Infection prevention and control: Practice, uptake, and administrative control among primary health-care workers in enugu metropolis, Southeast Nigeria

Abstract

Introduction: Administrative supervision of infection prevention and control (IPC) is the most important aspect of IPC/hazard controls. The practice, uptake, and compliance to IPC is a documented, cost-effective method of interrupting the infection transmission pathways. Poor or nonadherence to this has led to disabilities and loss of lives among health-care workers, especially in the face of emerging and re-emerging infections. The present study evaluated the practice of IPC as well as its uptake and administrative control among the primary health-care workers in Enugu metropolis, Southeast Nigeria. Methodology: This was an analytical cross-sectional study using semi-structured self-administered questionnaires and an observation checklist. Eligible health-care workers (HCWs) were selected using simple random sampling from ten primary health-care (PHC) facilities. Chi-square test was used to examine associations of interest. Binary logistic regression was employed to identify predictors of good IPC practices. Results: Three hundred eligible health-care workers participated in this study. More than a fifth (n = 65, 21.7%) of HCWs exhibited good practice of IPC measures. Correct practice of handwashing was noted among 275 (95.7%) respondents. Majority (n = 224, 74.7%) reported recapping of needles and engaged in unsanitary disposal of health-care wastes (n = 257, 85.7%). The prevalence of needlestick injuries 3 months prior to the study period was 53.3% (n = 160). Majority of those sampled reported a lack of IPC committee (n = 220, 73.3%), conspicuous signage to aid movement (n = 230, 76.7%), and an IPC policy (n = 217, 72.3%) in their respective centers. Identified predictors of good practice of IPC were age <40 years (adjusted odds ratios [AORs] 0.57; 95% confidence interval [CI] 0.38–0.57), being a community health extension worker or community health officer (AOR 3.76; 95% CI 1.56–9.03), and working for <20 years (AOR 5.10;95% CI 5.00-5.73). Conclusion: Poor practice of IPC and poor compliance to administrative control among PHC workers, in addition to lack of administrative facilities, remains a great challenge. There is an urgent need for capacity building on IPC and administrative support to reverse this trend.