Health Worker Compliance Research Articles

Hubungan Supervisi Kepala Ruangan Dengan Kepatuhan Tenaga Kesehatan Dalam Menjalankan Standar Operasional Prosedur Pemasangan Infus Di UPTD Puskesmas Mawasangka TimurTahun 2023

Infusion is one of the invasive procedures performed by health workers by injecting a certain amount of fluid into the body into the vein to improve or prevent fluid and electrolyte, blood, and nutritional disturbances. The act of installing an infusion will be of high quality if in its implementation it always complies with the standards that have been set. One of the factors that can affect the performance of nurses, including the compliance of nurses and midwives in providing actions according to the SOP is supervision. This study aims to analyze the relationship between the supervision of the head of the room and the compliance of health workers in carrying out standard operating procedures for infusion at the UPTD Puskesmas Mawasangka Timur in 2023. This study is a correlation analytic study with a cross sectional study design. The sample in this study was 41 people consisting of 21 nurses and 20 midwives. The sampling technique used in this study is nonprobability sampling with total sampling. Data were analyzed using the chi-square test to determine the relationship between the independent and dependent variables. The results of statistical tests showed that there was a relationship between the supervision of the head of the room and the compliance of health workers in carrying out standard operating procedures for infusion at the Mawasangka Timur Health Center UPTD in 2023 (p-value 0.000 <0.05). Supervision of the head of the room has a significant role in increasing the compliance of health workers, especially nurses and midwives, in carrying out standard operational procedures for infusion installation.
 

THE RELATIONSHIP BETWEEN KNOWLEDGE, TRAINING, AND INFRASTRUCTURE ON THE COMPLIANCE OF HEALTH WORKERS IN APPLYING STANDARD PRECAUTIONS IN HOSPITALS

Compliance with standard precautions among health workers in hospitals is currently still low. Based on the preliminary survey, it is known that the IPCLN has been formed and the PPI program has been created. The infection data found that there was one nurse who was positive for HBsAg, supervision was limited to service matters. The research objective was to determine the relationship between knowledge, training, and infrastructure on the compliance of health workers in applying standard precautions in hospitals. This type of research is a quantitative research that is correlational, with a cross-sectional research design. The population is all nurses in the emergency room, inpatient and outpatient settings. Sampling was taken using Purposive Sampling technique, the sample size was 163 respondents. Univariate and bivariate data analysis. The results showed that 66.2% of respondents had good knowledge, 70.6% had attended training, and 77.3% of respondents answered that the infrastructure was good. Bivariate analysis showed that the knowledge variable had a P value = 0.001 (<0.05), the training variable had a P value = 0.000 (<0.05), and the infrastructure variable had a P value = 0.000 (<0.05). The conclusion is that there is a relationship between knowledge, training, and infrastructure on the compliance of health workers in applying standard precautions. Suggestions that health workers should always apply standard precautions, hospitals can provide ongoing training and education to improve care adherence to standard precautions.

Analisis Faktor Yang Berhubungan Dengan Kepatuhan Penggunaan Alat Pelindung Diri Di Masa Pandemi COVID-19 Pada Tenaga Kesehatan

Compliance of health workers using Personal Protective Equipment (PPE) in the current pandemic conditions is more important to pay attention to because negligence in its use can endanger their safety. In fact, there are still many health workers who do not comply in using PPE according to predetermined standards. The study aims to determine the relationship between knowledge factors, attitudes towards the use of PPE and the availability of PPE with the compliance of health workers in the use of PPE in the Inpatient Installation of Kanjuruhan Hospital, Malang Regency. The study is correlational in design with a cross-sectional approach. The population of all health workers at the Wonosari Health Center, Kepanjen and Ngajum, Malang Regency, who focus on handling COVID-19. Determination of sample members using simple random sampling technique, a sample of 73 respondents. Data collection using questionnaire instruments, and data analysis using the Spearman test. Spearman's test results showed that there was a relationship between knowledge factors (p= 0.000,= 0.491), attitudes towards the use of PPE (p= 0.000, = 0.705), and the availability of PPE (p = 0.000, = 0.763) with the compliance of health workers in the use of PPE. Knowledge is related to compliance with the use of PPE because with good knowledge, health workers will increasingly realize the importance of using PPE for their safety. The attitude related to compliance with the use of PPE because of the positive attitude of health workers towards the importance of using PPE, is a situation where health workers view the use of PPE as an important thing to implement for their own safety, causing a tendency to behave towards compliance in the use of PPE. The availability of PPE is related to compliance with the use of PPE because to be able to comply with the use of PPE, of course, health workers need adequate facilities.

Compliance with Standard Precaution Practices During the Early Phase of the Covid-19 Pandemic among Nurses in Nigeria

Background: Nurses serve at the frontline during disease outbreaks. While measures have been adopted to control the rapid spread of the Covid-19 pandemic, little is known about the level of compliance of nurses to standard precaution practices during the early phase of the pandemic. Objective: This study aimed to assess compliance with standard precaution practices (SPPs) among 713 nurses in Nigerian hospitals during the early phase of the pandemic. Method: The study adopted a descriptive cross-sectional design using an anonymous online questionnaire to elicit data from respondents. Data were analysed with the Statistical Package for the Social Sciences, version 25. Chi-square test and multiple regression analyses were also conducted where appropriate. Results: Findings from this study indicated that 448 (62.8%) of the respondents had good knowledge of Covid-19 and 265 (37.2%) had poor knowledge. Also, 529 (74.2%) had good compliance with the practice of standard precautions, and 184 (25.8%) showed non-compliance. A significant association was found between the age of nurses (χ2=14.034 p=0.015), years of experience (χ2=8. 636 p =0.035) and their overall compliance with the practice of standard precautions. Conclusion: During the early phase of the Covid-19 pandemic in Nigeria, although over an average of the nurses had good knowledge of the disease, over one-third had poor knowledge, and one-quarter showed poor compliance with standard precautions. Interventions to improve the knowledge and compliance of health workers during the early phase of disease outbreaks are hereby advocated, as 21.3% had no previous training on Covid-19.

MHealth platform improved health worker's compliance to WHO’s IMNCI guideline in Nairobi, Kenya

Abstract Poor access to quality health services, especially in urban slums, is a global challenge. Given similar challenges in Nairobi's Kibra informal settlement area, we collaborated with the Langata/Kibra sub-county health management team to conduct a pilot program for improving the quality of child health services delivered by health care providers (HCPs). The pilot introduced a digital mHealth platform to HCPs working in Kibra informal settlement area in Nairobi. This mHealth platform was compliant to WHO's recommended guideline for integrated management of newborn and child illnesses (IMNCI) and was designed to help sick child assessment, diagnosis and management by HCPs. We aimed to determine if using this digital platform, coupled with supportive supervision and community outreach, would lead to improve compliance to the IMNCI guideline for assessment, diagnosis and treatment of sick children. We conducted baseline (February 2019) assessment, trained selected HCPs on the mHealth platform on handheld android tablets, conducted end line (March 2020) and measured any change in HCP's compliance to IMNCI guidelines. Total 89 HCPs were the mHealth platform users during end line assessment. When asked about the choice of antibiotic for treating childhood pneumonia, we found proportion of HCPs who preferred Amoxycillin dispersible tablet, the recommended treatment for childhood pneumonia, increased from 3% at baseline to 38% at end line. Proportion of HCPs who were aware that antibiotics should NOT be used for the management of simple diarrhea increased from 14% (at baseline) to 50% (at end line). At end line, more than 90% HCPs were found compliant in their practice to IMNCI guidelines for sick child assessment, diagnosis and management. These results demonstrate the use of the IMNCI compliant mHealth platforms as a potential important effective way to improve capacity and compliance among HCPs who are serving communities like Kibra informal settlement in Nairobi, Kenya. Key messages • WHO recommended IMNCI compliant mHealth platform enables health care providers to offer quality child health care. • Using mHealth platform to ensure WHO’s IMNCI guideline implementation by health care providers might have potential impact on saving sick children’s lives from preventable deaths.

