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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
4269.0: Tuesday, December 13, 2005 - Board 1

Abstract #110679

Changing health care providers' behaviour for injection safety in Zambia: Overcoming resistance

Answell Chipukuma, Higher Diploma1, Richard S. Hughes, MA2, Michael N. Favin, MA, MPH3, Christopher Mazimba, Mmed(ob/gyn)4, Martha Ndhlovu4, and Matildah Matipa Zyambo, mcips5. (1) Manoff Group inc., Prevention of medical transmission of HIV program, P.O Box 36873, Ngumbo Road, LongAcres, Lusaka, Zambia, 260-1-256255, achipukuma@jhpiego.net, (2) Zambia Country Office, JHPIEGO Corporation, 1615 Thames Street, Baltimore, MD 21231, (3) CHANGE Project, The Manoff Group, 2001 S Street, NW, Washington, DC 20009, (4) Prevention of medical transmission of HIV program, JHPIEGO Corporation, PO Box 32481, Lusaka, Zambia, PO Box 32481, Lusaka, Zambia, (5) Zambia Injection Safety, Chemonics International, P.O. Box 36873, Lusaka, Zambia

Behavior Change for health care Providers is cardinal to achieving good injection safety practices. This came to light when implementing the Prevention of medical transmission of HIV program in two districts of Zambia.

During the one-year of piloting, the Central Board of Health (CBoH) and the Injection safety team conducted a baseline survey and identified the following behaviors and practices: even after correct assessment of patient, health providers prescribe injections even when oral medication is indicated (45%); recapping of used needles (31%); provision of injection on request from patient (59%); use of a sharp box for disposal of used needles (73%). The major Causes for resistance to change were: In adequate knowledge on the dangers of unsafe injections; fear for loss of favors; bad habits; inadequate stocks of injection supplies; lack of hand washing facilities. All these have contributed to high levels of resistance to change.

The team carried out training of health providers in Injection safety practices including interpersonal communication, produced and distributed Behavior Change Communication (BCC) materials, procured and distributed injection supplies.

Review of the behaviors after one year showed positive improvement: Two-hand recapping (11%); use of a sharp box (97%).

This presentation highlights the behaviors among health care providers, the reasons advanced for failing to change, the activities carried out to influence change and the results after implementation of activities.

PARTNERS: Manoff Group inc., Chemonics International, JHPIEGO, USAID, CBOH/MOH, Ndola and Chipata Districts

Learning Objectives:

  • Participants will be able to

    Presenting author's disclosure statement:

    I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

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    The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA