Protocol to assess the values and preferences towards SARS-CoV-2 self-testing among the general population and their representatives, healthcare personnel and decision-makers in health: a multi-country mixed methods study.

Background Accessible, safe and client-centered SARS-CoV-2 testing services are an effective way to halt its transmission. Testing enables infected individuals to isolate or quarantine to prevent further transmission. In countries with limited health systems and laboratory capacity, the provision of accessible and safe screening for COVID-19 is challenging. Self-testing provides a convenient, private, and safe testing option. However, it also raises some important concerns relating to a lack of counselling and a clear pathway to ensure timely reporting of self-test results to national surveillance systems. Investigating community members' views and perceptions is crucial to inform the most effective and safe strategies for implementing SARS-CoV-2 self-testing. Objective Our main research question is to understand how useful, and under which circumstances, would SARS-CoV-2 self-testing be acceptable for populations in low-resource settings, to diagnose and prevent the spread of SARS-CoV-2. Methods This study will be conducted in nine countries: Brazil, India, Indonesia, Kenya, Malawi, Nigeria, Peru, Philippines, and South Africa. It is a multi-site, mixed methods, observational study that consists of two components: cross-sectional surveys and a qualitative inquiry among four respondent groupings: the general population, general population representatives, healthcare workers, and decision-makers. The general population and healthcare worker surveys will be analyzed separately, using bivariate and multivariate inferential analysis, and descriptive statistics. The qualitative inquiries, which will comprise semi-structured interviews and group interviews, will be audio recorded, transcribed, and coded. Thematic comparative analysis will be conducted. Results As of September 28, 2021, 4162, 1171 and 238 participants have been enrolled in the general population survey, the healthcare workers survey, and the qualitative inquiry respectively. All data are planned to be collected by December 31, 2021, with results expected to be published throughout 2022. Conclusions The views and perceptions of local populations are crucial for leading the discussion around the safest strategies for implementing SARS-CoV-2 self-testing. This study intends to generate evidence about the different sociocultural specificities that may hinder or accelerate the widespread utilization of SARS-CoV-2 self-testing. Dissemination of results will be via publications, presentations at conferences, and dissemination events specifically targeted at local decision-makers, civil society, and patient groups. Clinicaltrial This study does not include a health intervention on human subjects. Ethics approval will be obtained at the country level in each country prior to starting data collection. Informed consent will be obtained from all participants.