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


Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

4269.0: Tuesday, December 13, 2005 - Board 1

Abstract #110679

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

1.To learn the Zambian experience and use the experience in their own localities
2.Analyse and choose the best possible approaches when working with either receptive or resistant individuals
3.Discuss the importance of behaviour change communication in overcoming resistance to change

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.

Perspectives on Tertiary Care

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