KAP Assessment Report On COVID-19
KAP Assessment Report On COVID-19
KAP Assessment Report On COVID-19
PRACTICES (KAP)
ASSESSMENT ON COVID-19
COMMUNITY BASED MIGRATION PROGRAMME
September 2020
KNOWLEDGE, ATTITUDES AND PRACTICES (KAP) ASSESSMENT ON COVID-19
Conducted by
TRCS Community Centre staff
Tenadi Gölemerz
Mehmet Akdaş
Semih Paslı
Sayeeda Farhana
Klaudia Jankowska
Graphic Design
Engin Aygün
1
COVID-19 pandemic lockdown are extreme precautions or restrictions to prevent the spread of COVID-19. In Turkey shortly after the first COVID-19
case was reported in mid-March 2020, strict measures were introduced by the Turkish government to curb the spread of the pandemic in the country.
Lockdown was introduced for those above 65 years and under 20 years old and inter-city travel restrictions and weekend curfews were imposed. Other
containment measures included closing of schools, provisioning flexible working arrangements, recommending people to stay at home and banning
public gatherings. Beginning of June 2020, restrictions have been eased in Turkey by lifting curfews and reopening businesses, government offices
and other services which have been shut during the lockdown, with targeted restrictions depending on the COVID-19 situation in different cities. On
26 August 2020, the government has issued a new presidential decree on flexible working modalities for all state institutions to minimize the spread of
COVID-19.
Introduction.............................................................................................................................. 10
Background............................................................................................................................................................... 11
Why KAP assessment?............................................................................................................................................ 11
Goal and Objectives................................................................................................................................................. 12
Method...................................................................................................................................................................... 12
TRCS Community Centre social media ............................................................................................................. 12
Phone interviews by TRCS Community Centre staff........................................................................................... 12
Online consultation/Focus Group Discussion (FGDs)......................................................................................... 12
Limitations......................................................................................................................................................... 14
Demographic Profile................................................................................................................................................ 14
Gender.............................................................................................................................................................. 14
Age................................................................................................................................................................... 14
Nationality......................................................................................................................................................... 15
Status in Turkey................................................................................................................................................. 15
Highest level of education.................................................................................................................................. 15
Language spoken and understood.................................................................................................................... 16
Knowledge................................................................................................................................. 17
What do you know about the new Coronavirus?............................................................................................... 18
What kind of information have you received about the new Coronavirus?.......................................................... 18
How does the Coronavirus spread?.................................................................................................................. 19
What are the main symptoms of the Coronavirus infection?............................................................................... 19
Do you know how to prevent the Coronavirus contraction? .............................................................................. 20
Where do you get information about the new Coronavirus from?....................................................................... 20
Is there anything preventing you or making it difficult to receive information about the new Coronavirus?........... 21
If yes, what are the barriers?.............................................................................................................................. 21
Which channel/who do you trust the most for information related to the new Coronavirus?............................... 22
Do you know who is at the highest risk of the infection?.................................................................................... 23
Have you heard anything about the Coronavirus that you are not sure is true or not?........................................ 23
Attitudes....................................................................................................................................26
How dangerous do you think the new Coronavirus is?...................................................................................... 27
If a person gets infected with Coronavirus or has recovered in your community,
are they treated differently or discriminated because of it?................................................................................. 27
If yes or to some extent, which of the following groups are being discriminated in your community
because of the Coronavirus?............................................................................................................................. 28
What worries or concerns you the most about the Coronavirus?....................................................................... 29
Practices.....................................................................................................................................30
Are you taking any measures in your daily life to prevent the risk of infection?.................................................... 31
If not, why?....................................................................................................................................................... 31
If yes or sometimes, what have you and your family done to prevent becoming sick with the Coronavirus
in the recent days?............................................................................................................................................ 32
Are you facing any challenges in taking such preventive measures?.................................................................. 33
What would you do if you or someone from your family has symptoms of this disease?.................................... 34
Recommendations...................................................................................................................43
List of Tables
Table 1 Number and composition of FGD participants................................................................................................. 13
Table 2 Rumours and places where they are heard...................................................................................................... 25
