysis. For each HCW, the total pre and post-test scores were calculated by the sum of all questions scores. Frequency and percentage were calculated. The average of the pre- and post-training score were calculated by dividing the total achieved score by the maximum score. All the data of the quantitative variables were not normally distributed, as determined by the Kolmogorov-Smirnov test (p value < 0.05). However, the median and interquartile range (IQR) were calculated. The median difference between the pre- and post-training scores was calculated. The Wilcoxon Signed Ranks Test was used to test the significant difference between the knowledge, attitude and practice pre- and post-training. The association between the level of change on the KAP of HCWs towards IPC for COVID-19 and its associated factors was assessed. The dependent variables were KAP, while the independent variables were age, sex, occupation, education, and experience years. However, Kurskal-Wallis test was used for more than two categorical independent variables, Mann-Whitney U test was used for two categorical independent variables. Spearman’s correlation coefficient test was used to assess the statistical relationship between the change in knowledge, attitude and practice of HCWs. A p value < 0.05 was considered as a cut-off point for statistically significant.
Results
Socio-demographic characteristics
Out of 186 HCWs participated in the first and second phases of training courses, 181 HCWs filled the pre- and post-assessment, with a response rate of 97.3%.
Table 1 shows the socio-demographic characteristics of HCWs. The median (IQR) age of the participants was 33 (29 and 40) years. Almost 143 (79.0%) HCWs were male. Level of education showed that nearly 88 healthcare workers (48.6%) had a Diploma qualification, followed by 69 (38.1%) who had Bachelor’s degrees. The nurses and physician assistants were 94 (51.9%), and the physicians were 34 (18.8%). The median (IQR) years of work experience was 10 (5 and 15) years. Moreover, 140 (77.3%) HCWs had previously attended training regarding IPC for COVID-19, and 161 (89.0%) participated in the COVID-19 frontline.
Table 1.
Socio-demographic characteristics of HCWs, Yemen, 2021 (n = 181)
| Variables | Number | % |
|---|---|---|
| Age Median (IQR) | 33 (29 and 40) years | |
| Sex | ||
| Male | 143 | 79.0 |
| Female | 38 | 21.0 |
| Education | ||
| Diploma | 88 | 48.6 |
| Bachelors | 69 | 38.1 |
| High degree (Doctorate and Master) | 24 | 13.3 |
| Occupation | ||
| Nurse/physician assistant | 94 | 51.9 |
| Physician | 34 | 18.8 |
| Lab technician | 24 | 13.3 |
| Administrator | 12 | 6.6 |
| Epidemiological surveillance | 11 | 6.1 |
| Pharmacist | 6 | 3.3 |
| Years of work experience Median (IQR) | 10 (5 and 15) years | |
| Previous training regarding IPC for COVID-19 | ||
| Yes | 140 | 77.3 |
| No | 41 | 22.7 |
| Participate in the frontline | ||
| Yes | 161 | 89.0 |
| No | 20 | 11.0 |
COVID-19 Coronavirus disease 2019, IPC Infection Prevention and Control, IQR Interquartile range, HCWs Health care workers
Comparison the level of KAP before and after training
Table 2 shows the comparison of the pre- and post-training KAP of HCWs towards IPC for COVID-19. The median (IQR) knowledge score pre-training was 32.0 (30.0 and 33.0) compared to 35.0 (33.0 and 37.0) post-training. The median difference (IQR) in the knowledge scores was 3.0 (1.0 and 6.0). However, there is a statistical difference in the knowledge scores between the pre- and post-training (p value = 0.000).
Table 2.
