Knowledge and Perception of COVID-19, Prevalence of Pre-Existing Conditions, and Access to Essential Resources and Health Services in Somali IDP Camps
Authors: Alawa Jude , Al-Ali Samir , Walz Lucas , Wiles Eleanor , Harle Nikhil , Abdullahi Awale Mohamed , Mohamed Deqo , Khoshnood Kaveh 
Published: August 2020

AbstractBackgroundThree million internally displaced Somalis live in overcrowded settlements with weakened infrastructure, insufficient access to WASH facilities, and inaccessible health services. This vulnerable population is especially susceptible to COVID-19, which is expected to have worsened health outcomes and exacerbate existing structural challenges in the implementation of public health measures. This study examines knowledge of COVID-19, self-reported prevalence of preexisting conditions, and access to essential health services among residents of internally displaced persons (IDP) camps in Somalia.MethodsA descriptive, cross-sectional survey design assessing demographics, current health profiles, knowledge and perceptions of COVID-19, and access to resources was used. 401 Somali IDP camp residents completed the survey.ResultsThough 77% of respondents reported taking at least one COVID-19 preventative public health measure, respondents reported a severe lack of access to adequate sanitation, an inability to practice social distancing, and nearly universal inability to receive a COVID-19 screening exam. Questions assessing knowledge surrounding COVID-19 prevention and treatment yielded answers of “I don’t know” for roughly 50% of responses. The majority were not familiar with basic information about the virus or confident that they could receive medical services if infected. Those who perceived their health status to be “fair,” as opposed to “good,” showed 5.69 times higher odds of being concerned about contracting COVID-19. Respondents who felt more anxious or nervous and those who introduced one behavioral change to protect against COVID-19 transmission showed 10.16 and 5.20 times increased odds of being concerned about disease contraction, respectively.ConclusionThis study highlights immense gaps in the knowledge and perceptions of COVID-19 and access to treatment and preventative services among individuals living in Somali IDP camps. A massive influx of additional resources is required to adequately address COVID-19 in Somalia, starting with educating those individuals most vulnerable to infection.What is already known?There are no studies to date examining COVID-19 symptoms, as well as attitudes and perceptions, in Somali IDP camps.Investigations performed in other camp-like humanitarian settings have demonstrated high prevalence of COVID-19 symptoms.What are the new findings?People living in Somali IDP camps are generally unfamiliar with basic COVID-19 information, such as the possibility of transmission by asymptomatic individuals.A majority of respondents displayed at least one symptom consistent with COVID-19, and the vast majority were unable to access COVID-19 screening services.Older age, having implemented one behavioral change to protect against contraction, new stress or anxiety, and a “fair” health perception were significant predictors of being concerned about contracting COVID-19.What do the new findings imply?There is a significant gap in the knowledge and perception of COVID-19 by those in Somali IDP camps.Utilizing trusted sources of information may be an effective way of disseminating COVID-19 related information among Somali IDP camp residents.