Analysis of factors related to health personnel compliance with the use of personal protection equipment (PPE) during the COVID-19 pandemic

The role of infection prevention and control practices using personal protective equipment (PPE) is very important, especially for health workers who work on the front lines. Health workers, especially in the emergency room, are required to wear eye protection, head coverings, N95 masks or the equivalent, disposable gloves, boots and gowns that cover from head to toe. This study aims to determine what factors are related to the compliance of health workers in the use of PPE in the emergency room. The research design used a correlational research method with a cross sectional approach. The population of this study were Health Workers in the Emergency Room Dr. Ramelan Naval Central Hospital Surabaya as many as 75 people, the sample size is 75 people using total sampling analyzed using chi square correlation. The independent variables are age, years of service, workload and knowledge. The dependent variable is the Compliance of Health Workers in the use of PPE. The instrument uses a questionnaire. The results of the study showed that there was a relationship between age, working period, workload and knowledge with the compliance of health workers in using PPE in the Emergency Room Dr. Ramelan Naval Central Hospital Surabaya.

Financially incentivized knowledge assessments to improve provider compliance with treatment guidelines: a cluster-randomized controlled trial

BackgroundDespite increasing access to health care, under-5 mortality remains high in many parts of Sub-Saharan Africa. Interventions to improve quality of care have mostly focused on additional training for medical staff, but generally shown little impact. We will assess the impact of financially incentivized quarterly provider knowledge assessment on compliance with Integrated Management of Childhood Illness (IMCI) protocols in Congo, DRC.MethodsOut of a total of 1738 facilities currently receiving results-based financing under an ongoing health financing program, 110 facilities were chosen for this study. All health care workers providing outpatient services to children under age 5 in these facilities will be included in the study. Facilities were randomized with equal probability to control and treatment. Treatment facilities will receive quarterly medical staff knowledge assessments using interactive vignettes. Performance on these vignettes will be rewarded through financial bonus payments to facilities. A baseline survey of health worker knowledge was conducted in 2018. An endline assessment is scheduled to start in the second half of 2021. The primary outcome of interest is health worker compliance with Integrated Management of Childhood Illness (IMCI) guidelines. Compliance will be verified through direct observation of medical staff-patient interactions.DiscussionThis is to our knowledge the first trial assessing whether linking health financing to health care worker performance on knowledge assessments can increase compliance with under-5 case management protocols.Trial registrationClinicalTrials.gov NCT04634019. Registered on November 18, 2020.

HUBUNGAN ANTARA TINGKAT PENGETAHUAN TENAGA KESEHATAN TENTANG PENYEBARAN INFEKSI DENGAN KEPATUHAN MENCUCI TANGAN (FIVE MOMENT) DI RSD MANGUSADA

Infections that occur in hospitals called Healthcare Associated Infections (HAIs) are a serious problem for public health. HAIs are infections that patients get during undergoing treatment procedures and medical procedures in health services after jam 48 hours and after ? 30 days after leaving the health facility. One way to reduce nosocomial infections is by washing hands. The purpose of this study was to determine the relationship between the level of knowledge of health workers about the spread of infection with five moment compliance. The design of this research is descriptive correlational research with the approach used is cross sectional approach. Determination of the sample in this study was chosen by the total sampling technique which amounted to 40 people. The data collection of knowledge about the spread of disease using questionnaires and hand washing data five moments using the observation sheet. The statistical test used in this study was Rank Spearman. The results of this study are p value 0.104 <0.05 so that the hypothesis is rejected ie there is no relationship knowledge knowledge of infection spread with the compliance of health workers in hand washing (five moments). Based on the results of this study, it is recommended that the Badung Mangunsada General Hospital be used as a reference in compliance with five moments hand washing by health workers so as to prevent the spread of infection.

