Barriers and enablers experienced by health care workers in swabbing for COVID-19 in Papua New Guinea: a multi-methods cross-sectional study, November - December 2020.

Abstract Objective We aimed to identify the barriers and enablers Papua New Guinean (PNG) Health Care Workers (HCWs) experienced in swabbing for COVID-19. Methods We conducted a cross-sectional multi-methods study; a qualitative scoping exercise and a telephone survey. The target population was COVID-19 trained HCWs from all provinces of PNG. A descriptive analysis of survey responses was conducted alongside a rapid qualitative analysis of interviews and open-ended survey questions. Results Four key thematic areas were identified; human resources, logistics, HCW attitudes and community attitudes. The survey response rate was 70.3% (407/579). Commonly reported barriers to COVID-19 swabbing were insufficient staff trained (74.0%, n = 301), inadequate staffing in general (64.9 %, n = 264), insufficient supply of personal protective equipment (PPE, 60.9%, n = 248) and no cold chain to store swabs (57.5%, n = 234). Commonly reported enablers to swabbing were increasing community awareness and risk communication (80.8 %, n = 329), consistent and sufficient supplies of PPE (67.8 %, n = 276), increasing surge workforce (63.9 %, n = 260) and having a fridge to store swabs (59.7 %, n = 243). Conclusions A comprehensive community and HCWs engagement strategy in combination with innovations to improve supply chain are needed to increase COVID-19 swabbing in Papua New Guinea to reach national testing targets.