Strengthening health worker safety in Tanzania: A case study

Occupational exposure is a constant hazard for health workers in developing countries where infectious diseases are endemic and access to training, vaccinations and safety-engineered supplies are limited. With the lowest physician/patient ratio worldwide, in Tanzania there is an urgent need to protect and retain health workers. In response, AmeriCares (AC) and Bugando Medical Centre (BMC) launched the pilot Health Worker Safety Initiative (HWSI) in 2009. -Design health worker safety training curriculum and train 100% of BMC workers -Immunize 720 health workers against hepatitis B -Strengthen waste disposal systems -Analyze injury reporting and PEP procedure and formulate improvements -Define key revisions to hospital standard operating procedures AC provided management, funding, and gift-in-kind support, and BMC staff implemented the program onsite. All 1,350 BMC staff and 1,000 students participated. The pilot included “train-the-trainer” safety trainings; HBV and tetanus immunizations; waste management upgrades; supply donations; and policy updates. A dedicated HWSI team was integrated into BMC's quality improvement team. 100% of BMC staff were trained, and 900 vaccinated against HBV, an achievement recognized by Tanzania's Ministry of Health. Preliminary quantitative data suggest significant improvement in staff behavior and knowledge, decreased occupational injuries, and increased supply availability. Focus groups with all worker cadres indicate increased confidence and satisfaction. This project successfully contributed to increased BMC worker satisfaction and strengthened workers' ability to protect themselves from nosocomial infection and injury—a benefit extending to patients and the community. In 2013 the program will be replicated at three Tanzanian hospitals.