Voices from the frontline: barriers and strategies to improve tuberculosis infection control in primary health care facilities in South Africa.
BMC Health Serv Res
; 18(1): 269, 2018 04 10.
Article
em En
| MEDLINE
| ID: mdl-29636041
ABSTRACT
BACKGROUND:
Tuberculosis (TB) infection control at primary healthcare (PHC) level remains problematic, especially in South Africa. Improvements are significantly dependent on healthcare workers' (HCWs) behaviours, underwriting an urgent need for behaviour change. This study sought to 1) identify factors influencing TB infection control behaviour at PHC level within a high TB burden district and 2) in a participatory manner elicit recommendations from HCWs for improved TB infection control.METHOD:
A qualitative case study was employed. TB nurses and facility managers in the Mangaung Metropolitan District, South Africa, participated in five focus group and nominal group discussions. Data was thematically analysed.RESULTS:
Utilising the Information Motivation and Behaviour (IMB) Model, major barriers to TB infection control information included poor training and conflicting policy guidelines. Low levels of motivation were observed among participants, linked to feelings of powerlessness, negative attitudes of HCWs, poor district health support, and general health system challenges. With a few exceptions, most behaviours necessary to achieve TB risk-reduction, were generally regarded as easy to accomplish.CONCLUSIONS:
Strategies for improved TB infection control included training for comprehensive TB infection control for all HCWs; clarity on TB infection control policy guidelines; improved patient education and awareness of TB infection control measures; emphasis on the active role HCWs can play in infection control as change agents; improved social support; practical, hands-on training or role playing to improve behavioural skills; and the destigmatisation of TB/HIV among HCWs and patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Tuberculose
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Infecção Hospitalar
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Controle de Infecções
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Instituições de Assistência Ambulatorial
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País como assunto:
Africa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article