Knowledge, attitudes and practices of COVID-19 among income-poor households in the Philippines: A cross-sectional study

Introduction

The presence of the COVID-19 pandemic in low- and middle income countries (LMICs) is raising important concerns about the preparedness of health systems within these countries to address the disease as it continues to spread. With health care facilities that were already overburdened before the pandemic, it is becoming increasingly clear that adopting the measures employed by high income countries in LMICs  may not be feasible. Current recommendations focus heavily on hospital-based interventions, but in the context of severe resource limitations, addressing shortages of hospital beds, oxygen, ventilators and personal protective equipment as primary response initiatives may not be realistic. Moreover, there is a need within LMICs to provide emergency support to vulnerable populations, including individuals and households experiencing poverty.

There are also concerns around misinformation that may impede public health responses. As the WHO Director-General Dr Tedros Adhanom Ghebreyesus said, “we’re not just fighting an epidemic; we’re fighting an infodemic”. The reach of the pandemic on a global scale has led to a flood of information surrounding the virus, and despite the merits of rapid information dissemination through mass and social media for public health action, misinformation can also easily be propagated through the same channels. Both exaggerated and understated pandemic estimates can either fuel panic or a false sense of security among the general public.

Additionally, confusion surrounding basic information on how to reduce transmission and exposure to the virus puts people at risk of infection. In the context of LMICs, households in resource-poor settings might not have access to regular and reliable sources of information about disease etiology, leaving them ill-equipped to minimize the risk of infection during emerging out- breaks. Understanding public perceptions and their responses to COVID-19 is therefore critical in the ongoing planning and implementation of effective pandemic responses in LMICs, particularly by evaluating current public health messaging and communication strategies.