Community Engagement In Combating Covid-19 Among Migrant Workers In Industrial Zones In Vietnam In 2020#Sự Tham Gia Của Cộng Đồng Trong Phòng Chống Covid-19 Vai Trò Của Công Nhân Nhập Cư Tại Các Khu Công Nghiệp Ở Việt Na

RESEARCH REPORT COMMUNITY ENGAGEMENT IN COMBATING COVID-19 AMONG MIGRANT WORKERS IN INDUSTRIAL ZONES IN VIETNAM IN 2020 H P Bui Thi Thu Ha La Ngoc Quang Bui Thi My Anh Hoang Minh Duc U H Hanoi University of Public Health, Vietnam January, 2021 i TABLE OF CONTENTS I INTRODUCTION AND OBJECTIVES II METHODOLOGY 2.1 Study design 2.2 Conceptual theoretical framework 2.4 Participants 2.5 Sampling 2.6 Data collection 2.7 Data management and analysis 2.8 Ethical approval 2.9 Quality assurance III LITERATURE VIEW H P 3.1 Epidemiology of COVID-19 3.1.1 Global trend 3.1.2 Vietnam 3.2 Preventive measures for COVID-19 3.3 Health risk communication 3.4 Migrant and COVID-19 U 3.4.1 Migrants in global centet 3.4.2 Migrants in Vietnam 10 3.4.3 Migrant and their vulnerability during COVID-19 10 H 3.5 Governmental supports for migrants during COVID-19 14 3.6 Effective intervention for COVID-19 15 3.7 Progress of Vietnam with vaccine development and clinical treatment 15 3.8 Community engagement 16 3.8.1 Concept of community engagement 16 3.8.2 Application of community engagement approaches in solving local problem 16 IV FINDINGS 18 4.1 Factors influencing migrant workers during COVID-19 18 4.1.1 Demographic information 18 4.1.2 Migrant workers’ employment and working condition 19 4.1.3 Living condition 20 4.1.4 Migrant workers’ health status, Access to health Services during COVID-19 21 4.1.5 Supports to migrant workers during COVID-19 23 4.1.6 Migrant workers’ knowledge, attitudes and practice on COVID-19 prevention 25 4.2 Community engagement in tackling COVID-19 in Vietnam 29 ii 4.2.1 Committee on COVID-19 control and prevention 29 4.2.2 Health sector’s involvement 35 4.2.3 Related stakeholders’ involvement in COVID-19 prevention 43 4.2.4 Industrial zones and migrant workers 48 4.3 Proposed intervention 54 V DISCUSSION 56 VI CONCLUSION 62 VII RECOMMENDATION 63 REFERENCES 64 ANNEX 1: QUANTITATIVE TOOLS Error! Bookmark not defined ANNEX 2: QUALITATIVE TOOLS Error! Bookmark not defined H P U H iii FIGURES AND TABLES Table 1: Sampling frame for qualitative data collection Table Analysis of variables Table Demographic information of migrant workers 18 Table Occupational working environment 19 Table Employment, salary and economic responsibility 19 Table Living condition of migrant workers 20 Table Health status of people living in the same house 21 Table Migrant worker’s health status in two industrial zones 21 Table Mental symptoms and health risk behavior of migrant workers 22 Table 10 Relationship between having mental symptoms and health risk behavior 22 Table 11 Health care support during COVID-19 23 Table 12 Information received on COVID-19 23 Table 13 Sources of guidelines received on COVID-19 prevention 24 Table 14: Supports received during COVID-19 24 Table 15 Migrant workers’ knowledge on COVID-19 symptoms 25 Table 16 Migrant workers’ knowledge on COVID-19 transmission ways 25 Table 17 Migrant workers’ knowledge on COVID-19 prevention 26 Table 18 Migrant workers’ correct knowledge on COVID-19 prevention: symptoms, transmission, prevention methods 26 Table 19 Migrant workers’ correct attitude on COVID-19 prevention 27 Table 20 Migrant workers’ correct practice on COVID-19 prevention 27 Table 21 Relationship between migrant workers’ knowledge on COVID-19 and demographic and health risk behavior 27 Table 22 Relationship between correct knowlede and practice on COVID-19-prevention 28 Table 23 Relationship between KAP and sources of information 29 H P U Figure Conceptual Framework in combating COVID-19 for migrant workers H iv ABBREVIATION CDC CHC CRA DHC FDI FGD IDI IVAC KAP MOH PDH RCCE WHO WU YU Center for Disease Control Commune Health Centre Cumulative Risk Assessment District Health Central Foreignn Direct Investment Focus group discussion In-depth interview Institute of Vaccines and Medical Biologicals Knowledge Attitude Practice Ministry of Health Province Department of Health Risk Communication and Community Engagement World Health Organization Women Union Youth Union H P U H v I INTRODUCTION AND OBJECTIVES COVID-19 pandemic is rapidly spread over the planet and is no longer just a global health crisis with mobility dimensions but also a social and economic crisis that is impacting on the most vulnerable people [1], [2], [3] Migrant workers are among the vulnerable populations that most impacted by the pandemic [4], [5] as they are: 1) lack of household basic needs such as water, toilets, sewers, drainage, waste collection, space constraints; 2) often work in unsafe working condition and having low paid work; 3) often excluded from public policy, including healthcare and community services The migrant workers become even more vulnerable in emergencies due to lockdown and containment activities, threats of job losses, food insecurity, loss of family income and difficult access to effective surveillance and early-warning systems, and health services [6], [7], [8], [9], [10], [11], [12] The principal approaches for reducing COVID-19 transmission for migrants are the same in any context, i.e reduced physical contact and improved hygiene, supports of financial and non-financial resources (e.g information, equipment, supportive policymaking) [5] and must be included in national public health systems [13] The community engagement for health was shown effective in dealing with COVID-19 in different countries [14], [15] H P The first case of COVID-19 in Vietnam was declared on 23 January 2020 Up to now Vietnam has about 1300 cases with 35 death, and the country in the second wave of COVID19 transmission Vietnam’s strict containment measures and integration of resources from multiple sectors including health, mass media, transportation, education, public affairs, and defence have significantly reduced the spread of the epidemic in the country [16] U In Vietnam, the migrants are those living in the destination areas more than one month, are residing independently or with relatives, and who have temporary household registration books, or “tam tru” in Vietnamese Most of migrant in Vietnam are from rural to urban and female [12] The migrants are suffered from high risk of disease, including occupational and injury related diseases However, economic vulnerabilities were reason that contributed to low health service utilization among migrants [17] H The research is aimed to investigate factors associated with COVID-19 pandemic on migrant workers by applying a holistic Cumulative Risk Assessment (CRA) framework [18], using Vietnam as an example Furthermore, the research will use the framework to suggest potential interventions on community engagement for individuals, employers and authorities to improve the health of migrant workers in the country [19] The specific objectives: Explore the factors that affect the migrant workers during pandemic COVID-19 in Vietnam Identify the community engagement mechanism in tackling the impacts of COVID-19 for migrant workers Propose intervention on community engagement to mitigate the impact of COVID-19 on migrant workers II METHODOLOGY 2.1 Study design A cross - sectional with mixed qualitative and quantitative study will be adopted This study was conducted at Que Vo (Bac Ninh) and Phuc Son (Ninh Binh), Vietnam The Que Vo and Phuc Sơn located in the north-east area with 60km far from center Hanoi These areas are the large industrialized zone in Vietnam with the national and international factories The companies, where the study was carried out are foreign direct investment (FDI), and producing the electronic devices In the time of social distancing for controlling the COVID-19 pandemic, business services were closed and most migrants lost their job This could lead impacts on community engagement, psychological distress, and other social and public health access Que Vo industrial zone was established in 2002 by Kinh Bac urban development joint stock corporation in Bac Ninh province Que Vo industrial zone is located in key economic triangle center of north area Hanoi, Hai Phong and Quang Ninh provinces, with a large area of 640 Industrial zone occupies an important position in the economic, culture, commercial, traffic development with the center location is Bac Ninh province and the surrounding north areas in Thai Nguyen, Bac Giang, Vinh Phuc, Quang Ninh, Hai Duong GOERTEK VINA Co., Ltd - a subsidiary of GOERTEK Group in Shandong, Chinawas established in 2013, is one of the largest companies in Que Vo industrial zone with a total area of 472,000m2 This company specializes in manufacturing products for Samsung Vietnam such as headphones, earphones, microphones After years of establishing and development in Vietnam, GOERTEK VINA has gradually become one of the largest foreign enterprises in Que Vo industrial zone, with more than 