List of Figures
Figure 1 Gender-Age structure of respondents............................................................................................................ 14
Figure 2 Nationality-Status of respondents................................................................................................................... 15
Figure 3 Highest level of education of respondents by status and gender.................................................................... 15
Figure 4 Language spoken and understood by status................................................................................................. 16
Figure 5 Awareness about COVID-19.......................................................................................................................... 18
Figure 6 Types of COVID-19 information received........................................................................................................ 18
Figure 7 Understanding how COVID-19 spreads......................................................................................................... 19
Figure 8 Understanding COVID-19 symptoms............................................................................................................. 19
Figure 9 Understanding how to prevent COVID-19...................................................................................................... 20
Figure 10 Sources of COVID-19 information by status................................................................................................. 20
Figure 11 Barriers to receive information...................................................................................................................... 21
Figure 11a Barriers to receive information (follow up question)..................................................................................... 21
Figure 12 Trusted sources of information..................................................................................................................... 22
Figure 13 People with COVID-19 risk........................................................................................................................... 23
Figure 14 Attitudes towards COVID-19........................................................................................................................ 27
Figure 15 Likelihood of people to face discrimination in relation to COVID-19.............................................................. 27
Figure 16 People reported to face discrimination in relation to COVID-19..................................................................... 28
Figure 17 Worries and concerns in relation to COVID-19............................................................................................. 29
Figure 18 Likelihood of practicing preventive measures............................................................................................... 31
Figure 19 Reasons for not taking preventive measures................................................................................................ 31
Figure 20 Measures undertaken to prevent COVID-19................................................................................................. 32
Figure 21 Challenges in taking preventive measures.................................................................................................... 33
Figure 22 Actions taken if COVID-19 symptoms show................................................................................................. 34
Figure 23 What information communities need now..................................................................................................... 36
Figure 24 Preferred communication channels to receive information............................................................................ 37
Figure 25 Preferred language to receive information..................................................................................................... 38
Figure 26 Use of TRCS social media to receive COVID-19 information......................................................................... 39
Figure 26a Use of TRCS social media to receive COVID-19 information (follow up question)........................................ 39
Figure 27 Reasons for not using or sometimes using TRCS social media.................................................................... 39
Figure 28 Preferred channel to ask questions or share feedback with TRCS................................................................ 40
INTRODUCTION
Community Centre, 27 July 2020
Credit: TRCS
Method
This KAP assessment has been conducted via TRCS’ social media platforms, phone interviews, and online consultations/
focus group discussions (FGDs) with refugees and local people in 16 TRCS Community Centre (CC) locations. Comprising
both qualitative and quantitative data, a total of 3,840 individuals have been interviewed over the phone in 16 Community
Centre locations, while a further 320 refugees and local people have participated in 32 FGDs. Of these 320, 160 were men,
160 women, and 160 were refugees and 160 local community members. A KAP survey questionnaire, to be used on TRCS
social media platforms and phone interviews, and FGD questions have been developed through consultation with TRCS
CEA, Communication, and PMER departments as well as IFRC CEA, IM and PMER. KOBO toolbox - a free open-source
tool for mobile data collection - has been used to collect data for the survey. An online orientation on the KAP assessment
was held on 22 July 2020 for 25 TRCS staff from the Community Centres (CCs) to explain the objectives of the assessment,
how to use KOBO to collect data, and to go through the survey questionnaire and FGD questions.
2
Random sampling consists of a sample that is meant to be an unbiased representation of the total population. For the phone survey, the respondents
involved in CC activities, are randomly selected from the TRCS beneficiary database which records information of community members receiving or
accessing various services at the CC such as language courses, vocational training, PSS counselling, etc.
3
Snowball technique sampling is a nonprobability sampling technique where existing study subjects recruit future subjects from among their acqua-
intances. For the phone survey, the respondents not involved in CC activities are selected through snowball technique sampling, where the surveyed
respondents involved in CC activities select other individuals near their residence, who are not receiving or accessing any services at the CC.
4
The Advisory Committee comprises of community representatives (locals and refugees) and functions as a platform to share with TRCS, along with
other stakeholders, their feedback or concerns about the Community Centre activities and other issues affecting them. With a maximum of 15 mem-
bers, the committee comprises of both men and women from various profession and age.
İstanbul İstanbul
Bağcılar Sultanbeyl�
Ankara
Kocael� Kayser�
Kahramnamaraş
Şanlıurfa
Bursa
İzm�r
Mard�n
Konya Gaz�antep
K�l�s
Mers�n Adana
Hatay
Demographic Profile
Analysis of this assessment is based on 3,840 phone survey responses and 32 FGDs with refugees and local community
members in 16 Community Centre locations. Out of 3,840 respondents, 1,959 are female (51%) and 1,877 male (48.9%).
The age distribution of the respondents is: 0.9% 14-17-year-olds, 39.6% 18-29, 56.6% 30-59-year olds and 2.9% over
the age of 60. The FGDs are conducted separately with refugees and host community members. In total, 320 community
members participated in the FGDs, of which 160 were men, 160 women, and 160 refugees and 160 local community
members.
Gender Age
The highest level of education: 20.3% of respondents from the host population had completed university while 14.3%
of the refugee respondents had completed secondary education. 14.2% of female and 15.8% of male respondents had
completed university.
