Difficulties encountered by the Public Health Inspectors in the Northern Province during the COVID-19 pandemic

Abstract

Background and objective: The COVID-19 pandemic has significantly impacted northern Sri Lankan public health inspectors (PHI), causing challenges in preventive measures, surveillance, and case management. This study evaluated the difficulties faced by PHIs in the Northern Province during the COVID-19 pandemic, including psychological distress, resource availability, communication issues, and the association of these difficulties with sociodemographic and work-related factors. Methods: A descriptive cross-sectional study involving 98 active PHIs in the Northern Province was conducted. A self-administered online questionnaire was used to collect data on sociodemographic characteristics, psychological distress (DASS–21), resource availability, as well as communication and coordination challenges. Means, standard deviation, or the median and range were used to summarize numerical data. Frequencies and proportions were used to summarize categorical data. Results: In the sample, 52.6% were aged <35 years (mean 35.8, SD 7.7); 74.5% were married, 51% had children, and were predominantly Tamil (82.7%). With respect to work, 64.9% had <10 years’ experience; 92.9% were area PHIs; and 54.1% worked in their own residential area. Almost all (99.7%) reported not having any preexisting psychological problems. However, a considerable proportion reported experiencing psychological distress; 26.3% and 17.9% recorded moderate and severe stress, respectively; 24.5% and 26.6% recorded moderate and severe anxiety, respectively; and 26.3% and 16.8% recorded moderate and 16.8% severe depression, respectively. Apart from gloves (56.7%) and face shields (57.1%), <50% of PHIs reported availability of KN95 mask, gowns, goggles, shoe covers, and head covers all the time. Other than vehicle permits, <50% reported the availability of supporting staff, transport facilities, vehicle fuel facility, support and guidance from supervisors, and having the necessary training for the job, all the time. In terms of communication, while almost a quarter (24.5%) stated they had difficulty getting help from the municipal councils all the time, the following challenges were reported to have been experienced sometimes: low public awareness (40.2%), difficulty in approaching people (25.8%), and lack of support from hospital staff (36.7%). Conclusion and recommendations: The study highlights the difficulties faced by PHIs in the Northern Province during the COVID-19 pandemic. Interventions to promote mental health among PHI could include providing psychological support, ensuring resources, and enhancing healthcare system communication and coordination.