Horizons Projects | Preparedness of Health Workers to Implement Diagnostic HIV Testing and Counseling and Provide Comprehensive AIDS Management

HORIZONS PROJECT
Preparedness of Health Workers to Implement Diagnostic HIV Testing and Counseling and Provide Comprehensive AIDS Management

In order to assess the preparedness of health workers to provide diagnostic HIV testing and counseling (DTC), the Kenya Ministry of Health, with support from the Horizons program and the Centers for Disease Control and Prevention, conducted a national survey in public and private health care facilities. The survey also provided an opportunity to assess HIV-related service delivery in the country, to examine the occupational risk environment among health workers, and to assess how HIV has affected them in their personal lives.

The national survey was conducted among medical personnel (n=1,897) in 245 health facilities in 28 districts. Researchers used guided self-administered questionnaires and conducted 24 focus group discussions in selected facilities.

Key findings indicate:

The majority of health workers (88%) were employed in facilities where HIV testing was available. Half the respondents said that they conduct HIV counseling or testing in their facility, and about three-quarters of these had been trained in the procedure. Among those who actually provide HIV counseling and testing, over half still feel a need for further training.
The majority of the health workers feel there is an adequate supply of important infection control supplies, but important gaps remain. The vast majority of Kenyan health workers are concerned about becoming infected at work, yet most say their health facility lacks written guidelines about occupational exposure.
Although most respondents say they know of postexposure prophylaxis (PEP), only half have operational knowledge on how to access and use it. More than half of health workers (55%) who had operational knowledge of PEP and were potentially exposed to HIV infection did not seek PEP following exposure. Major reasons were lack of information and fear.
Nearly a third of health workers in Kenya have never been tested for HIV, including half the enrolled nurses, who represent the bulk of health care providers. Moreover, half of health workers who have a partner report that this individual has not been tested. There is great interest for self-testing among health workers, with 73 percent of respondents desiring this service.
Health workers feel that AIDS patients are not stigmatized; in fact four out of every ten feel that AIDS patients are treated better than other patients due to increased resources directed at the disease. However, focus group discussions suggest that there is still some underlying stigma, with AIDS patients being placed at the back of the wards, or in less-visible areas.

Location

Kenya

Duration

December 2004–December 2006

Horizons and Population Council researchers

Karusa Kiragu, Susan Kaai, Scott Geibel

Non-Council collaborators

Lawrence Marum, Mary Mwangi (CDC Kenya)

Isaiah Tanui (now at CDC Kenya), Godffrey Baltazar, Meshak Ndolo (National AIDS and STD Control Programme)

Donor

Centers for Disease Control and Prevention

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2006
Khan, Hena. "On the frontlines: Kenyan health workers confront HIV-related challenges at work and home," Horizons Report, June. Washington, DC: Population Council. (full text)

Khan, Hena and Ellen Weiss. "Initiating HIV diagnostic testing and counseling," Horizons Report, December. Washington, DC: Population Council. (full text)

National AIDS and STD Control Programme, Ministry of Health, Kenya. "Preparedness for HIV/AIDS service delivery: The 2005 Kenya Health Workers Survey." Nairobi: NASCOP. (PDF)

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