[version 1; peer review: awaiting peer review]
No competing interests were disclosed.
With the outbreak of the COVID-19 pandemic, the world was forced to reinvent itself to prevent and mitigate the spread of this disease (
The attitudes and practices regarding COVID-19 preventive measures in diverse settings of Mozambique: a qualitative study paper uses a subset of qualitative data from a mixed-method study collecting data through structured questionnaires, semi-structured interviews, non-participant observations and informal conversations. Two data collection techniques - the Rapid Ethnographic Methods and Rapid Rural Assessment – were applied (
We recruited 295 participants from 24 sites in nine provinces in Mozambique. In-person semi-structured interviews (SSIs) were conducted with 23 participants, and the remaining 272 SSIs were conducted by telephone. Final study data was comprised of 159 females and 136 males aged 18-98 years old (median [interquartile range] = 35 [29-43]). Of note, data regarding declines and drop-outs were not collected (or registered) during data collection.
The selection of study sites followed two steps. Primarily, during the first two days (17 th and 18 th of May 2020), data was collected in 6 sites (i.e., Manhiça and Mopeia districts, and Maputo, Matola, Xai-Xai and Quelimane cities) because Manhiça Health Research Center (CISM, Centro de Investigação em Saúde de Manhiça) has its offices and are places of residence of the research team members, and thus their constant presence and easy access to local communities. Secondly, and after an initial evaluation and preliminary data analysis, an additional 20 sites (i.e., Pemba, Moeda, Nampula, Nicoadala, Mocuba, Chinde, Ile, Morrumbala, Beira, Chimoio, Maxixe, Chonguene, Inhambane, Morrumbene, Jangamo, Limpopo, Mabalane, Chokwe, Boane, Magude) were included, and thus increasing the coverage of study area which includes cities and districts where the CISM office is not present thanks to the nature of the data collection approach (i.e., the use of the telephone for conducting the interviews). The second step lasted ten days, from 19 th to 28 th of May 2020. Telephone-based interviews allowed us to reduce the decline rate by including participants who are already in the network of each study team member and ensuring safety to COVID-19 thanks to the distance when conducting interview over telephone.
The qualitative data was collected using a semi-structured interview tool guide consisting of open-ended questions focused on ‘changes’ on participants’ routine dynamic soon after the declaration of the state of emergency in the country. The questions also sought to explore knowledge, attitudes, practices and adoption concerning COVID preventive measures in different contexts (e.g., at home and in public places).
The quantitative data were collected through a standardized structured questionnaire with close-ended questions including participants’ sociodemographic (i.e., age, gender, education level, occupation, marital status and his/her relationship with the head of the household) and household characteristics including place of residence, size of the household (e.g., number of household members and number of sleeping rooms).
The present research was conducted by a multidisciplinary team (including biologists, geographers, anthropologists, sociologist, epidemiologists and public health specialists) with a minimum of two years working experience, who aimed to draw a general picture of COVID-19 response behaviours at community level. The study team was composed of 34 researchers including one senior investigator as a Principal Investigator, one PhD candidate, seven junior investigators, 24 research assistants, and one data manager, each aiming at conducting 10 interviews. Of those, 47% (16/34) were females living at the communities where the study took place or being closer to participants through various type of networking.
Participants were selected based on their closeness or kinship with the team member. First, each team member selected potential participants on his/her electronic phonebook. Second, potential participants were phone contacted and asked for an interview which was either scheduled for an in-person meeting (face-to-face interview) or a virtual, telephone-based, meeting interview. After obtaining oral consent, the interview was scheduled and conducted at the date, time and place of participants’ convenience. Socio-demographic characteristics of the participants and other quantitative data were collected before the open-ended interview lasting 45 to 60 minutes. While quantitative data were hand registered into a standardized form, interviews were audio-recorded using a digital voice recorder (Olympus WS-852 and WS-853, Olympus Imaging America INC., New York, USA). Additionally, summaries of the participants’ responses were directly hand registered in the qualitative tool guide.
The study targeted different age groups aged 18 years old and above including young people (18-29 years old), adults (30-49 years old), and the elderly (50 years and older). Only participants who were close or with some degree of affinity and trust with at least one member of the research team, willing to participate and able to give his/her oral consent were included in the study.
We excluded participants who were unable to give oral consent or were not able to complete the interview for personal reasons or due to failures in the connection and discharge of the mobile phone battery.
Quantitative data was entered into a data charting form in MS Excel (Microsoft Excel 2010, Microsoft Corp.; Redmond, WA, USA) accommodating all collected variables. Qualitative data were entered into an MS Excel matrix based on the main response (i.e., concise summary of answers for each question).
This study was ethically evaluated and approved, on 16
th May 2020, by the
The collection of data about ‘education level’ and ‘occupation’ resulted in a high number of categories (i.e., >10 responses) due to inconsistency of participants’ responses. Thus, some categories were merged based on their similarities (e.g., retired and unemployed) or lower response rates under a variable named ‘others’.
This study has some significant limitations that may have influenced the reliability of the data. Such limitations invite a cautious interpretation and guide lessons learned for future studies. Telephone-based interviews introduced several challenges including poor listening, cancellation of some interviews because of audio quality and cell phone discharge during the interview. In addition, some participants could not finish the telephone interviews claiming it to be a lengthier interview than expected or to be involved in other activities. Although participants were conveniently selected, similar to what happens in other qualitative studies (
Therefore, other studies using a similar methodology should take into account the triangulation of data originated by different data collection techniques; this can ensure the validity of the data, as the limitations of one technique will be reinforced by the strengths of the other techniques.
Open Science Framework: Dataset for the attitudes and practices regarding COVID-19 preventive measure in diverse settings of Mozambique: a qualitative study,
This project contains the following underlying data:
SOCIO DEMOGRAFICOS _ DATABASE_MASTER_COVID SOND_MOZ_CSV.csv This dataset file contains the sociodemographic data of all interviewed participants. There are 76 variables, including 14 original (i.e., from the interview guide) and 62 inputted variables. Of note, some inputted variables may be duplicated during imputation process. TELENTREVISTAS- SSI_ COVID SOND_MOZ_CSV.csv This file contains qualitative data from SSIs of 295 participants, which are concise summaries of responses of 17 main open-ended questions. It also includes responses of uncounted follow up questions raised based on the responses of main question during the interview.
Open Science Framework: Dataset for the attitudes and practices regarding COVID-19 preventive measure in diverse settings of Mozambique: a qualitative study,
Anexo 5_Data record sheet of informal conversations on the public place (quantitative questionnaire) Anexo 7_COVIDSOND_Interview Guide (qualitative interview guide)
Data are available under the terms of the
We would like to thank the study team members who dedicated themselves to the study design, training the interviewers, and everyone who dedicated themselves to collecting data on all sites covered by the study. We would also like to thank all study participants who took the time to answer the interviewers’ questions. We also acknowledge the support of Centro de Investigação em Saúde da Manhiça, which is supported by the Government of Mozambique and the Spanish Agency for International Development (AECID).