Effect of a multifaceted intervention to improve clinical quality of care through stepwise certification (SafeCare) in health-care facilities in Tanzania: a cluster-randomised controlled trial

SummaryBackgroundQuality of care is consistently shown to be inadequate in health-care settings in many low-income and middle-income countries, including in private facilities, which are rapidly growing in number but often do not have effective quality stewardship mechanisms. The SafeCare programme aims to address this gap in quality of care, using a standards-based approach adapted to low-resource settings, involving assessments, mentoring, training, and access to loans, to improve clinical quality and facility business performance. We assessed the effect of the SafeCare programme on quality of patient care in faith-based and private for-profit facilities in Tanzania.MethodsIn this cluster-randomised controlled trial, health facilities were eligible if they were dispensaries, health centres, or hospitals in the faith-based or private for-profit sectors in Tanzania. We randomly assigned facilities (1:1) using computer-generated stratified randomisation to receive the full SafeCare package (intervention) or an assessment only (control). Implementing staff and participants were masked to outcome measurement and the primary outcomes were measured by fieldworkers who had no knowledge of the study group allocation. The primary outcomes were health worker compliance with infection prevention and control (IPC) practices as measured by observation of provider–patient interactions, and correct case management of undercover standardised patients at endline (after a minimum of 18 months). Analyses were by modified intention to treat. The trial is registered with ISRCTN, ISRCTN93644888.FindingsBetween March 7 and Nov 30, 2016, we enrolled and randomly assigned 237 health facilities to the intervention (n=118) or control (n=119). Nine facilities (seven intervention facilities and two control facilities) closed during the trial and were not included in the analysis. We observed 29 608 IPC indications in 5425 provider–patient interactions between Feb 7 and April 5, 2018. Health facilities received visits from 909 standardised patients between May 3 and June 12, 2018. Intervention facilities had a 4·4 percentage point (95% CI 0·9–7·7; p=0.015) higher mean SafeCare standards assessment score at endline than control facilities. However, there was no evidence of a difference in clinical quality between intervention and control groups at endline. Compliance with IPC practices was observed in 8181 (56·9%) of 14 366 indications in intervention facilities and 8336 (54·7%) of 15 242 indications in control facilities (absolute difference 2·2 percentage points, 95% CI −0·2 to −4·7; p=0·071). Correct management occurred in 120 (27·0%) of 444 standardised patients in the intervention group and in 136 (29·2%) of 465 in the control group (absolute difference −2·8 percentage points, 95% CI −8·6 to −3·1; p=0·36).InterpretationSafeCare did not improve clinical quality as assessed by compliance with IPC practices and correct case management. The absence of effect on clinical quality could reflect a combination of insufficient intervention intensity, insufficient links between structural quality and care processes, scarcity of resources for quality improvement, and inadequate financial and regulatory incentives for improvement.FundingUK Health Systems Research Initiative (Medical Research Council, Economic and Social Research Council, UK Department for International Development, Global Challenges Research Fund, and Wellcome Trust).

Health Worker Compliance with Infection Prevention and Control Policy in Ghana: A Case Study of La General Hospital

Infection Prevention And Control Is An Important Topic In The Delivery Of Quality Health Care Because It Aims At Protecting The Patient, The Health Worker, And The General Public. The Main Objective Of The Study Was To Determine Health Workers’ Compliance With Infection Prevention And Control Policy Guidelines During Health Care Delivery. A Cross-Sectional Design Using A Quantitative Method Was Used To Carry Out This Study In Which 143 Health Workers At The La General Hospital Were Selected Using A Stratified Sampling Method. The Data Collected Using A Structured Questionnaire Was Statistically Analyzed Using Chi-Square Test And Logistic Regression To Establish An Association Between The Dependent And Independent Variables Using A Significance Level Of P<0.05 At 95% Confidence Interval. The Results Indicated That Knowledge Of Infection Prevention And Control Among Health Workers Was High As 97% Had Adequate Knowledge, With 64% Of This Proportion Having Excellent Knowledge. Additionally, The Availability Of Infection Prevention Resources To Health Workers Always Was 31.4%; Non-Compliance Due To Time Constraints At Work Was 66.4%, And Compliance With Infection Prevention And Control Guidelines Was 30.7%. Time Constraint At Work Was Significantly Associated With Health Workers’ Compliance With Infection Prevention And Control (P = 0.001). The Paper Suggests That Regular In-Service Training On Infection Prevention And Control Must Be Continued To Improve The Standards Of Health Delivery Practice. Management Is Encouraged To Improve The Availability Of Infection Prevention Resources To Health Workers And To Duly Regulate Staff Workload In Order To Reduce Time Constraints And Prevent Burnout.

