Use of face masks for COVID-19 prevention: a qualitative study on barriers and motivators in Zimbabwe

Abstract

Abstract Introduction To mitigate the impact of the COVID-19 pandemic, face mask use has been a key component of public health measures. Research in most settings has focused on understanding the effectiveness of this intervention in reducing COVID-19 transmission. This study aimed to identify the barriers and motivators of face mask use in the Zimbabwean population. Methods Thirty key informant interviews (KIIs) and 10 focus group discussions (FGDs) were conducted with homogenous study groups of health workers, village health workers, church leaders, traditional healers, teachers, women leaders, transporters, youth leaders and the general population selected in 10 districts across the country from September–October 2022. Each study group consisted of key informants and FGD participants. Interviews and FGDs were captured using digital recording devices, transcribed verbatim, and translated into English. The data were analysed manually via thematic analysis. Findings Six themes were generated in this study. The four themes identified as barriers were individual factors (low risk perception in rural areas and as the number of cases declined due to vaccination, lack of conviction and lack of knowledge on the importance of face masking resulting in practices such as sharing and improper wearing of masks), access challenges (due to scarcity and affordability resulting in reusing dirty masks or washing surgical masks), concern about side effects (breathing difficulties and other respiratory complications), and sociocultural and religious beliefs (resulting in removal of masks by traditional healers during consultations, removal of masks in church). Two themes that were identified as motivators included perceived benefits (confidence in the effectiveness of facemasks for the prevention of COVID-19 transmission) and environmental factors (fear of law enforcement agents and village health workers). Conclusions The study findings underscore the need of awareness campaigns, improvement of accessibility and affordability of masks, sensitivity to religious and cultural beliefs to increase the usage and effectiveness of face mask during pandemics of respiratory diseases.