Comparison of pre- and post-training KAP of HCWs towards IPC for COVID-19, Yemen, 2021
| Variables | Pre-training Median (IQR) |
Post-training Median (IQR) |
Difference Median (IQR) |
P valuea |
|---|---|---|---|---|
| Knowledge: | ||||
| Score | 32.0 (30.0 and 33.0) | 35.0 (33.0 and 37.0) | 3.0 (1.0 and 6.0) | 0.000 |
| % score | 80.0 (75.0 and 82.5) | 87.5 (82.5 and 92.5) | 7.5 (2.5 and 15.0) | |
| Attitude: | ||||
| Score | 42.0 (39.0 and 45.0) | 43.0 (40.5 and 46.0) | 1.0 (-1.0 and 4.0) | 0.001 |
| % score | 84.0 (78.0 and 90.0) | 86.0 (81.0 and 92.0) | 2.0 (-2.0 and 8.0) | |
| Practice: | ||||
| Score | 44.0 (41.0 and 47.0) | 46.0 (42.0 and 49.0) | 2.0 (-1.0 and 5.0) | 0.000 |
| % score | 88.0 (82.0 and 94.0) | 92.0 (84.0 and 98.0) | 4.0 (-2.0 and 10.0) | |
COVID-19 Coronavirus disease 2019, IPC Infection Prevention and Control, IQR Interquartile range, KAP Knowledge, Attitude and Practice, HCWs Health care workers
aWilcoxon Signed Ranks Test
Moreover, the median (IQR) attitude score pre-training was 42.0 (39.0 and 45.0) compared to 43.0 (40.5 and 46.0) post-training. The median difference (IQR) in the attitude score was 1.0 (−1.0 and 4.0). However, there is a statistical difference in the attitude scores between the pre- and post-training (p value = 0.004).
The median (IQR) practice score pre-training was 44.0 (41.0 and 47.0) compared to 46.0 (42.0 and 49.0) post-training. The median difference (IQR) in the practice score was 2.0 (−1.0 and 5.0). However, there is a statistical difference in the practice scores between the pre- and post-training (p value = 0.000).
The correlation between the level of change in HCWs’ knowledge, attitude and practice
Table 3 shows the correlation between the level of change in HCWs’ KAP towards IPC for COVID-19. There are significant positive correlations between the change in knowledge, attitude and practice (all p values < 0.01).
Table 3.
Correlation between the change in KAP of HCWs towards IPC for COVID-19, Yemen, 2021
| Knowledge change | Attitude change | Practice change | ||
|---|---|---|---|---|
| Knowledge change | Correlation coefficient | 1 | 0.291a | 0.203a |
| P value | 0.000 | 0.006 | ||
| Attitude change | Correlation coefficient | 0.291a | 1 | 0.391a |
| P value | 0.000 | 0.000 | ||
| Practice change | Correlation coefficient | 0.203a | 0.391a | 1 |
| P value | 0.006 | 0.000 |
COVID-19 Coronavirus disease 2019, IPC Infection Prevention and Control, KAP Knowledge, Attitude and Practice, HCWs Health care workers
aCorrelation is significant at the 0.01 level (2-tailed)
The associated factors with the level of change in KAP
Table 4 shows the factors associated with the change in KAP of HCWs towards IPC for COVID-19. No statistically significant differences were found between the change in knowledge, attitude and practice scores, and age, sex, or work experience of HCWs.
Table 4.
