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Knowledge, Attitudes and Practices (KAP) Assessment on COVID-19 - Community Based Migration Programme, September 2020 [EN/TR]

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Türkiye
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IFRC
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Executive Summary

To understand communities’ knowledge, attitudes and practices (KAP), along with their information needs on COVID-19, this KAP assessment was conducted by the Turkish Red Crescent Society (TRCS), with support from IFRC, under the Community Based Migration Programme (CBMP) from 20 July to 12 August 2020. The assessment has been conducted via TRCS’ social media platforms, phone interviews and online consultations/focus group discussions (FGDs) with refugees and local people in 16 TRCS Community Centre locations. Comprising both qualitative and quantitative data, a total of 3,840 individuals have been interviewed over the phone in 16 Community Centre locations, with a total of 320 refugees and local people participating in 32 FGDs. The findings of the assessment are intended to inform understanding of community perceptions of, and knowledge about, COVID-19 and, in turn, shape risk communication, behaviour change and community engagement activities.
Although the KAP survey questionnaire was posted in TRCS social media, the total number of responses submitted was too low to consider the analysis meaningful and the findings statistically significant and therefore was not used in the analysis for this assessment. This report presents the survey results of the phone interviews and the outcome of the FGDs in 16 Community Centre locations.
Findings show that community members in all locations are well aware (96.5%) of the COVID-19 outbreak, including the symptoms of the infection, how it spreads, and how to reduce the risks of becoming infected. This indicates a high exposure to information related to this topic.
The most popular sources of information about COVID-19 were TV (66.4%), followed by government officials (38.7%),
Facebook (34.8%), health workers (31.4%), websites (23.8%) and family and friends (43.3%). Other sources mentioned were social media channels including that of TRCS and its website, TRCS staff and volunteers, Ministry of Health, doctors, mosques, newspaper, radio and NGOs. While the use of Facebook (24.5%) and WhatsApp (11.1%) is slightly higher among refugees, TV is more accessible by people from host communities (35.8%) as TV shows are mostly in Turkish and there is no language barrier for them. The majority (95.6%) of respondents reported that they did not encounter any challenges in receiving information about COVID-19. However, refugees identified language as one the of the key barriers and other challenges, such as, being unable to afford internet, or being unable to read or write in Arabic, which prevented people from accessing written information.
Communities’ most trusted sources of information are Government officials (46.9%), TV (44.3%), health workers (34.8%) and doctors (22.3%). Other channels include Facebook, family and friends, community leaders, Muhtars, websites, Ministry of Health, TRCS, World Health Organisation (WHO) and NGOs. In many locations, religious leaders are identified as one of the most trusted channels through which to receive information. Live sessions on TRCS Facebook or other social media channels featuring doctors or physicians are suggested to talk about COVID-19, raise awareness, and answer questions from the audience.
A majority of the respondents identified older people (85.8%) and people with chronic disease (74.1%) as being at the highest risk of COVID-19 infection. Others considered pregnant women, health workers or people working in factories and public areas, those using public transport, and people who do not follow the preventive measures as also being particularly at risk of COVID-19 infection. Although young people and children were recognised as being at relatively low risk, it was understood that they can be carriers of the disease.
There are various rumours spreading within the community both among refugees and local people about COVID-19. These rumours are spread mostly via word-of-mouth and social media. Misperceptions and rumours in a community can create social tension or lead to the practising of harmful behaviours and should be responded to by swiftly providing communities with the right information.
A majority of the survey respondents view COVID-19 as very dangerous (84.0%). Some respondents said that a minority of people in their community believed COVID-19 was a political problem or that it did not really exist.
When asked if a person who is infected or has recovered from COVID-19 is faced with discrimination, 21.7% of the host population answered “Yes” compared to 8.7% of the refugee respondents. This indicates that stigmatisation on COVID-19 is higher amongst the host population than in refugee communities. Among those (1,548 respondents) who are faced with discrimination are people who are or have been infected (60.1%) as well as those suspected of having COVID-19 (55.2%).
Two-thirds (67.1%) of the respondents are worried that they might become infected with COVID-19. Among other responses, the fear of losing employment (9%) or having lost employment (9.1%), paying rents/bills (9.4%), or being unable to afford food for the household (6.4%) or hygiene products (3.9%) was slightly higher among refugees than local people. These concerns are also higher for men compared to women.
Almost all - 94.3% - of survey respondents are taking some measures in their daily life to prevent the risk of COVID-19 infection, including frequently washing hands with soap, practicing personal hygiene, staying indoors and avoiding going out unless necessary, sterilizing surfaces and cleaning homes with disinfectant, using masks, and maintaining physical distance whenever outside. Those who said they were not taking any measures (64 respondents) highlight various reasons, including not knowing how to take preventive measures (50%), not believing these practices will prevent the risk (20.3%), and being unable to afford soap or disinfectants (14.1%).
Despite the high levels of awareness, community members in many locations now are becoming less inclined to follow the preventive measures compared to the early stages of the outbreak. Some believe that healthier people will not be infected and cannot spread the disease, while a few thinks that COVID-19 does not really exist. People find discomfort wearing masks in the hot weather or are not wearing the masks appropriately. After months of social isolation and staying indoors, more people are now beginning to go out to public places without heeding physical distancing or wearing masks. As people begin to attend their workplaces again, there is a growing need to encourage and motivate people to maintain safety and cleanliness measures at their places of employment.
Although around 55% of the respondents reported not needing any additional information on COVID-19, the remaining 45% requested information on various topics relating to COVID-19. While communities may have information about preventive measures, awareness raising activities need to be reinforced to inform people how to protect themselves in this post-lockdown1 situation. Information materials for children and young people, should be further developed to help them understand the risks and the necessary measures to avoid infection. Online trainings/seminars on COVID-19 and hygiene promotion are suggested to encourage community members, children and young people to practice healthy behaviours.
Well over half of respondents said they preferred to receive information from TRCS by phone (58.6%), followed by SMS (29.6%), TRCS Facebook (23.8%), and WhatsApp (20.3%). Turkish (59.6%) and Arabic (51.1%) were the main preferred languages, with English, Farsi, and Kurdish also reported, but in much lower numbers.
While a good percentage of refugee respondents reported following TRCS social media channels, most of the respondents from the local community were not aware about these platforms, or the TRCS website, or that these channels were a source of COVID-19 information. Of all respondents following TRCS social media (1,752 respondents), refugees are more likely to visit the TRCS Facebook and Community Centre Facebook pages (62.1%) than the local people (25.6%). For the host population, TRCS Instagram and Twitter, both the general and Community Centre accounts, were more popular, with more than half (52.4%) of host-community respondents reporting visiting them, compared to less than a third (28.3%) of refugees.
Around 72.4% of respondents said they would prefer to contact TRCS by phone to ask questions or share feedback.
Respondents also said they preferred face-to-face interaction by visiting TRCS Community Centres or meeting staff/ volunteers in person. Online meetings via Zoom/Skype were recognised as useful to ask questions and share key concerns from their community. It is suggested that TRCS conduct more surveys, similar to this KAP assessment in which communities can participate to discuss their situation and concerns about COVID-19.
Under the current situation, many people have lost employment. At the same time, the need for masks, hygiene kits, food parcels and psychosocial support (PSS) in the community is growing. Relevant services including mental health support are increasingly requested from TRCS to help communities respond to the COVID-19 outbreak. While this assessment shows there is a broad foundation of understanding of the direct risks posed by the virus and the steps to prevent its spread, there is a growing need to respond to its knock-on impacts, and to ensure organisations, and the information and services they provide, remain agile in responding to the swiftly changing situation.