Improving universal precautions and client teaching for rural health workers: a peer-group intervention

Abstract

Health workers can contribute to HIV prevention by minimizing HIV transmission in health facilities and increasing client teaching. We offered a peer-group intervention for Malawian rural health workers to build their universal precautions and teaching skills. A quasi-experimental design using independent sample surveys and observations compared health workers in an intervention and delayed intervention control district at baseline and at 15 and 30 months post-intervention. Controlling for demographic factors, the intervention district had more reported HIV teaching at 15 and 30 months and also had higher universal precautions knowledge and fewer needle stick injuries at 30 months. Observations at 15 and 30 months post-intervention showed higher levels of teaching in the intervention district. Observed glove wearing and hand washing were also higher at 30 months. This intervention should be made available for health workers in Malawi and provides a potential model for other high-HIV prevalence countries.

Keywords:

• client teaching
• health workers
• HIV prevention
• Malawi
• peer-group intervention
• universal precautions

Acknowledgements

The National Institute of Nursing Research, National Institutes of Health, Grant NR08058, funded this research. The interpretations and conclusions are those of the authors and do not necessarily represent the views of the National Institutes of Health. We also acknowledge earlier partial support for the initial development of the Mzake ndi Mzake intervention through a Fulbright African Regional Research Fellowship to Dr. K. Norr and sabbatical support from the University of Illinois at Chicago in 1999–2000. We especially thank the many people who have supported this project in the National AIDS Commission; the Ministry of Health and Population; the Nursing, Midwifery and Health Sciences Research Centre at Kamuzu College of Nursing and faculty and administrators at both universities; the district health care system; Traditional Authorities; and participating community leaders and members.