The situation of routine hand hygiene compliance of health workers at Cu Jut Medical Center, Dak Nong district and some influencing factors in 2020

Background: Hand hygiene is a great way to ensure safety for health staff and prevent infections in hospital. Objective: The study aimed to determine the rate of compliance with routine hand hygiene and to analyze some factors affecting hand hygiene compliance routine of medical staff. Method: A study that describes a cross-sectional study, a study that combines both quantitative and qualitative methods through the observation by a checklist of 92 health-care workers who perform a procedure on 368 hand-hygiene opportunities and gather information through burns. interviewed 92 medical staff, conducted 04 in-depth interviews and 02 group discussions, and collected from March to the end of June 2020. Research Using Epidata 3.1 software to input data and manage data; Stata 14.0 software for data analysis. Results show that the percentage of health staffs who complied with routine hand hygiene was 14.13%, and the knowledge and attitudes of hospital staffs were related to routine hand hygiene compliance, with p<0.05. Inspection and supervision, regulations on emulation and commendation; training and accessibility solutions were related withhand hygiene of health staffs. Conclusion: Hospital staffs' hand hygiene compliance rate was relatively low, which was related to knowledge and attitudes. Keywords: Routine hand hygiene, medical staff, influencing factors.

THE LEVEL OF COMPLIANCE OF HEALTHCARE WORKERS IN PERFORMING HAND HYGIENE: A LITERATURE REVIEW

Compliance level of healthcare workers in performing hand hygiene is a significant aspect of patient safety goals. However, it is still not optimal and is one of the critical problems of many hospitals globally, including in Indonesia. The non-optimal consequence of hand hygiene compliance is hospital-associated infections since hands are an intermediary medium for transmitting infection. This literature aims to determine the level of compliance of health workers in performing hand hygiene and find out several matters that can be done so that the health worker's compliance can be optimal or increased. Review of articles through several electronic databases including PubMed and ProQuest, with the keywords "Compliance", "Hand Hygiene", "Health Workers", and "Hospital". Inclusion criteria include articles published between 2005 and 2019, health worker respondents, English language, full text and observation, or interview data collection techniques. The literature search found 212 articles, and after manual review, ten articles were identified and assessed using the JBI form (Joanna Briggs Institute). The literature review findings suggest that, following the intervention, the level of compliance of health workers in performing hand hygiene is still lacking and growing. The conclusion is that more significant support from the hospital (e.g., role models, audits, adequate infrastructure, education and repeated training), the greater the compliance of health workers in performing hand hygiene.

A Facility-Based Cross-Sectional Study on the Implementation of the IMNCI Program in Public Health Centers of Soro District, Hadiya Zone, Southern Ethiopia.

