July, 2020UNICEF Yemen

Yemen –Rapid Assessment of Knowledge, Attitudes and Practices related to COVID19 – Round 2

Objectives Monitor knowledge, attitudes and practice levels

related to COVID-19 in Yemen, with focus on:

Knowledge of COVID-19 symptoms, transmission

and prevention.

Sources of information.

Risk Perception.

Information gap of respondents.

Stigma due to COVID-19.

Track shifts in practicing COVID-19 preventive

measures.

Assess the impact of interventions and address gaps.

Methodology Assessment was administered by partners

through phone (in the south) or face to face interviews (in the north).

Conducted during the first three weeks of July, 2020 in 22 governorates.

1312 respondents were interviewed for the quantitative assessment and 209 respondents for the qualitative assessment.

The responses were collected and uploaded through an online tool (Kobo toolbox) for analysis in UNICEF-C4D

Demographics

12%11%

9%9%

6%6% 6% 5% 5% 5%

4%3% 3%

2% 2% 2% 2% 2%2% 2% 1%

0.3%

Aman

at A

l Asi

mah

Al H

uday

dah

Ibb

Taiz

z

Dham

ar

Lahj

Sana

'a

Hajja

h

Aden

Abya

n

Sa'a

da

Amra

n

Al M

ahar

ah

Al D

hale

'e

Shab

wah

Al B

ayda

Hadr

amau

t

Al Ja

wf

Al M

ahw

it

soco

tra

Raym

ah

Mar

ib

Governorates

Demographics

43%

25%

13%9% 8%

3%

College Degree Secondary Read and Write Basic Can't read andwrite.

Master or Ph.D.

Education level

18% 17%15% 15%

10% 9% 8% 7%

Housewife Office oradministrative

Educational Student Unemployed other Agricultural handicraft

Occupation

Female39%

Male61%

Sex

Knowledge about COVID-19

No3%

Yes97%

Have you ever heard of coronavirus disease?

86%

6% 4% 3% 1%

It’s a virus that can cause a

disease

It’s a TV/radio campaign

other I don’t know anything

It’s a government’s programme

What do you know about coronavirus?

Knowledge about COVID-19

5%

28%

32%

35%

No information/ notavailable

Very informative

Somewhat informative

Informative

The information you received about how to prepare for the outbreak

3%

29%

32%

36%

No information/ notavailable

Very informative

Somewhat informative

Informative

The information you received about the spread of the epidemic

10%

16%

22%

23%

29%

Can’t say

No confidence

Total confidence

Little confidence

Confident

Your trust in official information about coronavirus disease epidemic from the

authorities

23%

24%

25%

28%

Excellent

Need improvement

Very good

Good

Your knowledge about how to protect yourself from getting sick

79% 78%

67%

43%37%

Symptoms ofcoronavirus

How to protectyourself from

the disease

How it istransmitted

What to do ifyou have

symptoms

Risks andcomplications

What kind of information have you received about the disease?

Sources of Information on COVID-19

3%

5%

8%

10%

14%

19%

16%

17%

18%

16%

16%

32%

4%

6%

9%

9%

10%

6%

9%

6%

9%

11%

13%

19%

4%

7%

6%

6%

5%

6%

5%

6%

9%

7%

9%

10%

4%

Midwifes or traditional healers

Any person from the community

Community leaders (sheikh, etc.)

Friends

Family members

Health unit/Health care worker

Radio

Community health workers

Relgious Leaders

Volunteers of UNICEF or any other…

WhatsApp

Social Media other than WhatsApp

TV

Which channel/who do you trust the most to receive information related to coronavirus from?

First mention Second mention Third mention3%

8%

11%

23%

25%

27%

30%

32%

33%

37%

56%

58%

67%

Traditional midwives or traditional healers

A person from the community

Community leaders

Health unit/Health care worker

Relgious Leaders

Community health workers

Radio

Volunteers of UNICEF or any other…

Family members

Friends

Social Media other than WhatsApp

WhatsApp

TV

Where did you hear about coronavirus? What are channels or sources?

Some respondents pointed out that WhatsApp and Social media are easily accessible all the time and do not require so much electricity or high internet speed. Some mentioned Radio as the only source available for them.

Some respondents mentioned posts on social media from Doctors or Health Workers as well as official pages and pages of international agencies.

Risk Perception

46%43%

10%

1%

Very dangerous More or lessdangerous

Is not dangerous other

How dangerous do you think coronavirus risk is?

Yes51%

I do not know32%

No16%

Do you think you are likely to become sick with coronavirus?

Risk Perception

4%

5%

9%

10%

20%

20%

31%

other

Only foreigners get Corona

I keep clean

I am young

There is no coronavirus in Yemen

I have a strong immunity.

