Nurses’ and Midwives’ Lived Experiences of Care Provision in Designated Healthcare Facilities for COVID- 19 Clients in Rural and Urban Settings of Tanzania
Authors: Isangula Kahabi , Kisaka Lucy , Mwasha Loveluck 
Published: July 2024

Abstract

Background
Evidence suggests that frontline health care providers (HCPs) are at higher risk of contracting the COVID-19 infection, creating fear and concerns over their safety and well-being. Nurses and midwives are likely to be the most affected because they constitute the largest proportion of the health workforce and have more patient contact hours. However, studies focusing on the perspective of the HCPs, specifically nurses on the frontlines fighting against COVID-9, are limited in Tanzania and other low-income countries.
Objective
This study explored the lived experiences of nurses and midwives providing care in COVID-19-designated healthcare facilities in selected regions of Tanzania.
Methods
A qualitative descriptive phenomenological approach was employed to explore the lived experiences of nurses in the context of COVID-19 care provision. In-depth interviews were conducted with 20 purposefully selected nurses and midwives in Dar es Salaam, Shinyanga, and Pwani Regions. The data were managed using NVIVO 12 and analyzed thematically.
Results
Nurses and midwives in urban areas described caring for more clients and experiencing more deaths than those in rural areas. However, they both demonstrated commendable awareness of the origin, signs, symptoms, management, and preventive measures. Nurses and midwives were selected to work in a COVID-19 care facility based on the criteria set by the Ministry of Health, including being a leader and having work experience in emergency care. They were involved in patient isolation, offering routine and specialized care, providing psychological support, health education, and post-mortem care. However, there was a consensus that they were inadequately prepared to care for COVID-19 patients due to a lack of specific training, insufficient personal protective equipment, medical supplies, and equipment. Additionally, they were not provided with risk allowances. Memorable events in COVID-19 care facilities include stigmatization and abandonment of patients by family members, witnessing helpless deaths amidst limited resources such as oxygen concentrators, burnout, and exhaustion, and being personally infected by COVID-19. Suggestions for preparing for future pandemics and disasters include strengthening health systems in terms of medical, financial, and human resources and emergency response teams, building the capacity of nurses and midwives through continued training and risk allowance, and continuing community education and sensitization.
Conclusion
Nurses and midwives who worked in COVID-19 designated care centers appear to have been weakly prepared to offer such care. Health system challenges such as human, medical, and financial resources, inadequate training, and fears among community members negatively impacted nurses’ and midwives’ ability to offer effective care to COVID-19 clients. There is a need to improve the preparedness of the health sector, HCPs, and community members to ensure an effective response to future pandemics and disasters.