47,000 workers BUJEON VIETNAM Electronics Co., Ltd is another company in Que Vo industrial zone with 100% Korean investment This company has 8,000 employees, specializes in manufacturing electronic components and is a partner enterprise of famous mobile phone companies in the world Phuc Son industrial zone is located in Ninh Phuc commune with a total area of 142 ha, belongs to the industrial complex of Ninh Binh province and was established in 2004 Phuc Son is a multi-industrial zone, focusing on investing in synchronous and modern technical infrastructure system, meeting the most stringent requirements and standards of investors, especially for foreign investors with variety of products such as manufacturing modular cameras and electronic components, producing safety glass doors, plastic doors with steel core, mechanical and metal manufacturing, etc To date, Phuc Son industrial zone has 10 companies with a toal of 13,214 labors, in which 13,065 domestic workers MCNEX VINA Co., Ltd is one of a largest company in Phuc Son industrial zone, 100% invested by Korea, specializes in manufacturing modular cameras and electronic components with the size of 8,000 workers H P U H 2.2 Conceptual theoretical framework The multiple factors in different domains can interact with each other resulting in cumulative risk that can then be used to inform new risk management approaches, exposure reduction and prevention strategies The Cumulative Risk Assessment (CRA) model assumes that factors arise from four dynamic interactive domains: the workplace (occupational); ambient environment (household); individual (behavior); and community (local community, health facilities) (Figure 1) Community: agency involved (authority, health facilities, police, informal), tasks and activities Health service delivery COVID 19 prevention and control Governmen t policy, IT, face mask, handwashing, distancing, information Environmental (household, residence, clean water, WC, food, Health care access, insurance, COVID-19 services Occupational: hazards, policy for COVID 19, working situation Job related: payment, loss job, H P Individual: demographic, KAP on COVID-19; behavior (smoking, drinking); economic status U Figure Conceptual Framework in combating COVID-19 for migrant workers *(The framework developed and adapted from Fox [18] and Aladmad [20]) H 2.3 Duration The study was carried out from Sept, 2020 – Feb, 2021 in Que Vo, Bac Ninh and Phuc Son, Ninh Binh industrial zones 2.4 Participants The migrant included those are in the temporary registration system (tam tru) in the local authority area, where the Que Vo and Phuc Son industrial zones located However, the system may not include non-registration/undocumented migrants, we required heads of resident groups “tổ dân phố”, who seemly know all of people reside in their management area, to provide information of non-registration/undocumented migrants Community was defined as a group of people who live in the same local geographical area or who have some other non-spatial element of shared social identity, such as a similar trade or group membership [21] In this study, we focus primarily on geographically-defined communities (migrant workers): (1) industrial zones, (2) local government of the industrial zone located, of local migrant’s residence, (3) health facilities of the industrial zones located and local migrant’s residence, other related stakeholders involved in the taskforce group of COVID-19 prevention and control in the local areas 2.5 Sampling Quantitative survey: 445 domestic migrant workers in Que Vo and Phuc Son industrial zones were selected, 219 and 226, respectively Convenient sampling approach were used Sample size: with a 95% confidence level (z), the maximum population variability (p = q = 0.5), Qualitative study: Purposive sampling to recruit diverse stakeholders The sampling frame is provided in Table Table 1: Sampling frame for qualitative data collection Que Vo Phuc Sơn Total Participants Methods (Bac Ninh) (Ninh Bình) (n=32) Individual & household Migrant workers 2 IDI Co-workers/ people sharing the same residence IDI/FGD 2 Owners of worker’s residence 2 IDI Occupational Health staffs in the factories 1 IDI Managers in factories (industrial zone) 1 IDI Community Leader of Commune Health Center where the IDI 1 company located Collaborators at CPC (village leaders, women IDI/FGD 1 union) where the company located Leader of Commune Health Center where the IDI 1 migrant’s residence located