Factors associated with the change in KAP of HCWs towards IPC for COVID-19, Yemen, 2021
| Variables | Knowledge Mediana (IQR) |
Attitude Mediana (IQR) |
Practice Mediana (IQR) |
|---|---|---|---|
| Age group (years) | |||
| 21–30 | 3.0 (1.5 and 6.0) | 1.0 (−2.0 and 4.0) | 1.0 (−3.0 and 4.0) |
| 31–40 | 3.0 (1.0 and 6.0) | 1.0 (−1.0 and 4.0) | 2.0 (0.0 and 5.0) |
| ≥ 41 | 4.0 (2.0 and 7.0) | 1.0 (−1.0 and 4.0) | 1.0 (−2.8 and 6.0) |
| P value b | 0.200 | 0.911 | 0.284 |
| Sex | |||
| Male | 3.0 (1.0 and 6.0) | 1.0 (−2.0 and 4.0) | 1.5 (−1.0 and 5.0) |
| Female | 4.0 (1.5 and 7.5) | 1.0 (0.0 and 4.0) | 2.0 (0.0 and 6.0) |
| P value c | 0.091 | 0.287 | 0.203 |
| Education | |||
| Diploma | 2.0 (0.3 and 6.0) | 1.5 (−2.0 and 5.0) | 2.0 (−1.0 and 5.0) |
| Bachelors | 3.0 (1.0 and 6.0) | 1.0 (−1.0 and 3.5) | 1.0 (−1.0 and 5.5) |
| High degree (Doctorate/Master) | 4.0 (2.3 and 7.8) | 1.0 (0.0 and 3.5) | 1.0 (−1.5 and 4.8) |
| P value b | 0.071 | 0.944 | 0.701 |
| Occupation | |||
| Nurse/physician assistant | 3.0 (1.0 and 6.0) | 1.0 (−2.0 and 4.0) | 2.0 (−1.0 and 5.0) |
| Physician | 4.0 (2.0 and 7.0) | 0.5 (−2.0 and 2.0) | 1.0 (−3.0 and 5.0) |
| Lab technician | 3.5 (1.3 and 7.0) | 1.5 (0.0 and 4.8) | 2.0 (−2.3 and 4.0) |
| Administrator | 2.0 (0.3 and 3.8) | 3.5 (0.3 and 8.3) | 1.0 (0.0 and 7.0) |
| Epidemiological surveillance | 6.0 (3.0 and 8.0) | 2.0 (0.0 and 5.0) | 1.0 (0.0 and 6.0) |
| Pharmacist | 1.0 (−4.0 and 2.3) | 1.0 (−1.8 and 5.3) | 1.0 (−9.5 and 4.3) |
| P value b | 0.031 | 0.294 | 0.722 |
| Work experience | |||
| 0–10 years | 3.0 (1.0 and 5.0) | 1.0 (−1.5 and 4.0) | 2.0 (−1.0 and 4.5) |
| 11–20 years | 4.0 (1.0 and 7.0) | 1.0 (−1.0 and 4.0) | 2.0 (0.0 and 6.0) |
| ≥ 21 years | 4.0 (2.0 and 6.0) | 1.0 (−2.0 and 5.0) | 1.0 (−3.0 and 6.0) |
| P value b | 0.237 | 0.987 | 0.740 |
COVID-19 Coronavirus disease 2019, IPC Infection Prevention and Control, IQR Interquartile range, KAP Knowledge, Attitude and Practice, HCWs Health care workers
aMedian difference
bKurskal-Wallis test
cMann-Whitney U test
The median (IQR) of change in knowledge among those working in epidemiological surveillance was 6.0 (3.0 and 8.0) compared to physician [4.0 (2.0 and 7.0)], lab technician [3.5 (1.3 and 7.0)], nurse/physician assistant [3.0 (1.0 and 6.0)], administrator [2.0 (0.3 and 3.8)], and pharmacist [1.0 (−4.0 and 2.3)]. There is a statistically significant association between the change in knowledge of HCWs, and their occupation (p value = 0.031).
Discussion
Training the HCWs is a crucial step toward increasing their theoretical knowledge and practical skills, to protect them and ensure their safety. However, this study is aimed to assess the effectiveness of training on the KAP of HCWs toward IPC for COVID-19. Statistically significant differences were shown in the KAP scores between the pre- and post-training.
The results of the study indicated that the median age of the participants was 33 years provides valuable insights into the demographic composition of the study sample. The majority of them were male and had Diploma education level. Moreover, half of the participants were Nurses and Physician assistants. The median years of work experience was 10 years. The majority of participants reported that they had participated in the COVID-19 frontline and attended training regarding IPC for COVID-19. This is reflected by the high KAP level pre-training.