I practice preventive measures

(If No) Why do you think you are not likely to get coronavirus?

72%

64%

56%

22%16%

11%7% 4%

Elderly People withunderlyingconditions

Healthworkers

Pregnantwomen

Childrenunder theage of five

Adults Youth Adolescentsup to the age

of 15

Who do you think is most likely to be infected with coronavirus?

Many respondents said they will not get infected because they trust in God. Others mentioned that they already got infected and recovered.

* Out of the total respondents who said No

*

Many respondents mentioned people with weak immunity. Other responses included foreigners, travelers, people who are psychologically fragile, people who are afraid from the infection or those who do not trust God.

Prevention Knowledge and Practices

1%6%6%10%13%

50%

61%64%67%

81%

3%7%11%17%

55%

71%70%71%

87%

Don't know Eliminate standingwater

Nothing Cook meat andeggs well

Avoid unprotecteddirect contact with

live animals andsurfaces in contact

with animals.

Stop going tosocial gatherings

Avoid closecontact with

anyone who has afever and cough

Wearing face maskwhen out of the

house

Covering mouthand nose when

coughing orsneezing

Washing handsregularly usingalcohol-based

cleaner or soap /water

What have you and your family done to prevent becoming sick with coronavirus?

How can you prevent coronavirus disease?

Some mentioned trust in God as a preventive measure

Prevention Practices

2%

4%

5%

23%

27%

48%

54%

73%

Called the Rapid ResponseTeam/Ambulance

Attempted to call the hotline or 195for help

Been asked to quarantine at home

Stayed away from the mosque

Isolated yourself voluntarily

Avoided social gatherings likeweddings, funerals, parties

Practiced social/physical distancing

Covered your face or worn a maskwhen outside your home

Have you done any of the following in response to Corona Virus?

9%9%14%16%

58%

No one has toldyou to practicesocial/physical

distancing

Don’t want to miss certain social events/gatherings

Not convinced ofthe effectiveness

of these measures

Need to care forothers outside

your home(elderly parents).

Need to earn anincome

Which of the following prevented you from physical distancing from people outside your household

Preventive Measures in the Community

No, 4%

I do not know, 9%

Yes, 86%

Do you consider it important to take action to prevent the spread of coronavirus in your

community?

6%

10%

15%

31%

38%

Excellent

Can’t say

Good

Need improvement

Not at all appropriate

How appropriate are the current measures in your community to control coronavirus?

Some respondents said the measures are relatively appropriate given the situation in the country

Responding to COVID-19 Infection

4%

7%

23%

24%

25%

51%

I will look for the traditional healer

I will go to the neighborhood nurse

I will buy medicines at the market

I will look for a more experienced relative to advise meon what to do

I will go to the hospital / health unit

I would stay in self-isolation

What will you do if you or someone from your family has symptoms of this coronavirus disease?

No66%

Yes31%

other3%

Have you or anyone you know shown signs of coronavirus?

Some respondents said they will use herbs, vegetables, citrus that boost immunity. Others said they will do nothing, while some mentioned waiting for God will

Trust in Health Services

No78%

Yes22%

When coronavirus symptoms shown, Did you or the person go to the hospital or

any health facility?

8%

11%

12%

27%

44%

45%

The health facility is far

I do not have the money/They charge too much

I heard that HFs are full.

They cannot treat corona in the HF.

I fear to get infection.

The symptoms were mild

If no, why did you not go to the health facility?

* Out of the total respondents who said No

*

Many respondents referred to the rumor about giving patients a lethal injection in hospitals (Injection of Mercy), others mentioned lack of care in hospitals.

Trust in Health Services

11%

11%

18%

29%

31%

Can’t say

Total confidence

Confident

Little confidence

No confidence

Pleae rate the ability of the health services in your community to deal with the epidemic

8%

16%

24%

24%

28%

Can’t say

No confidence

Little confidence

Total confidence

Confident

Please rate your own ability to protect yourself from the epidemic

Respondents Information Needs

27%27%31%

37%40%

49%

Symptoms ofthe new

coronavirusdisease

Most at riskgroups

How it istransmitted

How toprotect

yourself fromthe disease?

What to do ifyou have the

symptoms

How to treatit

What more would you like to know about the disease? Information needs identified included• Transparent information about the spread of

the disease in Yemen.• The real numbers of COVID-19 infections and

deaths in Yemen.• How to treat the disease using stuff found in

homes?• How to boost immunity against the disease• Can the virus be transmitted through

recovered people?• Long term complications caused by the virus.• When will coronavirus disappear from

Yemen?• When will life go back to normal?• Vaccines or medicines for the disease.• How to protect people who are not able to

practice preventive measures?

Stigma Due to COVID-19

No81%

Yes19%

Do you think the coronavirus disease is generating stigma against specific people?

