Healthcare worker safety in resource constrained settings: The Zambia experience

Background

Zambia's estimated population stands at 11,297,307(CSO-2000) and the HIV prevalence is 14% (ZDHS 2006). The goal of the USAID-funded medical injection safety project is to prevent the medical transmission of HIV and other blood borne infections such as Hepatitis B and C to health care workers as well as community members accessing public and private community-based health facilities. The project's focus on preventing the medical transmission of HIV/AIDS includes a focus on the creation of safe environments for health workers and clients.

Methodology/design

During baseline data collection at the start of the project, the project found low levels of provision of post-exposure prophylaxis and Hepatitis B vaccination and inadequate use of personal protective equipment. The project compared these results to those following project interventions, using quantitative and qualitative data, including in-depth interviews, observation, and cross checks to compare baseline data to data during the project cycle.

Results/Outcome

After project interventions: Post-exposure prophylaxis provision improved from 37.3% to 69.2%, needle stick injuries were reduced from 17.6% to 11.2%, and stock out of IP/IS commodities were significantly reduced (sharp boxes from 56.9% to 20.5% and disposable needles from 42.3% to 15%).

Conclusion

Cost effective interventions, introduced through a combination of training, supportive supervision, and procurement support, can be valuable in achieving significant improvements in infection prevention and injection safety practices.