O-2 Perspectives of primary care providers and policy makers on the impact of COVID-19 on the health system in Dominica

Methods: A qualitative study based on an interpretivist paradigm was conducted using audio-recorded one-on-one semi-structured interviews via Zoom. A gatekeeper assisted with the recruitment of a range of private and public primary care providers and health sector policy makers, in order to achieve maximum variation sampling. Purposive sampling, guided by the principle of saturation was discontinued at the 13th participant. Data management was facilitated by ATLAS.Ti 9 software. All audio files of interviews were subjected to verbatim transcription and analyzed using thematic analysis with constant comparison using an inductive theory-based coding frame. Coding was cross-checked by two researchers to ensure validation.

Results: Ten females and three males aged 30 to 60 years, participated in the study. Participants' perspectives identified that the health system's impact of COVID-19 is shaped not only by the government-implemented protocols but also by the perceived technical and human resource capacity of frontline healthcare providers and policy level stakeholders. This was captured in four organizing themes, two of which include; i) “Gaps in Health System Preparation” and ii) “Areas for Health System Strengthening/Capacity Building”.

Conclusion: Multiple stakeholder standpoints exist regarding the health system's impact of the COVID-19 pandemic. In addition to their own views, policy makers should capture the perspectives and experiences of frontline primary care providers and of the general public in order to inform the health system's response to COVID-19 in Dominica.