Male Prefer
Female
not to answer
University 544 (14.2%) 605 (15.8%) 2 (0.1%)
High School 476 (12.4%) 479 (12.5%)
Secondary 353 (9.2%) 378 (9.8%) 1 (0.0%)
Primary 407 (10.6%) 246 (6.4%)
Vocational training 49 (1.3%) 79 (2.1%)
Masters/PhD 51 (1.3%) 58 (1.5%)
No formal education 64 (1.7%) 25 (0.7%)
Other 15 (0.4%) 7 (0.2%) 1 (0.0%)
Prefer
Host population Refugee Other
not to answer
Arabic 331 (8.6%) 1,861 (48.5%) 22 (0.6%) 1 (0.0%)
English 384 (10.0%) 241 (6.3%) 12 (0.3%) 2 (0.1%)
Farsi 5 (0.1%) 26 (0.7%) 1 (0.0%) 0 (0.0%)
Other 189 (4.9%) 65 (1.7%) 8 (0.2%) 0 (0.0%)
Turkish 1,870 (48.7%) 664 (17.3%) 26 (0.7%) 2 (0.1%)
KNOWLEDGE
Community Centre, 5 August 2020
Credit: TRCS
Survey findings show about 96.5% of the respondents are aware about COVID-19. This number indicates a high
exposure to information about COVID-19 with these 96.5% of respondents reporting that COVID-19 is a virus that can cause
disease. However, the remaining 3.5% of respondents either did not know anything about it (1.6%), thought COVID-19 was
used as a TV/radio campaign (1.4%), or gave another response (0.5%).
Other 20 (0.5%)
Under “Other” the following responses were recorded: the new Coronavirus is a punishment sent by God, a virus originating
in China, a virus similar to what causes flu, a virus spread by bats. Two respondents said they did not know enough to
answer this question.
Respondents have received various information about COVID-19 including its symptoms (88.2%), how it is
transmitted (83.4%), how to prevent the disease (70.5%), and how to wear masks (55.3%) or wash hands (48.5%).
People also reported being informed about what to do if infected (42.5%), the risks involved for people with chronic disease
or pregnant women (31%) and who to ask questions on COVID-19 (22.1%).
What kind of information have you received about the new Coronavirus?
more than one answer possible
There were no significant differences in answers provided by refugees/host community members or women/men. Under
“Other” the following responses were recorded: the virus can cause an economic crisis, people should practice physical but
not social distancing, there is no cure for the disease, people should stay at home unless it is absolutely necessary to go
out. Nine respondents said they had not received any information.
Droplets from infected people when coughing and sneezing 3,325 (86.6%)
Direct contact with infected people 2,723 (70.9%)
Touching contaminated objects/surfaces 2,479 (64.6%)
Touching nose, eyes and mouth with contaminated hands 2,076 (54.1%)
Blood transfusion 157 (4.1%)
Contact with wild animals 139 (3.6%)
Contact with pets 129 (3.4%)
Other 79 (2.1%)
Drinking unclean water 69 (1.8%)
Do not know 51 (1.3%)
Through rainwater 14 (0.4%)
Other answers not covered in the list: the virus spreads from/through people who are not careful enough and do not follow
the restrictions, through breathing (airborne), the main sources of the virus spread are hospitals.
Almost all respondents mentioned that the main symptoms of COVID-19 are fever (94.6%), cough (84.7%) and
shortness of breath (74.3%). Other symptoms mentioned were muscle pain (35.2%), headaches (35.1%), loss of taste or
smell (31.8%) and diarrhoea (30%).
These survey findings complement the FGDs which found that the vast majority of respondents in all locations are well
aware of the COVID-19 outbreak, the symptoms of infection, how it spreads, and how to reduce the risk of getting infected.
FGD participants explained that the common symptoms of infection include fever, dry cough, sore throat, lack of sense
of smell and taste, and breathing difficulties. The virus can spread through droplets during coughing and sneezing or by
touching eyes or mouth with dirty hands; and as well as being transmitted through air, physical contact with an infected
person can also spread the disease.
According to FGD respondents a lot more people are now aware about the disease and have sufficient information compared to
during the early stages of the outbreak. However, in certain locations such as Mersin, awareness of COVID-19 was lower among
refugees than amongst people from the local communities. The reason for this is mainly due to the language barrier, which can
negatively impact refugees’ access to information and motivation to practice healthier behaviours and adopt precautions.
Wash your hands frequently using soap and water 3,473 (90.4%)
Wear masks when you go out 3,249 (84.6%)
Maintain physical distance (1 meter) whenever outside 3,157 (82.2%)
Use a hand sanitizer that contains at least 60% alcohol 2,220 (57.8%)
Cover your mouth and nose when coughing or sneezing 1,896 (49.4%)
Avoid touching mouth, nose, and eyes with contaminated hands 1,360 (35.4%)
Wear masks if you are sick or taking care of an infected person 1,201 (31.3%)
Use disinfectants to clean surfaces 611 (15.9%)
Other 79 (2.1%)
Do not know 41 (1.1%)
Other recorded prevention methods: not going out unless absolutely necessary, taking care of personal hygiene, avoiding
meeting other people.
Survey findings complement FGD reports where participants reported being well aware of preventive measures to reduce the
risk of infection. Encouragingly, participants also said they shared information they receive about COVID-19 and necessary
precautions with their family members, friends, neighbours, and community forums, as well as with other employees at work
via WhatsApp groups or social media.
