{'fraction_non_alphanumeric': 0.01975051975051975, 'fraction_numerical': 0.004158004158004158, 'mean_word_length': 5.899641577060932, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 1, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Identifying Enablers and Barriers of COVID-19 Management in Sri Lankan Hospitals

The current COVID-19 pandemic has revealed the lack of preparedness in health systems even in developed countries. Developing countries, especially, the countries in South Asia, deal with enormous challenges, and their fragile health systems can be rapidly overwhelmed. Sri Lankan hospitals have faced multiple challenges during this pandemic. However, very few studies have been published on the COVID-19 management experiences in developing countries, including in Sri Lanka. Therefore, lessons learnt from ongoing pandemic management would be immensely helpful in improving health systems for future disaster situations. This study aims to identify enablers and barriers of COVID-19 management in Sri Lankan hospitals through healthcare workers’ perceptions. Frontline doctors and nurses with different expertise from different levels of public hospitals were interviewed online. Both inductive and deductive coding and thematic analysis were performed on transcribed data. This study identified four themes under enablers;preparing for surge, teamwork, helping hands and less hospital-acquired infections. Seven themes were identified as barriers;lack of information sharing and communication challenges, lack of testing facilities, issues with emergency equipment, substandard donations, overwhelmed morgues, funding issues and psychological impact. These preparedness gaps were prominent in smaller hospitals compared to larger hospitals. The results of this study will inform hospital planners and policymakers to build upon their hospital’s resources and capabilities. It also provides guidance to address preparedness gaps and opportunities for improvement. These findings will be beneficial in providing sustainable solutions for strengthening the resilience of local health system, as well as the health systems of other countries.