Compliance With Infection Prevention Guidelines By Health Care Workers at Ronald Ross General Hospital Mufulira District

Objective: To determine the level of health-care workers’ compliance with Infection Prevention Guidelines and identify factors that influence compliance at Ronald Ross General Hospital, Mufulira District. Methods: A quantitative study was carried out in 2007. Convenient sampling method was used. Data was obtained using a self administered interview schedule and an observation checklist. A total of 77 health care workers who included Doctors, Registered Midwives and Nurses, Enrolled Midwives and Nurses, clinical Officers, Laboratory Technicians and physiotherapists took part in the study. Additionally, 40 out of the 77 interviewed health workers were observed carrying out at least one procedure requiring compliance with the Infection Prevention (IP) guidelines. Results: The study revealed that, high compliance was associated with inclusion of Guidelines in the Curricular, high knowledge of infection prevention/hospital acquired infections, positive attitude towards infection prevention and availability of materials for infection prevention. The study further reviewed revealed varied levels of compliance on different components of infection prevention. The highest level of compliance (100%) was with single use of needles and syringes while the lowest (35.1) was with decontamination of needles and syringes with 0.5% chlorine solution prior to disposal. Compliance with hand hygiene was moderate (61%). Conclusion: The study findings suggest a need for inclusion of Infection Prevention Guidelines in the health workers’ curricular, provision of in-service training in infection prevention protocols and improvements in the supply of materials for infection prevention

Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study

<p>Abstract</p> <p>Background</p> <p><it>Zuo yuezi </it>is the month postpartum in China associated with a variety of traditional beliefs and practices. We explored the current status of <it>zuo yuezi </it>from social, cultural and western medical perspectives.</p> <p>Methods</p> <p>We interviewed family members (36) and health workers (8) in Fujian Province, selecting one rural and one rapidly developing urban county. We asked about their traditional beliefs and their behaviour postpartum. We used a framework approach to identify main themes. We categorised reported behaviour against their probable effects on health, drawing on Western standards.</p> <p>Results</p> <p>Respondents reported that <it>zuo yuezi </it>was commonly practiced in urban and rural families to help the mother regain her strength and protect her future health. <it>Zuo yuezi </it>included: dietary precautions, such as eating more food and avoiding cold food; behavioural precautions, such as staying inside the home, avoiding housework and limiting visitors; hygiene precautions, such as restricting bathing and dental hygiene; and practices associated with infant feeding, including supplementary feeding and giving honeysuckle herb to the infant. Respondents reported that the main reasons for adhering to these practices were respect for tradition, and following the advice of elders. Categorised against Western medical standards, several <it>zuo yuezi </it>practices are beneficial, including eating more, eating protein rich food, avoiding housework, and daily vulval and perineal hygiene. A few are potentially harmful, including giving honeysuckle herb, and avoiding dental hygiene. Some women reported giving infants supplementary feeds, although <it>zuo yuezi </it>emphasises breast feeding.</p> <p>Conclusion</p> <p><it>Zuo yuezi </it>is an important ritual in Fujian. In medical terms, most practices are beneficial, and could be used by health staff to promote health in this period. Further research on reported potentially harmful practices, such as supplements to breast feeding, is needed.</p

Association between social support and place of delivery: a cross-sectional study in Kericho, Western Kenya

Background: An estimated 358,000 maternal deaths still occur worldwide each year. The place of delivery is of great significance to the reduction of maternal mortality. Moreover, socio-economic factors, cultural traits, and local customs are associated with health-seeking behavior. This study aimed to explore determinants of association between social support and place of delivery. Methods: This cross-sectional study was conducted from September to November 2011 at Sosiot Health Center, Kericho West District, Kenya. Participants were 303 mothers who brought their babies to the health center for immunization within their first year of life. Women underwent a structured interview using a questionnaire on demographic characteristics and their experiences of delivery including place of delivery and social support. Results: The proportion of deliveries at health facilities was significantly higher in unmarried than married women (93% and 78%, respectively; P = 0.008). Unmarried women whose mothers supported them in housework and whose sisters helped them fetch water were more likely to deliver at health facilities (P = 0.002 and 0.042, respectively) than those without this support. However, married women whose husbands supported them in farming and whose neighbors helped them fetch water were less likely to deliver at health facilities (P = 0.003 and 0.021, respectively) than those without this support. Married women who were advised to deliver at a health facility by their mother-in-law or health staff were more likely to deliver at health facilities (P = 0.015 and 0.022, respectively) than those who did not receive this advice. Multivariate analysis revealed that married women were more likely to deliver at health facilities if they were highly educated (odds ratio [OR] = 2.5); had financial capability (OR = 4.3); had medical insurance (OR = 4.2); were primiparous (OR = 3.5); did not have the support of sisters-in-law for fetching water (OR = 2.2); or were advised to deliver at a health facility by family or neighbors (OR = 2.5).Conclusions: Promotion of delivery at health facilities requires approaches that consider women\u27s social situation, since factors influencing place of delivery differ for married and unmarried women

