Assessing the State of Nosocomial HIV Infection Control (NHIC) in Health Zones in the Eastern Kasai Province (Democratic Republic of the Congo)

Abstract

BACKGROUND/OBJECTIVES: With the escalating HIV related morbidity and mortality rates in Sub-Sahara Africa, serious concerns have been expressed about unsafe medical care practices that jeopardize the safety of patients and pose considerable HIV infection risks to health care workers. However, little is known regarding the organization of nosocomial HIV infection control (NHIC) activities within African health care facilities. We launched a two-year long pilot capacity development project aimed at assessing and improving NHIC in one of the provinces of the Democratic Republic of the Congo. METHODS: Thanks to a grant coming from USAID through the Association Liaison Office for University Cooperation in Development (ALO), Northern Illinois University and the University of Mbuji Mayi formed a partnership and surveyed 218 health care workers in 2 rural and 2 urban health zones in the Eastern Kasai province. We collected baseline demographic data and other information pertaining to the availability and operation of NHIC programs and participation in NHIC related continuing education (C.E.) programs. We used SPSS to explore the patterns of magnitude and variation of these organizational features. RESULTS: Respondents included medical doctors (7.3%), nurses (71%), pharmacists (1.4%), laboratory technicians (5%) and administrative/ancillary staff (18%). About one half of the respondents (49%) was aware of an organizational structure set up to address NHIC issues. About 70% are dissatisfied with the operation of this structure. About 57% said their health facilities are involved in a limited or very limited extent in NHIC activities; only 18% reported a large or very large level of organizational involvement. Seventy-seven percent are dissatisfied with this involvement. Fifty-four percent reported that a NHIC leader has been appointed. The NHIC leaders are mostly nurses (37%). The medical profession is the next category assuming this role (27%). About 66% were mostly or somewhat dissatisfied with this appointee's performance. Whereas 52% indicated the availability of NHIC CE programs, only an average of 2 CE programs was provided in the last 3 years. A large majority is dissatisfied with the amount and quality of these CE programs (70%), and the amount (75%) and quality (77.5%) of resources provided to address NHIC issues. CONCLUSIONS: Several deficiencies exist in the organization of NHIC programs, jeopardizing the safety of both health care workers and patients. They should be systematically investigated and addressed.