1 INTRODUCTION

COVID-19, first identified in Wuhan in late 2019, rapidly spread across the globe, disrupting everyday life and exposing inequalities in healthcare access (WHO 2022). By April 2022, more than 500 million cases were recorded worldwide. Migrants, particularly those living in high-density housing or employed in precarious work, faced heightened vulnerability (Hintermeier et al. 2021).

Finland also saw significant COVID cases among immigrants. The Finnish Institute for Health and Welfare reported that over one fourth of infections were among individuals whose mother tongue was not Finnish, Swedish, or Sámi (THL 2020). Among these groups, Bangladeshi immigrants form a small but growing community, arriving mainly for studies, work, and family reasons (Statistics Finland 2020).

However, no previous studies have explored how this Bangladeshi immigrant community in Finland experienced and responded to the pandemic. Therefore, this study examined their knowledge, attitudes, and practices (KAP) regarding COVID-19 in Kuopio, Finland, to better understand their experiences and guide future health interventions.

2 METHOD

This is a qualitative descriptive study with a phenomenological approach. In order to understand the impact of knowledge, Attitudes and Practices towards COVID 19 prevention this study adopted the phenomenology approach. Quantitative approaches have focused largely on studies in healthcare environments and medical education. The quantitative studies identified the interaction process and barriers but, the reasons behind the barriers and how the barriers affect the health possibly explored in more details through the qualitative way, However, within the academic areas, there are study issues that can be approached more accurately through qualitative research. Phenomenology is one technique that enables the investigator to take advantage of relative immersion in order to achieve a deep definition, although there are several qualitative approaches (Renjith & al. 2021)

This study contextualized the KAP framework to analyze the Knowledge Attitudes and Practices of an individual by following the phenomenology qualitative research approach.

In addition, as there are few qualitative studies discovered during COVID-19 in KAP, this study followed phenomenology approaches to uncover the socio-cultural, economic and political reality of daily practices of why and how an individual explain the health issue, perception of disease and prevention measures based on their knowledge, attitudes.

Participants and recruitment: Eleven Bangladeshi immigrants (7 men, 4 women), aged 24 to 42, who had lived in Finland for 1 to12 years, were included. Participants were recruited through convenience sampling and community networks. Eligibility required being over 18 and residing in Finland for at least one year. Recruitment continued until data saturation was reached.

Data collection: Semi-structured, in-depth interviews were conducted by the primary researcher in Bangla and English, following a piloted interview guide that covered knowledge, attitudes, and practices related to COVID-19. Interviews were recorded, transcribed verbatim, and anonymized.

Analysis: A manual thematic analysis was applied. Transcripts were repeatedly read, open-coded, and clustered into subthemes and major themes on knowledge, attitudes, and practices. The researcher maintained reflexivity throughout, acknowledging insider status within the Bangladeshi community as both an advantage and a potential bias.

Ethics: Written and verbal informed consent was obtained. Confidentiality was assured, and data were securely stored. Ethical approval was granted by the University of Eastern Finland.

3 RESULTS

Knowledge: All participants reported being aware of COVID-19 early, mostly through social media channels, including Facebook, WhatsApp, and community groups. They demonstrated a general understanding of transmission routes, mask usage, and hygiene measures, such as frequent handwashing and disinfecting surfaces. However, participants’ knowledge was sometimes vague, particularly regarding the precise rules of social distancing. For instance, one participant stated, “I knew we should keep distance, but I wasn’t sure if it was one meter or two.” This uncertainty reflected gaps in specific procedural knowledge despite overall awareness of preventive measures.

Gender differences emerged in knowledge application. Female generally reported stricter adherence to preventive behaviors and actively reminded family members to follow guidelines. One female participant noted, “I always remind my family to wear masks and wash hands, even at home,” highlighting a gendered pattern in cautious behavior. Male, particularly those engaged in delivery or cleaning jobs, demonstrated awareness but were less able to consistently implement precautions due to occupational constraints. This indicated that knowledge alone did not always translate into practice, particularly when economic survival was at stake.

Attitudes : Fear of death and personal loss strongly shaped participants’ perceptions of risk. Four individuals reported losing relatives in Bangladesh to COVID-19, which increased their vigilance. One participant explained, “After my uncle died, I took every precaution; I couldn’t risk losing anyone else.” This underscores how personal experiences with mortality heightened adherence to protective behaviors.

Religious beliefs influenced how participants understood and emotionally processed the pandemic. Many viewed COVID-19 as a spiritual test or punishment from God, which provided comfort but also shaped perceptions of personal vulnerability. As one participant reflected, “I prayed a lot; I believe God protects us, so sometimes I felt less worried about the virus.” This demonstrates that faith could simultaneously reinforce coping and reduce perceived risk, highlighting the complex role of spirituality in health behavior.

