Quality in Primary Care Open Access

Assessing community health workers compliance to WHO best practices for safe injection of contraceptive in a rural community setting of Tanzania

5^th International Congress on Primary Healthcare & Family Medicine

November 29-30, 2017 Madrid, Spain

A Kalolella, D Danda, I Nyarusi, J Baraka, A Rusibamayila, E Mlay, C Festo, C Baynes, F Eetaama, M Hiza and J Phillips

Ifakara Health Institute, Dar es Salaam, Tanzania Ministry of health and Social Welfare, Tanzania Columbia University, USA USAID-Dar es salaam, Tanzania

Posters & Accepted Abstracts: Quality in Primary Care

Abstract:

Objective: The objective of this study was to assess Community Health Workers (CHW) compliance with World Health Organization�s (WHO) guidelines of safe contraceptive injection; infection prevention and intramuscular injection technical performance steps in rural community settings of Kilombero district, eastern Tanzania. Method: The cross sectional descriptive study design using structured observation checklist was adopted to collect injection safety steps data. The CHWs trained to provide injectable contraceptive were direct observed by reproductive health nurse while administering intramuscular injection to women in need of injectable contraceptive as part of family planning program. About 1704 women received injection from 35 trained CHWs. In this study we assessed if intramuscular injection performance and infection prevention steps administered complied with WHO based best practices for safe injection when CHW interacted with client. Results: Majority of CHW complied with WHO best practice for safe injection: Over 89% steps for infection prevention measures and over 91% steps for intramuscular injection technical performance complied with WHO safe injection guideline. The result also shows that CHW are likely to comply with WHO safety guidelines when they conduct injection at their own homes compared to other locations; infection prevention steps at CHW�s home - 90.7%, health centre 80%, client home - 77% and 59.4% in other settings, while intramuscular injection performance steps; CHW�s home - 89.6%, health centre - 83.1%, patient�s home - 84% and other places -81%. Young CHW aged 1825 years are highly likely to comply with WHO guidelines for infection prevention steps by 79.3% compared to 77.2% CHWs aged 25 years and above, while for safe intramuscular steps - 91.7% for CHW aged 17-24, and 82.4% for CHW aged over 25 years. Conclusion: CHW complied with WHO guidelines for safe contraceptive injection, qualified for task shifting of injectable contraceptive from health facilities to community settings to increase access.