The most popular sources of information about COVID-19 reported by respondents were TV (66.4%), followed
by government officials (38.7%), Facebook (34.8%), health workers (31.4%), websites (23.8%) and family and
friends (43.3%). Other sources mentioned included social media channels - including those of TRCS and its website - and
TRCS staff and volunteers.
No 3,670 (95.6%)
Yes 170 (4.4%)
Male Prefer
Female not to answer
I do not know which is the trusted source of infomation 56 (32.9%) 55 (32.4%) 0 (0.0%)
I do not have access to internet 20 (11.8%) 15 (8.8%) 0 (0.0%)
The social media channels I follow have limited information in my langugage about coronavirus 14 (8.2%) 4 (2.4%) 0 (0.0%)
I do not use social media 7 (4.1%) 8 (4.7%) 0 (0.0%)
I live far away from the Community Centre 9 (5.3%) 2 (1.2%) 0 (0.0%)
I do not have a phone 1 (0.6%) 3 (1.8%) 0 (0.0%)
FGD participants from refugee communities in Ankara, Kahramanmaras, Kocaeli, Mardin and Urfa, identified language
as one of the key barriers in accessing information. In other locations, community members can receive information from
TRCS Community Centres or other institutions in both Arabic and Turkish languages. School-going children in many refugee
families support by translating and explaining COVID-19 related information from Turkish to Arabic. In Bursa, it is reported
that refugees with poor financial conditions have challenges to afford internet access, making it difficult for them to access
information from social media or websites. Some refugees are not able to read or write in Arabic, and this can prevent them
from accessing written information.
Which channel/who do you trust the most for information related to the new
Coronavirus?
more than one answer possible
Overall Host population Refugee
Government officials 1,801 (46.9%) 1,084 (28.2%) 704 (18.3%)
TV 1,702 (44.3%) 839 (21.8%) 839 (21.8%)
Health workers 1,336 (34.8%) 817 (21.3%) 512 (13.3%)
Doctors 855 (22.3%) 473 (12.3%) 373 (9.7%)
Facebook 636 (16.6%) 107 (2.8%) 525 (13.7%)
Family/neighbours 520 (13.5%) 196 (5.1%) 321 (8.4%)
Website 506 (13.2%) 177 (4.6%) 327 (8.5%)
TRCS social media & web 420 (10.9%) 160 (4.2%) 258 (6.7%)
TRCS staff/volunteers 403 (10.5%) 106 (2.8%) 296 (7.7%)
Friends 377 (9.8%) 121 (3.2%) 254 (6.6%)
WhatsApp 307 (8.0%) 72 (1.9%) 228 (5.9%)
Brochures/leaflets 286 (7.4%) 168 (4.4%) 115 (3.0%)
Twitter 281 (7.3%) 203 (5.3%) 74 (1.9%)
Instagram 207 (5.4%) 104 (2.7%) 101 (2.6%)
Other 122 (3.2%) 68 (1.8%) 52 (1.4%)
Community leaders 73 (1.9%) 51 (1.3%) 21 (0.5%)
Radio 63 (1.6%) 52 (1.4%) 10 (0.3%)
Religious leaders 19 (0.5%) 12 (0.3%) 6 (0.2%)
In the FGDs, participants reported that their trusted sources of information were
family, friends, doctors or healthcare professionals, Ministry of Health and other People around me prefer to get
government institutions, TRCS and its Community Centres, community leaders, information from community
Muhtars5, World Health Organization (WHO) and NGOs. In Bursa, Bağcilar, leaders and Muhtars on
Kahramanmaraş, Mersin, Kayseri and Sultanbeyli, respondents also mentioned COVID-19.
religious leaders as one of the trusted channels to receive information. Religious
leaders should be involved and engaged in encouraging communities to Salih,
practice positive behaviours and explaining the importance of following Turkish man - 61, Adana
health advice. FGD participants suggested that the sharing of key messages
or announcements by the Muhtars could be quite effective in reinforcing the
importance of undertaking preventive measures to stop the spread of disease.
FGD participants also said that communities prefer to receive information through local or national TV channels (TRT1),
news channels (TRT News, A News) and Arabic TV channels as well as through SMS, online meetings, phones, social
media platforms and TRCS staff or volunteers. In Gaziantep and Kocaeli, participants recommended TRCS to conduct live
sessions together with doctors or physicians on Facebook or other social media channels to talk about COVID-19, raise
awareness among people to take precautionary measures, and answer questions from the audience.
5
Muhtar - Muhtar is the elected government representative who carries out management and executive roles in the city neighbourhoods and villages
in Turkey
Other vulnerable groups mentioned in the survey were people with compromised immune systems, those working outside
(especially men), and people staying/working in crowded places. Twenty individuals said that everyone is at risk of contracting
the virus, while twelve could not indicate any vulnerable groups.
