Understanding COVID-19 preventive behavior among health workers in Bali’s referral hospitals: A socio-ecological approach

2024-08-31T13:28:19+00:00

Background and purpose: Coronavirus Disease (COVID-19) is one of global health problems which affect all aspects of people’s life. Because hospitals are high-risk environments for COVID-19 transmission, healthcare workers' preventive behaviors are critical. These behaviors are shaped by the interaction of personal, interpersonal, and institutional factors. Therefore, this study aimed to explore the COVID-19 preventive behaviors of registration staff at three referral hospitals in Bali, utilizing the Socio-Ecological Model.

Methods: This qualitative study applied a phenomenological approach based on the Socio-Ecological Model of Health Behavior. The study was conducted in March 2021 at three COVID-19 referral hospitals in Bali (Sanglah, Wangaya, and Tabanan Hospitals). We purposely sampled 50 health workers from the registration section. Data were collected via online semi-structured interviews, observations and documentation, then analyzed using phenomenological techniques. Data validity was ensured through source triangulation (comparing insights from staff in outpatient, emergency, and COVID-19 registration posts, as well as the unit heads) and methods triangulation.

Results: The findings demonstrate that preventive behaviors at the personal level interacted dynamically with interpersonal and institutional dimensions. At personal level, workers adhered to standard protocols (masking, handwashing, and physical distancing), utilized hand sanitizer after patient registration, conducted routine disinfection, and wore appropriate personal protective equipment. Individual actions were reinforced through informational support from peers on how to safely interact with patients and their families. At the institutional level, the health facilities supported these personal and interpersonal efforts through official preventive policies and by physically modifying the environment in registration areas.

Conclusion: Preventing the transmission of infectious diseases in healthcare facilities requires a comprehensive approach that encompasses individual behavior, interpersonal support, a safety-oriented work culture, and robust institutional policies. These findings may serve as a reference for developing training programs, establishing standard operating procedures (SOPs), and strengthening a culture of safety among healthcare workers, thereby enhancing their preparedness to respond to future infectious disease outbreaks.

Local Wisdom, Global Impact: Integrating Perarem for Sustainable Tourism in Bali Province, Indonesia

2026-08-05T07:25:27+00:00

The COVID-19 pandemic has accelerated the ongoing global transformation, reshaping tourism, and highlighting the indispensable link between travel and public health ¹. Highly mobile travellers can carry infectious diseases across borders, turning local vulnerabilities into worldwide risks^2,3. Failure to embed robust public health systems into the heart of the tourism sector potentially creates socioeconomic instability rather than sustainable recovery and growth^4.Driven by these heightened risks, modern travellers no longer choose destinations solely for their breathtaking scenery or rich culture—they expect robust health and safety infrastructure as part of the package⁵. Yet, despite growing emphasis on health-conscious travel, a serious disconnect persists on the ground. In destinations like Indonesia, particularly Bali, the public health and tourism sectors continue to operate in silos. This lack of integration creates a critical blind spot for two-way disease transmission. A truly sustainable framework must work both ways: shielding local communities from imported pathogens while simultaneously protecting visiting tourists from endemic health risk.

Public Health and Preventive Medicine Archive

Understanding COVID-19 preventive behavior among health workers in Bali’s referral hospitals: A socio-ecological approach

Local Wisdom, Global Impact: Integrating Perarem for Sustainable Tourism in Bali Province, Indonesia