Our result found that the knowledge score was significantly higher in post-training as compared to pre-training. There is a significant change or improvement in knowledge of HCWs post-training (p value = 0.000). Around 7.5% of improvement in the knowledge level is attributed to the exposure of HCWs to a large amount of knowledge about IPC and COVID-19 during the training course. This result agrees with the results of previous studies in Egypt [14–18], Oman [19], Saudi Arabia [20], India [1, 20–25], Spain [26], Nigeria [3, 5], Nepal [27] and Japan [28]. A study in China and Papua New Guinea found that there were improvements in knowledge following of the online training program [10, 29]. A study in Thailand indicated that the training improves the knowledge of healthcare personnel regarding the usage of respiratory protective equipment [30]. A study in Kuwait revealed that the education program significantly improved the knowledge of environmental service workers in hospitals regarding the management of infections and sharps [31]. A systematic review and meta-analysis found that the effectiveness of educational interventions in improving the waste management knowledge of HCWs [32].
This study indicated that the attitude score was significantly higher post-training as compared to pre-training. However, the training courses could significantly improve the level of attitude among HCWs toward IPC for COVID-19 (p value = 0.001). This change may be attributed to the training that might improve the level of knowledge among HCWs. Similar findings were observed in studies conducted in Egypt [14–18] and India [20, 25] and Japan [28]. A study in Kuwait revealed that the education program significantly improved the attitude of environmental service workers in hospitals regarding the management of infections and sharps [31]. However, our findings are dissimilar to findings of studies in India [30].
Moreover, the study found that the practice score was significantly higher post-training as compared to pre-training. There is a significant improvement in the practice of HCWs after the implementation of the training program (p value = 0.000). Our result is similar to studies in Egypt [14–18], Oman [19], Saudi Arabia [33], and India [20, 27]. A study in Thailand indicated that the training improves the practice of healthcare personnel regarding the usage of respiratory protective equipment [30]. A study in Kuwait revealed that the education program significantly improved the practices of environmental service workers in hospitals regarding the management of infections and sharps [31]. A systematic review and meta-analysis found that the effectiveness of educational interventions in improving the waste management practices of HCWs [32].
This improvement in knowledge could be attributed to the content and process of the training, and the success of the goals of the training program. Moreover, the improvement in HCWs’ attitude and practice related to COVID-19 and its IPC measures might be attributed to the knowledge gained by training.
The current study found that there are significant positive correlations between the change in knowledge, attitude and practice (all p value < 0.01). The study suggests that increased knowledge can lead to more positive attitudes and practices regarding COVID-19 among HCWs. Our results agree with results of previous studies in Egypt [14–16, 18] and Nigeria [3].
Regarding the associated factors for the change in the change in the knowledge of participants towards IPC for COVID-19, only the participants who are working in epidemiological surveillance have more significantly change in their knowledge than other occupation categories (p value = 0.031). This might be attributed to the nature of their work related to epidemiological surveillance activities with a direct focus on disease control. However, there is no significant association between the change in the knowledge, attitude and practice, and age, sex, or work experience of HCWs (p value > 0.05). The failure to reach a significant level could be attributed to the small and non-random sample of this study. Study in Egypt reported that age, job, years of experience and education were associated factors for KAP of nurses, while sex was not an associated factor [17]. Another study in Egypt showed that the associated factors for knowledge were age, education, and years of experience, while sex was not an associated factor. Age, sex, education, and years of experience were associated factors for attitude. Age and sex were associated factors for practice, while education and years of experience were not associated factors [15]. A study in Jordon showed that years of experience was associated factor for attitude and practice levels, while education was not an associated factor knowledge, practice and attitude levels [4]. Another study in Nigeria indicated that age and gender were not associated factors for knowledge [3].
This evaluation has some limitations which should be considered. First, as a result of the weakness of the net in Yemen, the post-training data was collected immediately after the training session. Therefore, the results of the practice after training might not reflect the real practices of HCWs during their work. Second, it used a non-probability sampling technique, which limits the generalization of our results. Third, timeframe of study was chosen to measure the short-term impact of the training session.
Conclusion
This evaluation concludes that the training program is effective in improving the KAP of HCWs toward IPC for COVID-19. It provides scientific evidence about the importance of training courses for HCWs during the COVID-19 pandemic. Further study to evaluate the retention of the KAP after a period of training is recommended.