FGD participants recognized that everyone could be at risk of infection, but specifically mentioned, older people (above 60
years of age), those with chronic diseases and people with weak immune systems as being at a higher risk of becoming
infected. Many participants felt pregnant women, health workers, people working in factories and public areas, those using
public transport, and people not following the preventive measures (not wearing masks, not maintaining personal hygiene
or not paying attention to physical distancing) could be equally at risk of COVID-19 infection. Most participants recognised
that although young people and children are at relatively at low risk themselves, they can be carriers of the disease.
Have you heard anything about the Coronavirus that you are not sure is true or not?
Participants in the FGDs stressed that there are various rumours spreading within their communities about COVID-19.
These rumours are spread mostly via word of mouth and social media (Facebook, Twitter and Instagram). Misperceptions
and rumours in a community can create social tension or lead to practising harmful behaviours and should be responded
to swiftly by providing communities with the right information.
In most locations, participants said they checked official websites including those of the Ministry of Health and NGOs
to verify rumours. They suggested that audio, video, and visual information materials should be developed to provide
communities with accurate, reliable information. These could be published on official social media accounts and websites
including those of TRCS and Ministry of Health, as well as being shared by TV channels. Others said they would like to
receive factual information via phone, leaflets, information kiosks, SMS, WhatsApp groups and TRCS Community Centres.
Sl No Rumours Location
Kahramanmaraş, Şanlıurfa,
1 There is no coronavirus.
Bağcilar, Mersin
Coronavirus will infect you anyways. So, you don’t need to pay
2 Mardin, Kahramanmaraş
attention to preventive measures.
5 We can protect ourselves with onion, garlic and olive oil. Mardin
8 Garlic, onion and coffee are protectors against the virus. Kayseri
16 The virus disappears when the weather gets hot. Kocaeli, Mardin, Bursa
20 The virus can be cured if we eat sumac plant. Mardin, Bursa, Kayseri, Şanlıurfa
31 Coronavirus will not infect you if you perform ablution.6 Bursa, Kilis, Mersin
35 The virus does not infect the Muslims. Gaziantep, Kilis, Mersin
Survey respondents also reported similar rumours in their communities. Below is a summary of their responses:
• Drinking alcohol/tea/water with lemon or eating garlic/onion/sumac/hot pepper can protect against COVID-19.
• The virus is a governmental programme/biological weapon.
• Antibiotics are a good cure for the virus.
• Unverified information about vaccination.
• Animals can get infected.
• It is very dangerous.
• Masks can protect from the virus.
• The infection rate will decrease in the summertime.
6
Ablution or “Wudu” is the Islamic procedure for cleansing parts of the body before prayers such as washing face, arms, wiping the head and washing
the feet.
ATTITUDES
Community Centre, 7 August 2020
Credit: TRCS
The majority of survey respondents view COVID-19 as very dangerous (84.0%), while few think COVID-19 is
“more or less” dangerous (12.9%), or not dangerous at all (1.7%).
Other 53 (1.4%)
The following responses were reported under the “Other” category: it varies from one person to another, not very dangerous
if taking necessary precautions, dangerous only for those with compromised immune systems, dangerous only for those
over 65 years old and/or with chronic diseases. Seven “I don’t know” answers were also reported.
Almost all participants in the FGDs considered COVID-19 to be deadly and highly contagious, first transmitted from China and
then spread across other countries. A few respondents in Hatay and Izmir reported that some people in their communities
believed COVID-19 to be a political problem or that it did not really exist.
When asked if a person who is infected or has recovered from COVID-19 would face discrimination, 21.7% of the
host population answered “Yes” compared to 8.7% of the refugee respondents. This suggests that stigmatisation
of COVID-19 is higher among the host population than among refugee communities.
Of those who face discrimination (1,548 respondents), people who have, or have previously had, COVID -19
(60.1%) were the most recognised as being discriminated against, followed by people suspected of having
COVID-19 (55.2%). Again, these responses are significantly higher among the host population (39.9% and 38.2%
respectively) compared to refugees (19.9% and 16.7% respectively). Others recognised as being stigmatised were older
people, Syrians, health workers, refugees, and poor people.
These findings complement FGDs where participants, particularly those from the host community, said that in general
people who are infected or who have recovered from COVID-19 experience discrimination in the community. People would
stay away from the infected or recovered person for fear of also becoming infected. People who have already recovered
from COVID-19 are still considered to be potential carriers of the disease. Participants also gave examples where not only
was the person infected treated differently but their families were also stigmatised.
“One of our neighbours was infected, and his whole family was discriminated against in the neighbourhood,” said one
respondent from the host community in Gaziantep.
In Izmir, it was reported that healthcare professionals found it difficult to find day care or babysitters for their children because
people were afraid that their children might pass on the virus. Participants also reported that people on low-incomes – both
refugees and local people - were bound to go to workplaces because they needed the money for their livelihoods, and so
could be at risk of infection.
People in local communities also reported rumours that foreigners had brought the virus into Turkey, creating some negative
attitudes towards people from other countries. In Sanliurfa, Mersin, Kocaeli and Kayseri, participants from host communities
said that people believe refugees cannot maintain proper hygiene due to lack of money to buy hygiene products or to live
in good housing conditions, and so are at higher risk of infection. As a result, they said, local people avoid interacting with
refugees and discriminate against refugees who have, or have had, COVID-19.