36%37%

51%

IDPsMarginalized(Mohamasheen)

Foreigners

(If yes) Which group is being dis-criminated against in your community because of coronavirus?

* Out of the total respondents who said Yes

*

Stigma Due to COVID-19

No29%

Yes71%

Would you personally interact with someone who has recovered from

coronavirus?

5%13%

31%86%

My neighbors will frown at meIt is a disease of dirty people

Corona is a bad diseaseI don’t want to catch the disease

(If no) Why not?

3%

12%

41%

44%

Strongly agree

Agree

Disagree

Strongly disagree

I get infected, I will be ashamed to tell anyone in my community

3%

15%

40%

42%

Strongly agree

Agree

Disagree

Strongly disagree

if I get infected, I will be afraid to tell anyone in my community

* Out of the total respondents who said No

*

How much you agree or not with these statements

Sources of Information on Other Diseases

62%

55% 54%

34% 32% 30% 30%27% 26%

22%

11% 9%3%

TV Social Mediaother thanWhatsApp(Facebook,

Twitter,Telegram,

etc.)

WhatsApp Volunteers ofUNICEF or any

otherorganization

Friends Communityhealth

workers

Familymembers

RelgiousLeaders

Radio Healthunit/Healthcare worker

Communityleaders

A personfrom the

community

Traditionalmidwives ortraditional

healers

From where/who do you usually receive information on other diseases?

Trend Analysis: Knowledge about the Virus

83%

97%

Heard about coronavírus

Round 1

Round 2

85%90%

Know it is a virus that can cause disease

Round 1

Round 2

* Out of the total respondents who heard about the virus

**

Trend Analysis: Information Received

75%70% 68%

49%44%

78%

67%

79%

43%37%

How to protect yourself fromthe disease?

How it is transmitted Symptoms What to do if you have thesymptoms

Risks and complications

Information received about the disease Round1

Round2

Trend Analysis: Knowledge of Transmission

79%

66%

41% 43%

25%

14% 12% 12%

4% 2% 4%

84%

60%

50%

40%

12% 12%9% 7% 5% 4% 2%

Direct contactwith infected

people.

Touchingcontaminated

objects/surfaces

Droplets frominfected people

Airborne Contact withcontaminated

animals

Eatingcontamined food

Drinking uncleanwater

Sexualintercourse

contact

Blood transfusion Mosquito bites Don't know

How does coronavirus spread? Round1

Round2

Trend Analysis: Risk Perception

90.5% 90%

14% 16%

38%

51%

Do Not believe they are likely to become sick with coronavirus

Believe that coronavirus is very dangerous or somehow dangerous

Believe they are likely to become sick with coronavirus

Trend Analysis: Knowledge of Symptoms and Prevention Practices

61%59%

Knowledge of Symptoms Index

56%

66%

Prevention Practices Index

Trend Analysis: Responding to COVID-19 Infection

64%

49%

15%

4% 2% 1%

25%

51%

24%

7%

23%

4%

I will go to the hospital /health unit

I would stay in quarantine I will look for a moreexperienced relative to

advise me on what to do

I will go to the neighborhoodnurse

I will buy medicines at themarket

I will look for the traditionalhealer

What will you do if you or someone from your family has symptoms of this coronavirus disease?Round1

Round2

Summary and Key Points Knowledge on COVID-19 generally improved compared to round 1.

Top 3 main sources of information remain TV, WhatsApp, Social Media

Most trusted sources are TV, Social Media, WhatsApp, volunteers, health workers.

Percentage of respondents who would go to health facilities if COVID-19 symptoms shown has significantly decreased from round 1.

Only 29% of the respondents were confident of the ability of the health services in their communities to deal with the epidemic, while only 21% think the measures in their communities to control the disease are appropriate.

Percentage of respondents who think they will likely to be infected with the virus has increased.

Gap between respondents knowledge and practice of COVID-19 preventive measures.

Majority of the respondents would not be ashamed or afraid to tell anyone from their communities if they got infected with the virus.

Implications for RCCE Response and Way Forward Study factors for non-use of health services and motivations for adoption of prevention

practices. Further analysis of the assessment to identify governorate and district level gaps. Address identified areas of concern Facilitate partner and key stakeholder engagement on assessment findings. Review/revise messages and interventions in districts with significant knowledge gaps

or poor adoption of preventive measures. Continue mass and social media engagement – (TV, social media, WhatsApp etc.) Scale-up interventions to promote Home-based care; continuity of services and

prevention of self-medication Support community and household level behaviour adoption (production and

distribution of reusable cotton masks; handwashing soap by Field Offices. Empower CVs (with aids – face masks, soap, sanitizer to continue interpersonal

communication actions) Continue work on Shielding