BackgroundIntegrated Management of Neonatal and Childhood Illnesses (IMNCI) is one of the child health programs and it provides an integrated approach and focuses on the well-being of the whole child. Globally, nearly nine million children pass away every year with preventable and treatable conditions. IMNCI program is provided by the health facilities to aid children under five years of age from illness. This study is aimed at assessing the implementation of the IMNCI program in public health centers of Soro District, Hadiya Zone, Southern Ethiopia.MethodsThe implementation of the IMNCI program was studied using a facility-based cross-sectional study design integrating both qualitative and quantitative data collected from 9 public health centers in Soro district, Hadiya Zone, Southern Ethiopia. A total of 390 (92%) caregivers were included in the study by the proportion of under-five outpatient coverage from each public health center. Data were collected through face to face interviewer-administered questionnaires, document review checklist, observation checklist, and in-depth interview guide.ResultsBased on agreed criteria resources' availability was 80.11% and judged as fair. Less than 50% of health centers (HCs) had cotrimoxazole and gentamycin. The compliance of health workers was 85.5% and judged as good. Below 85% of prescribed drugs were given correctly for the classified disease. Counseling on medication and follow updates were given for less than 80% of caretakers. The overall satisfaction of clients on IMNCI was 79.5% according to the judging criteria. The caretakers who took less than 30 minutes to reach the health center on foot (AOR=7.7, 95% CI [3.787–15.593]), caretakers who waited for less than 30 minutes to see the health care provider (AOR=2, 95% CI [1.00–3.77]), the caretakers who found prescribed drugs in HCs pharmacy (AOR = 3.7,95% CI [1.91–7.34]), the caretakers who have less than four family size (AOR=2, 95% [1.109–4.061]) were more satisfied in IMNCI services, whereas, caregivers who measured the weight of child were negatively associated with satisfaction (AOR= 0.24, 95% CI [0.13–0.45]).ConclusionThis study found that the overall implementation of the Integrated Management of Neonatal and Childhood Illnesses was good. All health centers had trained health workers, ORS, paracetamol, vitamin A, chart booklet, and IMNCI guidelines were available; however, cotrimoxazole, gentamycin, ampicillin, and mebendazole were less abundant drugs in health centers. Further, a large-scale study is required to be conducted in future in other districts to ensure proper implementation of the IMNCI program in Ethiopia.

Kepatuhan Petugas Kesehatan Terhadap Standar Pelayanan Antenatal Yang Berkualitas Di Puskesmas Kabupaten Karawang

Selama tahun 2014 - 2016, cakupan pelayanan antenatal (ANC) kabupaten Karawang selain melampaui dari target, cakupan ini juga diatas cakupan provinsi dan nasional. Meskipun cakupan ANC mengalami peningkatan, namun kabupaten Karawang menempati rangking kedua kabupaten di Jawa Barat yang jumlah kematian ibu terbanyak. Tingginya hasil cakupan ANC (kuantitatif), namun masih tingginya jumlah kematian ibu, hal ini menunjukkan masih rendahnya kualitas ANC di kabupaten Karawang. Penelitian ini bertujuan mengetahui gambaran kepatuhan petugas kesehatan dalam melaksanakan standar pelayanan antenatal. Lokasi penelitian di Puskesmas Rengasdengklok, Puskesmas Ciampel, dan Puskesmas Jatisari Kabupaten Karawang. Penelitian ini merupakan jenis penelitian kualitatif dengan pendekatan etnografi. Pengumpulan data dilakukan melalui observasi, dokumentasi, dan wawancara mendalam. Analisis data menggunakan cara interaktif yang terdiri atas: reduksi data, penyajian data dan penarikan simpulan. Keabsahan data menggunakan teknik triangulasi, analisis kasus negatif, member check, dan low inference descriptor (verbatim), dan diskusi teman sejawat. Hasil penelitian menunjukkan bahwa petugas kesehatan pada tiga puskesmas lokus penelitian lebih berfokus pada kebijakan, sarana dan prasarana, standar operasional prosedur, dan koordinasi tim. Kepatuhan petugas kesehatan akan lebih baik jika ada kebijakan yang lebih memadai, kelengkapan sarana dan prasarana, standar operasional prosedur yang jelas, dan koordinasi tim yang lebih serta kepemimpinan yang kuat.