Trust in Finnish healthcare was generally high. Participants appreciated the accessibility of hospitals and available treatment. However, there was concern about potential system overload, particularly during periods of high infection rates. One participant remarked, “I trust doctors here, but I worry if too many people get sick at once.” This suggests that while formal healthcare systems were trusted, uncertainty about systemic capacity influenced participants’ sense of security.

Practices: Gender differences in preventive practices were evident. Women tended to implement more family-focused protective measures, such as consistent mask use at home and frequent handwashing. In contrast, men, especially those whose work required physical presence or contact with the public, often faced practical dilemmas between income and strict adherence to safety measures. A male participant admitted, “I wore a mask when needed, but sometimes I couldn’t avoid close contact because of work.”

Community bonds shaped behavioral choices, particularly regarding social gatherings. Despite awareness of risk, social visits and family interactions were frequent, and masks were not consistently used. Participants described this as reflecting strong trust and mutual reliance within the community, even when it increased infection risk. One participant noted, “We visit each other often; it feels safe because everyone is like family, but yes, masks are not always used.” This highlights a tension between social cohesion and public health recommendations.

Vaccination was widely accepted. All participants had received three doses, which contributed to feelings of safety and confidence in personal protection. However, vaccination sometimes led to reduced adherence to other preventive measures, such as mask-wearing in public. One participant stated, “After the third dose, I felt protected, so I didn’t always wear a mask outside.”

Livelihood and Stress: The pandemic had significant implications for economic stability and psychological well-being. Job losses, financial hardship, and separation from family in Bangladesh contributed to stress and emotional strain. Feelings of boredom, loneliness, and helplessness were commonly reported. One participant shared, “It was hard not seeing my family. I felt stressed and bored, especially when work stopped.” These experiences indicate that livelihood insecurity and social isolation compounded the challenges of pandemic-related stress, affecting both mental health and the ability to consistently follow preventive measures.

Contradictions and Diversity: Participants’ responses were heterogeneous, influenced by gender, occupation, and duration of residence in Finland. Women were generally more cautious at home, prioritizing family safety, whereas men faced trade-offs between occupational demands and preventive practices. Participants who had lived longer in Finland appeared more familiar with local healthcare practices and more confident in adhering to public health guidelines. This diversity underscores that knowledge, attitudes, and practices were shaped by a combination of personal experience, social roles, and contextual factors, rather than being uniform across the community.

4 DISCUSSION

The study explored the level of knowledge, attitudes, and practices regarding COVID-19 among Bangladeshi immigrants living in Kuopio, Finland. Specifically, it aimed to identify the sources of knowledge, assess the level and correctness of that knowledge, evaluate motivation, observe the tendency to disseminate knowledge, and examine misconceptions, risk perception, and the variability of attitudes at different levels of risk. The study also investigated the factors that supported or hindered adherence to standard COVID-19 practices, the types of practices and behaviors adopted, and the challenges faced by this population. Similarly, a study in China found that people’s age, sex, and level of education influenced COVID-19 prevention behaviors in relation to their knowledge of the disease (Hossain & al. 2020) For instance, a study in Oman revealed a strong association between knowledge and preventive practices (Ala-loul & al. 2021) While participants were aware of COVID-19 preventive measures, practices did not always align.

This same findings from other migrant studies (Skogberg, Koponen & Lilja 2021; Mathur, Rentsch & Morton 2021). Participants were well informed about preventive measures such as mask use, hygiene, and social distancing. However, this knowledge did not always translate into consistent practice. This mismatch suggests that behavior was influenced by daily challenges rather than lack of awareness. For example, those working in delivery or cleaning could not always avoid close contact, showing how livelihood concerns shaped health decisions. Women, who were more home based, managed to maintain stricter routines.

Faith strongly influenced how participants understood and coped with the pandemic. Seeing COVID-19 as a test or punishment from God provided comfort but also affected risk perception. Some relied more on prayer than on preventive action, while others saw faith as motivation to follow rules carefully. This shows how religion acted both as a psychological support and a behavioral guide.

Women displayed higher responsibility for family safety, consistent with global patterns where women often assume caregiving roles during health crises

In this study, women shown attention to hygiene and vaccination within the family underlines the importance of gendered roles in health behavior. Men, on the other hand, faced occupational exposure that limited strict adherence. This contrast demonstrates how everyday responsibilities and working conditions influenced risk taking and safety behavior.

Social networks have remained a vital source of emotional support. However, frequent gatherings without masks also increased infection risk. This dual nature of community life highlights how the same bonds that provide comfort can unintentionally promote risky behavior. Effective health promotion for similar groups could build on community trust while encouraging safer practices. A significant aspect highlighted in the findings was the interplay between community belongingness and preventive behavior. The study indicated that Bangladeshi immigrants largely relied on their own diaspora networks for information and emotional support, leading to the internal circulation of knowledge within the group. This social cohesion helped disseminate awareness about preventive measures but, paradoxically, also perpetuated collective complacency, as social gatherings continued within the community despite understanding the associated risks. The “comfort zone” phenomenon, where individuals felt safe only among fellow Bangladeshis but cautious with other nationalities, reflects a limited level of acculturation. Such selective caution underscores how social identity shaped behavioral responses during the pandemic.