Supplementary Information
Abbreviations
- COVID-19
Coronavirus disease 2019
- IPC
Infection Prevention and Control
- IQR
Interquartile range
- KAP
Knowledge, Attitude and Practice
- HCWs
Health care workers
- MoPHP
Ministry of Public Health and Population
- PPE
Personal Protective Equipment
- WHO
World Health Organization
Authors' contributions
Abdulkareem Ali Hussein Nassar was the principal author involved in the concept, design and implementation of the study, analysis and interpretation of data, and prepared the report and the manuscript. Abdulwahed Abduljabar Al Serouri was a co-author involved in the concept, study design, and the final manuscript revision. Ahmed Hamod Al-Shahethi and Khaled Abdullah Almoayed were co-authors involved in the final manuscript revision. All authors reviewed and approved the final version of the manuscript.
Funding
This evaluation was financially supported by The Task Force for Global Health. However, the authors declare that the funder had no role in the conceptualization, design, data collection, analysis, decision to publish, or preparation of the manuscript.
Data availability
All relevant data are presented in this paper, and more information can be provided upon reasonable request from the corresponding author.
Declarations
Ethics approval and consent to participate
This study was approved by the Research and Ethics Committee at MoPHP in the Republic of Yemen (Registration number: 2656- 15/03/2021). Methods were performed in accordance with the Declaration of Helsinki. The aim of the study was explained to all study participants. Informed consent was obtained from all participants. Their participation was entirely voluntary through answering question consent before starting the questionnaire. The collected information remained anonymous. Confidentiality of data was assured and ensured.
Consent for publication
Not applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Thaker SS, Thaker SB, Jadhao A, Dass R, Dhoble MA, Tiwari PN. Evaluation of effectiveness of COVID-19 training of tertiary health care workers. Int J Community Med Public Health. 2020;7(7):2635–9. 10.18203/2394-6040.ijcmph20202989. [Google Scholar]
- 2.Olum R, Chekwech G, Wekha G, Rhoda Nassozi D, Bongomin F. Coronavirus Disease-2019: knowledge, attitude, and Practices of Health Care Workers at Makerere University Teaching Hospitals, Uganda. Front Public Health April. 2020;8(181):1–9. 10.3389/fpubh.2020.00181. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Okoro J, Ekeroku A, Nweze B, et al. Attitude and preventive practices towards COVID-19 disease and the impact of awareness training on knowledge of the disease among correctional officers. Emerald Open Res. 2022;2(51):2–16. 10.35241/emeraldopenres.13839.2. [Google Scholar]
- 4.Al-Aaraj H, Alnawafleh KA, Alfarajat EM, Mohammed AT, Ghatasheh AAR. Knowledge, attitudes, and practices regarding infection Prevention towards COVID-19 pandemic among intensive clinical training nursing students at Al-Hussein Bin Talal University. Hist Med. 2023;9(1):775–82. 10.17720/2409-5834.v9.1.2023.084. [Google Scholar]
- 5.Shehu NY, Okwor T, Dooga J, Wele AM, Cihambanya L, Okonkon II, et al. Train-the-trainers intervention for national capacity building in infection prevention and control for COVID-19 in Nigeria. Heliyon. 2023;9(11):e21978. 10.1016/j.heliyon.2023.e21978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.WHO Coronavirus Disease (COVID-19) Dashboard, Data Table. Available at: https://covid19.who.int/. Accessed 2 June 2024.
- 7.Dureab F, Al-Awlaqi S, Jahn A. COVID-19 in Yemen: preparedness measures in a fragile state. Lancet Public Health. 2020;23(6). 10.1016/S2468-2667(20)30101-8. [DOI] [PMC free article] [PubMed]
- 8.Alrubaiee GG, Al-Qalah TA and Al-Aawar MS. Knowledge, attitudes, anxiety, and preventive behaviors towards COVID-19 among health care providers in Yemen: an online cross-sectional survey. Research Square. 10.21203/rs.3.rs-32387/v1. [DOI] [PMC free article] [PubMed]
- 9.Zhang M, Zhou M, Tang F, Wang Y, Nie H, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. J Hosp Infect. 2020;105(2):183–7. 10.1016/j.jhin.2020.04.012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Ye Y, Shi P, Gui Y, Li A, Huang G, et al. Point-of-care training program on COVID-19 infection prevention and control for pediatric healthcare workers: a multicenter, cross-sectional questionnaire survey in Shanghai, China. Transl Pediatr. 2021;10(1):44–53. 10.21037/tp-20-247. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Giao H, Han NTN, Khanh TV, Ngan Vk, Tam VV, Pham Le VV. Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City. Asian Pac J Trop Med. 2020;13. 10.4103/1995-7645.280396.