Does health worker performance affect clients\u2019 health behaviors? A multilevel analysis from Bangladesh

BackgroundSuboptimal healthcare quality may be a barrier to achieving child health improvements, yet little is known about the relationship between provider compliance with evidence-based practices and client behavior change. We assess provider compliance in the context of infant and young child feeding (IYCF) counseling, its relationship with client IYCF behaviors in Bangladesh, and explore its potential determinants.MethodsWe use data from a 2017 evaluation of an IYCF program that includes a health worker survey (n = 74), caregiver survey (n = 232), and direct service observation checklists of counseling sessions (n = 232 observations of 74 health workers). We assess the relationship between provider compliance with recommended IYCF counseling topics and behaviors (standardized to a 100-point scale) and three reported IYCF behaviors among clients using multi-level models with random effects at the health worker and sub-district (sampling) levels. We also evaluate whether health worker self-efficacy, satisfaction, and technical knowledge are associated with provider compliance.ResultsHealth worker compliance was significantly associated with reported exclusive breastfeeding for children under 6 months of age (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.06, 95% CI 1.01, 1.12) and marginally associated with minimum dietary diversity (adjusted odds ratio per 1 percentage point increase in counseling compliance score = 1.05, 95% CI 1.00, 1.11). Counseling compliance was significantly and positively associated with both health worker self-efficacy and technical knowledge.ConclusionsWe find evidence for an association between health worker compliance and client health behaviors; however, small effect sizes suggest that behavior change is multifactorial and affected by factors beyond care quality. Improvements to technical quality of care may contribute to desired health outcomes; but policies and programs seeking to change health behaviors through counseling may also wish to target upstream factors such as self-efficacy, alongside technical skill-building and knowledge, for maximum impact.

Supply chain management of laboratory commodities for tuberculosis in Indonesia: using assessment results to strengthen staff capacity

Background High quality laboratory diagnosis is critical for any tuberculosis (TB) control program. Reliable and accurate laboratory testing depends on collecting high quality specimens, using careful collection methods, and properly storing and transporting specimens. Although various guidelines for proper collection and handling exist in Indonesia, there was no data on health worker compliance with those guidelines. Such data could help the Ministry of Health ensure staff capacity to carry out high quality laboratory diagnosis.

Health worker factors associated with prescribing of artemisinin combination therapy for uncomplicated malaria in rural Tanzania

BackgroundImproving malaria case management is partially dependent on health worker compliance with clinical guidelines. This study assessed health worker factors associated with correct anti-malarial prescribing practices at two sites in rural Tanzania.MethodsRepeated cross-sectional health facility surveys were conducted during high and low malaria transmission seasons in 2010 and collected information on patient consultations and health worker characteristics. Using logistic regression, the study assessed health worker factors associated with correct prescription for uncomplicated malaria defined as prescription of artemisinin-based combination therapy (ACT) for patients with fever and Plasmodium falciparum asexual infection based on blood slide or malaria rapid diagnostic test (RDT) according to national treatment guidelines.ResultsThe analysis included 685 patients with uncomplicated malaria who were seen in a health facility with ACT in stock, and 71 health workers practicing in 30 health facilities. Overall, 58% of malaria patients were correctly treated with ACT. Health workers with three or more years’ work experience were significantly more likely than others to prescribe correctly (adjusted odds ratio (aOR) 2.9; 95% confidence interval (CI) 1.2-7.1; p = 0.019). Clinical officers (aOR 2.2; 95% CI 1.1-4.5; p = 0.037), and nurse aide or lower cadre (aOR 3.1; 95% CI 1.3-7.1; p = 0.009) were more likely to correctly prescribe ACT than medical officers. Training on ACT use, supervision visits, and availability of job aids were not significantly associated with correct prescription.ConclusionsYears of working experience and health worker cadre were associated with correct ACT prescription for uncomplicated malaria. Targeted interventions to improve health worker performance are needed to improve overall malaria case management.

Changes in postoperative infections following implementation of safe surgery checklist and hand hygiene in University of Gondar Hospital

To measure the changes in post opertive wound infections before and after introduction of hand hygiene and safe surgery check list. To see the compliance of health workers on hand hygiene and on using the safe surgery check list.