Exclusive Breast Feeding Practice in Zambia

Background: Exclusive Breast Feeding (EBF), the best feeding practice for infants aged from birth to six (6) months has faced challenges of adherence, exposes infants to infections such as diarrhoea, despite information on its importance being given to mothers. The main objective of this study was to establish levels of EBF practice among breast feeding mothers who had infants aged from birth to six months, factors influencing the practices and support required for mothers in Luangwa district.Methods: A descriptive cross section study design was used and a total sample of 171 breast feeding mothers with infants aged from birth to six months were selected using systematic sampling method. The study was conducted in five randomly selected health facilities. The respondents were interviewed using a pretested semi-structured interview schedule and five focus group discussions each group with seven participants, were conducted using a focus group discussion guide at study sites. Quantitative data was analysed using SPSS computer software package and Fishers Exact test was used to test the association between the dependent and independent variables. Qualitative data from the focus group discussions was analysed using content analysis with the help of qualitative research computer software Nvivo.Results: The prevalence of exclusive breast feeding practice was at 61%. The factors that were found to be statistically significant to exclusive breast feeding were age of infant and support breast feeding mothers received. The others factors were found not to be statistically significant to exclusive breast feeding and these were educational level of the mother, knowledge on benefits of breast feeding and support from spouse.The study revealed that mothers found it difficult to practice Exclusive Breast Feeding because of the amount of work at home and spouses found it difficult to help with house chores because culturally it was a woman's work.Conclusion: Though exclusive breast feeding practice had improved in the district, there was still need to strengthen the practice in the district through education of spouses, family and the community on infant feeding for them to support breast feeding mothers. With the support, mothers will have time to exclusively breast feed their infants

Intersectoral debate on social research strengthens alliances, advocacy and action for maternal survival in zambia

The Health Promotion Research Centre of the National University of Ireland, Galway and the University of Zambia's School of Medicine conducted operational research to understand and address the socio-cultural and gender contexts of maternal survival. Together with an analytical policy and programming review and qualitative research, the project process also involved the convening of 'Interest Group' meetings involving intersectoral stakeholders at Central (Lusaka) and Provincial (Kasama) levels. These meetings aimed to catalyse debate and stimulate advocacy on the project theme by using discussion of qualitative research as entry point. Participants came from government departments, civil society groups, the indigenous health system, academia, technical provider associations, and media, advocacy and human rights organisations. We found that engagement in Interest Groups was successful at Provincial level with lively participation from civil society, media and advocacy stakeholders and strong engagement by the health system. The process was welcomed as an opportunity to fill gaps in understanding about underlying social determinants of health and jointly explore intervention approaches. Overburdened government staff at central level faced with disease-focused interventions rather than underlying contextual determinants, and a weak culture of health sector engagement with civil society, academics and activists, contributed to less successful functioning in Lusaka. Final Dissemination and Discussion Events incorporated material from Interest Group Meetings to stimulate wider discussion and make recommendations. This project highlights the potential value of intersectoral stakeholder discussions from the inception stage of research to stimulate intersectoral exchange and alliance building, inform advocacy, and catalyse the process of research into action

Medical students’ clerkship experiences and self-perceived competence in clinical skills

Introduction. In a traditional curriculum, medical students are expected to acquire clinical competence through the apprenticeship model using the Halstedian ‘see one, do one, and teach one’ approach. The School of Medicine, University of Zambia, Lusaka, Zambia, used a traditional curriculum model from 1966 until 2011, when a competence-based curriculum was implemented.Objective. To explore medical students’ clerkship experiences and self-perceived competence in clinical skills.Methods. A cross-sectional survey was conducted among 5th-, 6th-, and 7th-year medical students at the School of Medicine, University of Zambia, two months before the final examinations. Students were asked to rate their clerkship experiences with regard to specific skills on a scale of 1 - 4 and their level of self-perceived competence on a scale of 1 - 3. Skills evaluated were in four main domains: history-taking and communication, physical examination and procedural skills, professionalism, teamwork and medical decision-making. Using the Statistical Package for the Social Sciences (SPSS), correlations were performed between experiences and self-perceived competence of specific skills, within domains and overall.Results. Of clinical students (N=197), 138 (70%) participated in the survey. The results showed a significant increase in the proportion of students performing different skills and reporting feeling very competent with each additional clinical year. Overall correlations between experience and selfperceived competence were moderate (0.55). For individual skills, the highest correlation between experience and self-perceived competence was observed mainly with regard to medical- and surgical-related procedural skills, with the highest at 0.82 for nasogastric tube insertion and 0.76 for endotracheal intubation.Conclusion. Despite the general improvement in skills and self-perceived competence some deficiencies were noted, as significant numbers of final year students had never attempted important common procedures, especially those performed in emergency situations. Deficiencies in certain skills may call for the incorporation of teaching/learning methods that broaden students’ exposure to such skills