Background:
In December 2019, a series of pneumonia cases of unknown cause were
detected in Wuhan City, Hubei Province of China. The pathogen identified
was named as novel coronavirus (2019-nCoV), currently called, severe
acute respiratory syndrome corona virus-2 (SARS-CoV-2), an enveloped and
single stranded RNA virus [4] which has phylogenetic resemblance to
SARS-COV-1 [5]. COVID-19 is the name that has been given to a new
severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2).
The disease was notified to the World Health Organization (WHO) on
December 31, 2019 [1] and it was declared as public health emergency
of international concern (PHEIC) by WHO on January 30, 2020. Due to the
rapid spread of the virus, the severity of illness and reported
fatalities, COVID-19 was further labelled as a global pandemic on March
11, 2020 [2]. By June 2020 COVID-19 has spread to over 210 countries
and territories, caused 6,313,662 laboratory confirmed cases and 376,282
deaths [3]. Till date (June 2020), no medicine has demonstrated
efficacy in preventing, treating or curing COVID-19.
Pakistan’s first COVID-19 case was reported on 26 February 2020 [7].
As of June 9, 2020, Pakistan has 108,317 laboratory confirmed cases and
2,172 COVID-19 associated deaths. Punjab (n=40,815) has highest number
of cases followed by Sindh (n=39,555), Khyber Pakhtunkhwa KP (n=14,006),
Baluchistan (n=6,788), Gilgit Baltistan (952), Islamabad (n=5,785) and
Azad Jammu Kashmir (n=412) [8]. First systematic response emerged on
March 13, when the government convened an emergency meeting of the
National Security Committee, an apex civil-military coordination body,
and made the decisions to seal the border with Iran, prohibit
large-scale public gatherings, institute social distancing to limit
infections, and close down educational institutions across the country.
The COVID-19 Pakistan Preparedness and Response Plan (PPRP), prepared
with the support of the UN and is guided by the WHO Strategic
Preparedness and Response Plan (SPRP) [9], outlines the
international assistance required by the Government of Pakistan (GoP) to
stop the transmission of the pandemic and respond to the emerging public
health needs in Pakistan. It is
Accordingly, the Government of the province Khyber Pakhtunkhwa (KPK) has
taken all the necessary actions to cope with the situation of COVID-19
in the province [10]. Communication campaign under the title ‘RCCE’
(Risk Communication and Community Engagement) is under implementation
across the province and its review reveals that false public perception
due to easing of lockdown by Government has resulted in escalation of
COVID-19 cases in Pakistan that needs to be addressed through a
nationwide enforcement intervention to increase compliance with COVID-19
preventative actions [11].
Ex FATA, now known as Newly Merged Districts (NMDs) is the poorest
region of Pakistan. 73% of its 5 million population lives in poverty
compared to a national average of 39%
[12]. Adult literacy stands at
28% (8% for women) compared to a national average of 57% (43% for
women) [13]. One million, out of 1.8 million children (aged 5-16),
are out of school. Many families do not send their girls to school,
particularly as they reach puberty. Livelihoods and economic
opportunities are limited. Many people live in barren, dry, mountainous
areas vulnerable to climate change. Only 10% of land is fertile and
only 7% currently suitable for farming [14].
This area is inaccessible for online and digital surveys due to security
and logistical reasons [18]. Therefore, to tailor the response for
this isolated area, this face to face survey was direly needed to assess
their knowledge and perceptions regarding the COVID 19 pandemic.
Fortunately, Khyber Pakhtunkhwa Merged Districts (KPMD) Support Program
is implementing outreach activities under DFID support and the staff and
resources being well positioned were utilized for the survey. This
survey aimed at assessing the knowledge of residents of Newly merged
districts, NMDs, about COVID-19.