"Working in the Dark": Experiences of Frontline Health Workers in Bangladesh During COVID-19 Pandemic.

Introduction: Frontline health workers (FHW) are working relentlessly to combat the COVID-19 pandemic globally. This is particularly challenging for low- and middle-income countries such as Bangladesh because of resource scarcity. Therefore, it is critical to understand the challenges of healthcare providers to help shaping a contextual pandemic response plan address current and future similar crises. Aim: This study aimed to describe the challenges faced by FHWs in Bangladesh in terms of information on COVID-19, managing patients with COVID-19, and what motivated them to continue providing service during the pandemic. Methods: This qualitative study explored the experiences of 18 FHWs who were purposely recruited from different health interventions of a development organization in Bangladesh. In-depth interviews and focus group discussions were conducted during July-August 2020 using a semi-structured interview guide. The interviews were transcribed verbatim and content analysis was used to analyze the data which led to four categories. Results: Four main categories and ten sub-categories emerged from the analysis. Categories derived from the analysis were as follows: i) experiences of the FHWs regarding information on COVID-19: "Working in the dark", ii) experience of providing care: "Patients are grateful", iii) impact on personal/family life: "Life is still in lockdown" and iv) motivation to carry on providing care. Conclusion: FHWs desire a stable information source to prepare themselves for future health care crises. Organizational support is essential for them to overcome physical and mental struggles and keep themselves motivated to continue service provision during pandemics.