171779 Safety of health care paraprofessionals at peripheral health centers in the era of task shifting for HIV treatment

Monday, October 27, 2008

Ngoyi K. Zacharie Bukonda, PhD, MPH , Public Health Sciences, Wichita State University, Wichita, KS
Ntumba G. Disashi, PhD, MD , Unite de Recherche et de Formation en vue de l' Amelioration de la Qualite des Services de Sante, University of Mbuji Mayi, Medical School, Mbuji Mayi, Congo-Kinshasa
Musau WaKabongo, PhD , San Bernadino County Public Health Department, Laboratory Response Network, Redlands, CA
Kim Young, MPH , Department of Health Care Administration, Sunlin College, Pohang City, South Korea
There have been renewed calls in favor of “task-shifting” for HIV treatment. Yet infection control practices by health care paraprofessionals and beneficiaries of such delegation schemes have not yet been assessed. Given the escalation of HIV infection in Africa and its alleged association with unsafe medical care, we assess the extent of access to training in universal precautions (UPs) and compliance with infection control standards of paraprofessionals in Eastern Kasai (Congo). Methods: Survey of 279 health workers in 2005 provided, among other things, data on training in UPs, knowledge of HIV infection control, involvement in risky procedures, exposure to blood and body fluids (BBFs), fear to provide HIV care, and needle stick experience. We focus on data provided by 66 workers posted at peripheral primary health care centers (24%). Results: We find (a) only 42.9% of health workers trained in UPs; (b) a 65% incidence rate of needle stick injuries; (c) a high level of fear in HIV care provision (scale of 1-5); (d) greater involvement in risky procedures in health centers; (e) an equality in terms of knowledge of infection control concepts; and (f) a more frequent exposure to BBFs in health centers than in referral hospitals. Conclusions: Given widespread infection control inefficiencies at peripheral primary health care centers, greater efforts should also be devoted to medical care cleanness and continuing education in UP as task-shifting schemes for HIV treatment are envisioned.

Learning Objectives:
a) State the rationale and requirements of task-shifting for HIV treatment being advocated in favor of health care paraprofessionals; b) Determine the proportion of health care paraprofessionals posted at peripheral health centers that have had access to training in universal precautions (UPs) in Eastern Kasai (Congo); c) Explain the degree of compliance with key HIV infection control indicators at peripheral health centers and at intermediary levels of the primary health care system; d) Differentiate health care paraprofessionals from their counterparts posted at intermediary levels of the primary health care system in terms of access to training in universal precautions (UPs) and compliance with key HIV infection control indicators.

Keywords: HIV/AIDS, Workplace Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived the research project, collected and analyzed data, and developed the abstract in collaboration with the other colleagues.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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