A participant from the host community in Kayseri said, “If the infected person is a refugee, the local community do not want
to meet him or her at all, even if they recover.”
Refugee participants in Konya, Kocaeli, Kayseri, Bursa and Gaziantep said that refugees encounter difficulties accessing
hospitals, especially if they do not have ID cards. Language is also an added barrier to communicating with doctors at the
hospitals. Many refugees tend to think that they will not be admitted or provided treatment if they go there.
Almost all participants recommended that TRCS organise seminars or meetings online for people to discuss this topic and
build a non-discriminatory attitude to support those who have been infected or recovered from COVID-19.
Survey respondents also mentioned that they were concerned about their family members getting sick, their children
becoming ill, death of a family member, and that the disease is/will become more widely spread.
These findings are similar to the fears aired in the FGDs. Respondents in all locations said that their greatest fear was that
they or their family members would become infected with COVID-19, particularly for people whose family members have
chronic diseases or are older. While some were concerned about losing current employment, others worried about not
finding employment due to COVID-19. For households with low incomes and poor financial conditions, many are already
unable to afford adequate hygiene materials or food for their families and children.
“I may become unemployed if I get infected,” said a respondent from the local community in Kocaeli.
Respondents also reported fear of going to hospitals, the re-opening of schools in the future, of becoming infected through
contact with people who do not show symptoms, or hearing about the death of a family member due to the disease.
Others said they were afraid they could become infected or infect one of their family members, because they were regularly
going to their workplaces. Many parents were concerned that their children cannot access the online and distance-learning
programmes which is being organised to make up for lost school time.
People are also worried about how long the pandemic will last, when the situation will improve, and when vaccines or
effective treatments will be available. “I am worried about the uncertainty”, is how one respondent from the local community
in Mardin expressed his fears about the future.
PRACTICES
Community Centre, 5 August 2020
Credit: TRCS
Overwhelmingly, survey respondents (94.3%) said they were taking some measures in their daily life to prevent
the risk of COVID-19 infection. While 4% said they only sometimes take measures, just 1.7% of the respondents said
they are not doing anything about it.
Are you taking any measures in your daily life to prevent the risk of infection?
Yes 3,621 (94.3%)
Sometimes 155 (4.0%)
No 64 (1.7%)
Those who said they were not taking any measures (64 respondents) highlighted various reasons, for example,
not knowing how to take preventive measures (50%), not believing these practices will be effective in preventing
the risk (20.3%), and being unable to afford soap or disinfectants (14.1%). Others said there was too much conflicting
information (12.5%), or that family members were compelled to go out for work (12.5%) and as a result not able to follow
safety measures.
If not, why?
More than one answer possible; 64 respondents
If yes or sometimes, what have you and your family done to prevent becoming
sick with the Coronavirus in the recent days?
More than one answer possible; 3776 respondents
Wash hands frequently using soap and water 3,399 (90.0%)
Wear mask when going out 3,286 (87.0%)
Maintain physical distance (1 meter) whenever outside 2,971 (78.7%)
Use a hand sanitizer that contains at least 60% alcohol 2,117 (56.1%)
Cover mouth and nose when coughing or sneezing 1,836 (48.6%)
Wear mask if I am sick or taking care of an infected person 957 (25.3%)
Avoid touching mouth, nose, and eyes with contaminated hands 955 (25.3%)
Wear gloves 710 (18.8%)
Use disinfectants to clean surfaces 629 (16.7%)
Other 97 (2.6%)
These survey results align well with the FGD findings. To prevent the risks of becoming infected, FGD participants said they
were taking necessary precautions in their daily lives, such as, frequently washing hands with soap or using hand sanitizers,
practicing personal hygiene, staying indoors and avoiding going out unless necessary, sterilizing surfaces and cleaning
homes with disinfectant, using masks, and maintaining physical distance whenever outside.
Participants stressed that the most important actions to reduce the risks of COVID-19 infection were to wash hands with
soap frequently and for at least 20 seconds, to eat healthy food, wear masks, maintain personal hygiene, and keep physical
distance when outside. Avoiding crowds and practicing good coughing etiquette were also given as ways to reduce the
chances of COVID-19 infection.
Participants in Kayseri, Kilis and Mersin said that they avoided going to hospital unless they had a major illness, and that
they had also cut down on visiting their relatives’ homes. However, they also recognised that there were people in their
communities living in poor economic conditions who were compelled to go out for work and unable to undertake these
precautions. People in poor economic conditions often could not afford to buy hygiene products such as masks, gloves,
and disinfectants increasing their risks of infection, the participants said.