- 12.Tadesse DB, Gebrewahd GT, Demoz GT. Knowledge, attitude, practice and psychological response toward COVID-19 among nurses during the COVID-19 outbreak in Northern Ethiopia, 2020. New Microbes New Infect. 2020;38:100787. 10.1016/j.nmni.2020.100787. ISSN 2052-2975. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.WHO. Technical guidance for Coronavirus disease (COVID-19). Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance. Accessed 5 Jan 2021.
- 14.Saber MHA, Abdelmohsen AS, Shafik SA, El-Zayat OS. In-service training program for nurses regarding prevention and control COVID-19. IJCBS. 2023;24(6):147–56. [Google Scholar]
- 15.Miligi ES, Abdelhady MS, Atiea KM, Shaker MS. Impact of Training Program on Nurses’ Knowledge, Attitude and Practices towards Coronavirus (COVID-19) at Fayoum University Hospitals. EGYPT SYLWAN. 2021;165(3). ISI Indexed, Mar 2021. https://www.researchgate.net/profile/Khadra-Muhmmed/publication/357913471_2-Nursing_Management_and_leadership_King_Saud_bin_Abdul-Aziz_University_for_Health_Sciences_Riyadh_Kingdom_of_Saudi_Arabia_College_of_Nursing_3-King_Abdullah_International/links/61e714a19a753545e2dd6daf/2-Nursing-Management-and-leadership-King-Saud-bin-Abdul-Aziz-University-for-Health-Sciences-Riyadh-Kingdom-of-Saudi-Arabia-College-of-Nursing-3-King-Abdullah-International.pdf.
- 16.Ahmed NH, Tosson MM, Badia TS. Effect of Educational Program on Maternity nurses’ knowledge, attitude and practice of preventive measures towards COVID-19. Assiut Sci Nurs J. 2022;10(28):77–90. 10.21608/ASNJ.2022.116049.1301. [Google Scholar]
- 17.Elshenawie HAE, El Sayed H, Dabou AAR. Impact of Educational Program regarding Safety measures guidelines on nurses’ knowledge, attitude and practice toward COVID-19 patients. Egypt J Health Care. 2020;11(3):612–27. [Google Scholar]
- 18.Elasrag GAEA, Elsabagh NE, Abdelmonem AF, Ahmed AA. Impact of educational intervention on nurses’ knowledge, practice and attitude related prevention measures of COVID 19. Indian J Forensic Med Toxicol. 2021;15(3):2939–48. [Google Scholar]
- 19.Sannathimmappa MB, Nambiar V, Aravindakshan R, Muthusami J, Jacob A, Al Shafaee M. Evaluation of the effectiveness and perceived benefits of interventional structured infection prevention and control training module introduced in the undergraduate medical curricula. J Adv Med Educ Prof. 2023;11(2):120–9. 10.30476/JAMP.2023.97218.1747. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Gupta S, Goswami B, Madhu SV. Effectiveness of video-based Educational intervention on knowledge, attitude, and practice (KAP) of COVID-19 Health Care workers: lesson for future pandemic preparedness. Ann Natl Acad Med Sci (India). 2023;59(04):233–6. 10.1055/s-0043-1772218. [Google Scholar]
- 21.Rohilla R, Gupta PK, Narula H, Sharma AK, Mehta V, Rao S, Gupta J, Gupta P. Assessment of cognitive and psychomotor domains regarding biomedical waste management and hand hygiene among various categories of health–care professionals at a tertiary care center in Northern India. J Educ Health Promot. 2021;10(1):186. 10.4103/jehp.jehp_884_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Singh V, Supehia S, Gupta PK, Narula H, Sharma M, Devi K, Bhute AR. Effectiveness of video modules in infection control trainings during COVID–19 pandemic: a quasi–experimental study in tertiary care institute. J Edu Health Promot. 2021;10:183. 10.4103/jehp.jehp_1009_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23.Sharma R, Mohanty A, Singh V, Gupta PK, Jelly P, Gupta P, Rao S. Effectiveness of Video-Based Online Training for Health Care Workers to prevent COVID-19 infection: an experience at a Tertiary Care Level Institute, Uttarakhand, India. Cureus. 2021;13(5):e14785. 10.7759/cureus.14785. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Singh V, Narula H, Supehia S, Sharma M, Gupta PK, Sharma A, Rao S. Impact of video modules-based training on knowledge, attitude, and practices of cleaning and disinfection among housekeeping staff at a tertiary care center during the COVID-19 pandemic. Cureus. 2021;13(10):e19125. 10.7759/cureus.19125. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25.Kakkar SK, Bala M, Arora V. Educating nursing staff regarding infection control practices and assessing its impact on the incidence of hospital.acquired infections. J Edu Health Promot. 2021;10(1):40. 10.4103/jehp.jehp_542_20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 26.Brito-Brito PR, Fernández-Gutiérrez DÁ, Martínez-Alberto CE, Sáez-Rodríguez MJ, Núñez-Marrero J, García-Hernández AM. Use of the nursing outcomes classification (NOC) to measure perceived knowledge about the control of SARS-CoV-2 infection: the impact of a training programme in primary healthcare professionals. Int J Nurs Knowl. 2021;1–11. 10.1111/2047-3095.12356. [DOI] [PubMed]
- 27.Bohara Ak, Thapa S, Yilmaz S and McBee SH. An Impact Evaluation of COVID-19 Training Program: Knowledge and Awareness of Public Health Professionals of Province Five, Nepal. 2021. Available at: 10.37506/mlu.v21i2.2642.
- 28.Kobayashi D, Mami K, Fujishiro S, Nukanobu N, Ueno SI, et al. Online training of Covid-19 infection prevention and control for healthcare workers in psychiatric institutes. BMC Psychiatry. 2023;23(1):325. 10.1186/s12888-023-04826-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 29.Mohamed Y, Hezeri P, Kama H, Mills K, Walker S, Hau’ofa N, et al. Evaluation of an online training program on COVID-19 for Health workers in Papua New Guinea. Trop Med Infect Dis. 2023;8(327):1–18. 10.3390/tropicalmed8060327. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Teerasantipun CC, Pichetweerachai W, Pruetpongpun N, Suwannawat K, Chaiwong W, Kunanusont C. The effect of training on knowledge, perception, and practice of healthcare personnel on the use of respiratory protective equipment during COVID-19 pandemic at a private hospital in the Northern part of Thailand. Bangkok Med J. 2021;17(2):110–110. 10.31524/bkkmedj.2021.21.004. [Google Scholar]
- 31.Abdo NM, Hamza WS, Al-Fadhli MA. Effectiveness of education program on hospital waste management. Int J Workplace Health Manage. 2019;12(6):457–68. 10.1108/IJWHM-10-2018-0137. [Google Scholar]
- 32.Conti A, Viottini E, Comoretto RI, Piovan C, Martin B, Albanesi B, et al. The effectiveness of Educational interventions in improving waste management knowledge, attitudes, and practices among healthcare workers: a systematic review and meta-analysis. Sustainability. 2024;16:3513. 10.3390/su16093513. [Google Scholar]
- 33.Said AR. Knowledge and practices of nurses regarding Corona Virus (COVID-19): an Educational intervention. Medico-Legal Update. 2021;21(2):36–47. 10.37506/mlu.v21i2.2642. [Google Scholar]
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