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. 2023 Jul 17;18(7):e0288465.
doi: 10.1371/journal.pone.0288465. eCollection 2023.

Availability and use of personal protective equipment in low- and middle-income countries during the COVID-19 pandemic

Salomé Henriette Paulette Drouard  1 , Tashrik Ahmed  2 , Pablo Amor Fernandez  1 , Prativa Baral  2 , Michael Peters  2 , Peter Hansen  2 , Tawab Hashemi  2 , Isidore Sieleunou  2 , Munirat Iyabode Ogunlayi  2 , Alain-Desire Karibwami  2 , Julie Ruel Bergeron  2 , Edwin Eduardo Montufar Velarde  3 , Mohamed Lamine Yansane  4 , Chea Sanford Wesseh  5 , Charles Mwansambo  6 , Charles Nzelu  7 , Helal Uddin  8 , Mahamadi Tassembedo  9 , Gil Shapira  1
Affiliations

Availability and use of personal protective equipment in low- and middle-income countries during the COVID-19 pandemic

Salomé Henriette Paulette Drouard et al. PLoS One. .

Abstract

Background: Availability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs.

Methods: Data were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE.

Results: There were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not.

Conclusion: After more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

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Conflict of interest statement

The authors declare no competing interest.

Figures

Fig 1
Fig 1. Availability at the HF level and to all HCWs for each piece of PPE by country.
The gap in availability is shown by the distance between the availability of the PPE barrier at the health facility and the availability to all HCWs points.
See this image and copyright information in PMC

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