I don’t face any challenges or difficulties in taking action 1,409 (36.7%) 1,412 (36.8%) 27 (0.7%)
Difficult to stay at home as I/member of my family needs to go out for work 256 (6.7%) 256 (6.7%) 6 (0.2%)
I had to overcome people around me who didn’t want me to take action 353 (9.2%) 153 (4.0%) 1 (0.0%)
Difficult to afford soap or disinfectants 114 (3.0%) 312 (8.1%) 4 (0.1%)
Other 120 (3.1%) 101 (2.6%) 2 (0.1%)
Prefer
Female Male not to answer
I don’t face any challenges or difficulties in taking action 1,462 (38.1%) 1,387 (36.1%) 1 (0.0%)
Difficult to stay at home as I/member of my family needs to go out for work 214 (5.6%) 302 (7.9%) 2 (0.1%)
I had to overcome people around me who didn’t want me to take action 248 (6.5%) 257 (6.7%) 2 (0.1%)
Difficult to afford soap or disinfectants 221 (5.8%) 209 (5.4%) 0 (0.0%)
Other 131 (3.4%) 91 (2.4%) 1 (0.0%)
The following challenges were recorded under the “Other” category: difficulty in wearing a mask (either general or due to
asthma), not having enough money to purchase masks, other people not taking the necessary precautions (e.g. not wearing
masks, washing hands, keeping physical distance).
FGD participants reported that despite the high levels of awareness, community members in many locations are now
becoming less inclined to follow the preventive measures compared to in the early stages of the outbreak. In Hatay, for
example, following the withdrawal of curfew, people felt that the risk of infection has reduced and so the health advice is
less relevant for them. In Gaziantep, Mardin, Mersin, Kilis and Kayseri, participants tended to feel that healthier people
would not be infected and could not spread the disease. A few people also reported beliefs that COVID-19 does not
really exist. Discomfort wearing masks in the hot weather was also reported, as well as observations that people do not
wear the masks appropriately. After months of social isolation and staying indoors, more people are now beginning to go
out to public places. As a result, public transport is becoming crowded, and physical distance cannot be maintained in
all locations. In Kahramanmaraş and Kayseri, it was suggested that young people are less willing to follow health advise,
and so risked becoming infected and further spreading the disease. In Adana and Kahramanmaraş, refugee participants
explained that it can be difficult to maintain physical distancing due to cultural norms, such as greeting people by shaking
hands or hosting guests at home. In addition, misinformation and rumours on social media were undermining accurate
health information. Rumours, such as that COVID-19 decreases in hot weather, impact people’s beliefs and behaviour to
adopt healthy practices. As more people return to their workplaces, there is a growing need to raise awareness and re-
energise people’s motivation to maintain safety and cleanliness in the office.
FGD participants in Bursa, Kahramanmaraş, Sultanbeyli and Hatay felt that women were more attentive than men in
following the health advice, maintaining personal hygiene and undertaking preventive measure. In Mersin and Şanlıurfa,
people from the host community said that more men use public transport and go out to work than women, increasing their
chances of becoming infected. Refugees from amongst the FGD participants in Adana inform that there are some refugees
in the community who rely in fatalism, hence undertake poor precautions. Refugees are also perceived to be at higher risk
of infection by the host community due to their poor economic conditions, lacking affordability to buy hygiene products and
language barriers.
What would you do if you or someone from your family has symptoms of this
disease?
More than one answer possible
I will go to the hospital 3,009 (78.4%)
I will contact a doctor or hospital to get advice 1,554 (40.5%)
I would stay at home to isolate myself from others 1,213 (31.6%)
I will ask my relative/friends to advise me on what to do 388 (10.1%)
Other 71 (1.8%)
I will buy medicines from the market 34 (0.9%)
Continue life as normal 32 (0.8%)
I will go to a religious leader 23 (0.6%)
Do nothing 13 (0.3%)
Other responses given included: call 112, call 184, call an ambulance, self-isolate. Three people did not know what they
would do in such a situation.
CHANNELS
Community Centre, 6 August 2020
Credit: TRCS
Although just over half, 55% (2,113), of respondents said they do not need any more information about COVID-19,
that still leaves 45% (1,727) of people who do recognise that they need information. Out of those who requested
for information (1,727 respondents), subjects included: symptoms of COVID-19 infection (31.7%), trusted sources of
information (26.5%), how COVID-19 is transmitted (25.1%), and how to protect oneself from the disease (20.7%).
What information do you need right now about the new Coronavirus?
More than one answer possible
Other information needed: if there is going to be second/third wave of the Coronavirus, if COVID-19 is real, what are the test
and treatment procedures, numbers of cases in each city, when the pandemic will end, information about curfews.
FGD participants in all locations said people need information about any new symptoms of COVID-19 infection, how to
maintain personal hygiene, how and when to use masks, and what should be done after a person has recovered from
the disease. They stressed that while communities may have information about preventive measures, awareness needs
to be raised about protective behaviours people can adopt themselves in post lockdown, and that people needed further
encouragement to adopt safe and healthy practices. Dissemination of information about the presence of COVID-19, its
risks, how it can spread, as well as the importance of wearing masks in public areas and physical distancing, should
be reinforced to ensure people are taking care of themselves, participants said. They felt this was particularly important
for people at increased risk such as older people, and people with chronic diseases, as well as for young people in the
community. FGD participants suggested TRCS collaborate with public institutions to maximise the impact of dissemination
of key information and highlight the importance of preventive measures.