Another important insight drawn from the findings is the emotional toll of isolation. Respondents expressed experiences of stress, loneliness, and frustration stemming from the inability to visit Bangladesh or socialize freely. The sense of confinement was especially pronounced during quarantine, which, while followed, caused irritation and mental fatigue. Yet, this discomfort did not translate into resistance against Finnish health policies, showing a high degree of trust in the host country’s system. Participants’ strong confidence in Finnish healthcare created a sense of security during the pandemic. Contradictory, research conducted in Finland on Russian, Somali, and Arab immigrant communities that aimed to learn about their life experience during COVID 19 observed concern for physical and material soundness, distrust in the authority of the host country, disparity, and the risk of lack of support during illness among the study participants and thereby showed distrust enervating the migrants and making them vulnerable to stress and making them reluctant to seek support and assistance during distress (Finell & al. 2021). Therefore within the different immigrant groups are varied due to socio-cultural perspective. This trust encouraged compliance with vaccination but also led to reduced caution afterward. The finding emphasizes that communication should continue even after vaccination campaigns, reminding people that preventive measures remain important.

Finally, although participants showed good attitudes and solid knowledge, these did not always result in regular practices. Situational convenience, exhaustion, and the perception that vaccination had made them less susceptible were the main causes of behavioral gaps. Therefore, even with awareness, the sustainability of preventative measures depended more on social reinforcement and perceived danger than on personal knowledge. The results combined imply that in order to close the ongoing gap between knowing and doing, successful COVID-19 solutions among immigrant populations must address socio-cultural realities, gender norms, emotional well-being, and acculturation issues. A few numbers of participants and focus only in one city limit the generalizability of the results. However, the study offers valuable insight into how Bangladeshi immigrants in Kuopio combined knowledge, faith, and daily realities in their response to COVID-19.

---

Author of the article: Rezwan Siddique, Savonia University of applied science

---

References:

Alaloul, F., AbuAlrub, R., Alrawashdeh, H. & Al-Dwaikat, T. 2021. Public knowledge, attitude, practices, and level of anxiety toward the COVID-19 pandemic among people living in Oman. Nursing Forum, 05 May 2021, 104926. https://doi.org/10.1111/nuf.12592. Accessed 12.03.2022

Finell, E., Tiilikainen, M. & Jasinskaja-Lahti, I. 2021. Lived experience related to the COVID-19 pandemic among Arabic-, Russian- and Somali-speaking migrants in Finland. International Journal of Environmental Research and Public Health, 18, 2601. https://pubmed.ncbi.nlm.nih.gov/33807723/. Accessed 01.02.2022.

Hintermeier, M., Gencer, H. & Kajikhina, K. 2021. SARS-CoV-2 among migrants and forcibly displaced populations: A rapid systematic review. Journal of Migration and Health, 4, 100056. https://pubmed.ncbi.nlm.nih.gov/34151312/. Accessed 01.02.2022.

Hossain, M.A., Jahid, M.I.K. & Hossain, K.M.A., 2020. Knowledge, attitudes, and fear of COVID-19 during the rapid rise period in Bangladesh. PLOS ONE, 15, p.e0239646. [online] Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239646 [Accessed 14 November 2025].

Skogberg, N., Koponen, P. & Lilja, E. 2021. Access to information, preventive measures and working conditions during the coronavirus epidemic. Helsinki: Finnish Institute for Health and Welfare. https://www.julkari.fi/bitstream/handle/10024/141067/TYO%202021_008_14042021.pdf?sequence=7&isAllowed=y. Accessed 17.04.2022.

Renjith, V., Yesodharan, R., Noronha, J., Ladd, E. & George, A. 2021. Qualitative methods in health care research. International Journal of Preventive Medicine, 12, 20. https://pubmed.ncbi.nlm.nih.gov/34084317/. Accessed 10.02.2022.

Statistics Finland, 2022. Population and society: Population (size and structure of the permanently resident population and related changes) [online]. Helsinki: Statistics Finland. Available at: https://stat.fi/til/vrm_en.html [Accessed 21 January 2021].

World Health Organization (WHO), 2022b. WHO Coronavirus (COVID-19) Dashboard. [online] Available at: https://covid19.who.int/ Accessed 25 April 2022.

Article has been previously published at This artcile is prepared from my Master’s thesis from University of Easrern Finland. Link: https://erepo.uef.fi/server/api/core/bitstreams/ae2ed7d8-305a-4b0b-895b-73e872f0764e/content