Collaborators at CPC (village leaders, women IDI/FGD 1 union) where the migrant’s residence located Health facilities Leader of Provincial Department of Health in IDI 1 charge of COVID-19 Leader of District Health Center in charge of IDI 1 COVID-19 Leaders of Commune Health center in charge IDI 1 of COVID-19 where the company located Leaders of Commune Health center in charge of IDI 1 COVID-19 where the migrant’s residence located H P U H 2.6 Data collection 2.6.1 Quantitative data collection Migrant survey will be conducted to understand the migrant experiences in combating with COVID-19 The questionnaires is included the information following the conceptual framework, covered: 1) Individual information (demographic, socio-economic status, employment, health status, psychological condition and habit); 2) Environment (household): number of people living in the same house, health status, access to clean water, WC, internet; 3) Employment information (occupational hazard, working status, incomes); 4) Community engagement in combating with COVID-19: guidance on COVID-19 prevention, measures applied, supports for migrants, and KAP on COVID-19 The questionnaire is included in the Annex An online survey was conducted to understand the migrant experiences in combating with COVID-19 Migrant workers have received a REDCap link via Zalo or SMS text The link showed three parts: Part 1: study introduction, Part 2: Consent form, and Part 3: a questionnaire After viewing the study introduction part, the consent form appeared A participant selected “No” to stop the survey or select “yes” to agree to answer the questionnaire The REDCap tool was authorized to HUPH by Vanderbil University 2.6.2 Qualitative data collection In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with key informants to understand situation and experiences of different stakeholders in combating with COVID-19 The experienced public health researchers conduct the IDIs or FGDs using the question guides structured around the components of the conceptual framework (Figure 1) 2.7 Data management and analysis 2.7.1 Quantitative analysis A total of 634 migrant workers received information and accessed the REDCap link to answer the questionnaire on their smart devices such as mobile phones or computers 445 migrant workers had completed the survey with valid information Data was backed up and cleaned daily during collection time The data were entered using EPI DATA 3.1 and analyzed using SPSS version 20 Descriptive data analysis was applied We report the findings following the conceptual framework in Figure Characteristics of participants related to impacts of COVID-19, knowledge, attitude, and practice on COVID-19 prevention of migrant workers were compared between between two companies using Chi-square or Fisher exact tests for statistical significance The report of findings following the conceptual framework of study Table Analysis of variables # Content Sub-content Question Criteria Correct knowledge on E1 Select both options: Fever and dry cough COVID-19 symptoms Select all bellowed answers: Correct Through coughing or sneezing knowledge on E2 spread from person to person COVID-19 spread from animal to human transmissions Object contained with the virus The summary Select all bellowed answers: correct Avoid contact with people from knowledge on respiratory illness (cough, sneezing, COVID-19 flu) prevention: Clean and disinfect objects and Correct surfaces knowledge on Wash hand frequently with soft and E3 how to prevent water COVID-19 Cover mouth and nose when cough/sneeze Avoid touching eyes, nose, mouth with unwashed hands Avoid crowded places Wearing a mask in public places H P U H 5.1.5 Migrant workers’ KAP and COVID-19 Knowledge of migrant on COVID-19 was good (>90%) Most of them know the symptoms (fever, fatigue, dry cough); transmission ways (coughing/sneezing; person to person) and prevention measures The proportion of knowledge in Ninh Binh was better than in Bac Ninh province However, the combined correct knowledge of three mentioned above areas was modest (50.6%), and people in Ninh Binh was better than Bac Ninh (69>31%) The situation is quite similar to China, where migrants have limited knowledge [78] Almost all migrant workers (99%) have strong strong beliefs on government action to control COVID-19 and most of them well complied with preventive measures (> 90%) The people who have correct knowledge were 3.63 times more likely to have correct practice (OR = 3.63; p