Given the evolving situation, communities were also interested in information on the number of COVID-19 cases in each
city in Turkey, where and which hospitals are available to treat infected patients, how to get admitted to these hospitals,
information about TRCS blood support, and any updated information on COVID-19 including vaccines or drugs to treat
patients. Information materials on COVID-19 with visuals for children should be developed and disseminated to help young
people understand the risks and the necessary steps to protect against infection, participants said.
How would you prefer to receive information about the Coronavirus from TRCS?
More than one answer possible
Other methods of communication people mentioned included: email, e-government, public places (e.g. metro). Eleven
people said they did not want to receive any information from TRCS.
FGD participants suggested several ways they would like to receive information about COVID-19, including social media
platforms (WhatsApp, Facebook, Instagram and YouTube), where audio, video and visual information materials can be
posted in different languages. Other preferred channels were TV (mainly news channels and TRT Arabic), SMS, phone
calls, radio, information kiosks, brochures and official websites of public institutions, Ministry of Health and TRCS. Online
trainings, seminars or live sessions on social media organized by TRCS were also mentioned as ways to raise awareness
among people.
In Kilis, Kayseri and Gaziantep, many participants said they would prefer face-to-face interaction at the TRCS Community
Centre while others suggested household visits, which would be particularly helpful to share information with older people.
In Şanlıurfa, Kocaeli and Konya, participants suggested creating WhatsApp groups to share information about COVID-19.
While social media is quite popular among young people, it was recognised that television is more accessible for older
people. Participants stressed that audio, video, and visual information was more effective than written information, especially
for children, older people and those who cannot read or write. In Şanlıurfa, respondents said that sign language can be quite
useful in videos for those with hearing impairment. It is recommended that the use of social media platforms is maximized
to disseminate information about COVID-19.
7
“14 rules’’ - These are the precautionary measures that the Ministry of Health in Turkey has underlined for people to prevent COVID-19. The 14 rules
are explained in this link here.
Figure 26a Use of TRCS social media to receive COVID-19 information (follow up question)
The main reason people (2,088 respondents) gave for not following these social media channels was that they
did not know about them. This lack of awareness was higher amongst people from the host population (37.9%) than
amongst refugees (26.8%). For refugees, the main reasons given were not having internet (3.4%) or that the content was
not in Arabic or in their native languages (5.3%).
Figure 27 Reasons for not using or sometimes using TRCS social media
If you wanted to ask questions or share feedback with TRCS on the Coronavirus,
how would you prefer to do so?
More than one answer possible
Host population Refugee Other Prefer
not to answer
Phone 1,403 (36.5%) 1,356 (35.3%) 20 (0.5%) 1 (0.0%)
WhatsApp 395 (10.3%) 590 (15.4%) 14 (0.4%) 1 (0.0%)
SMS 293 (7.6%) 315 (8.2%) 10 (0.3%) 1 (0.0%)
TRCS website 375 (9.8%) 144 (3.8%) 5 (0.1%) 1 (0.0%)
TRCS Facebook page 147 (3.8%) 332 (8.6%) 5 (0.1%) 0 (0.0%)
Face to face TRCS Community Centre 228 (5.9%) 237 (6.2%) 2 (0.1%) 0 (0.0%)
Face to face with TRCS staff/volunteers 250 (6.5%) 212 (5.5%) 1 (0.0%) 0 (0.0%)
Feedback and Complaint Box at TRCS CC 76 (2.0%) 77 (2.0%) 1 (0.0%) 0 (0.0%)
Online meetings through Zoom/Skype 63 (1.6%) 49 (1.3%) 1 (0.0%) 0 (0.0%)
Other 62 (1.6%) 15 (0.4%) 2 (0.1%) 1 (0.0%)
8
TRCS’ 168 call centre provides a free of charge helpline for beneficiaries on the Emergency Social Safety Net (ESSN) cash assistance programme. It
aims to provide information on the ESSN application processes; receive feedback and complaints and ensure that specific issues are followed up on
and resolved.
9
Through European Union funding, and a partnership between the IFRC and TRCS, Emergency Social Safety Net (ESSN) programme provides hu-
manitarian support to more than 1.7 million refugees in Turkey through monthly cash assistance enabling them to cover essential needs like food, rent
and utilities.
RECOMMENDATIONS
Community Centre, 29 July 2020
Credit: TRCS
10
Youth Club - Like the advisory committee, a youth club has been formed in each of the TRCS Community Centres comprising members from local
and refugee children. The youth club acts as a platform where TRCS can share information about its services and provide opportunity to the members
to voice issues affecting them and participate in the designing of youth activities at the centre.
/ KizilayTM / KizilayTM
www.kizilaytoplummerkezleri.org