HORIZONS PROJECT
Caring for Health Workers: Addressing Psychosocial Burden of HIV/AIDS on Health Personnel in Zambia

This study is examining the HIV/AIDS needs of hospital workers in Zambia. In 2004, baseline data were collected from 1,424 employees in five large hospitals in two Zambian provinces. Structured questionnaires were administered to a sample comprising physicians, clinical officers, nurses, paramedical staff, medical training students, and administrative and support staff. Focus group discussions were also conducted with similar cadres of hospital personnel. A provider-centered workplace intervention started in August 2004 and is ongoing. Follow-up data were collected in March 2006 from 1,461 employees in the same hospitals, using the same procedures as at baseline.

Key findings from the study:

• Hospital workers face potential HIV exposure at work but have limited awareness about post-exposure prophylaxis (PEP).
• Hospital workers are stressed from caring for HIV patients at work and at home.
• Intimate partner violence is a problem for many female hospital workers.
• Hospital workers report multiple partnerships accompanied by limited use of protection.
• “Trust” is a major reason why condoms are not used, even among respondents with multiple partners.
• Even among those with multiple partners, there is limited desire to use condoms.
• The level of HIV testing among health workers and their partners is low.
• Those respondents with multiple partners are no more likely to have been tested than those with one partner.
• Preliminary analysis shows that the intervention was associated with increased awareness of PEP, access to condoms, and improved perceptions of management’s role in helping hospital workers address HIV/AIDS.

Hospitals are not often seen as a workplace in the same sense as factories and farms, yet they are at the crux of managing the HIV epidemic. A country with a weak and incapacitated hospital work force is unlikely to deal effectively with HIV. The results suggest that both clinical and nonclinical staff in Zambian hospitals are uninformed about critical components of HIV prevention and many also engage in behaviors that put them at risk for HIV, pointing to the need for HIV/AIDS workplace programs for hospital workers. Interventions at hospitals are feasible but should be designed to fit staff members' busy work schedules.

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Location

Copperbelt and Southern Provinces, Zambia

Duration

December 2003–June 2007

Horizons and Population Council researchers

Karusa Kiragu, Naomi Rutenberg

Non-Horizons collaborators

Peter Eerens (Zambia Integrated Health Project)

Chilufya Mwaba (Zambia Health Education and Communication Trust)

Thabale Ngulube (University of Zambia, Institute of Economic and Social Research)

Panganani Njobvu (Zambia Medical Association)

Mutinta Nyumbu (Support to the HIV/AIDS Response in Zambia)

Donors

US Agency for International Development

Support to the HIV/AIDS Response in Zambia

Zambia Integrated Health Project

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

2007
Kiragu, Karusa, Thabale Ngulube, Mutinta Nyumbu, Panganani Njobvu, Peter Eerens, and Chilufya Mwaba. "Sexual risk-taking and HIV testing among health workers in Zambia," AIDS and Behavior 11(1): 131–136. (abstract)

2006
Khan, Hena and Ellen Weiss. "Promoting VCT at the workplace," The Horizons Report, December. Washington, DC: Population Council. (full text)

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Related Project

• Kenya: Preparedness of Health Workers to Implement Diagnostic HIV Testing and Counseling and Provide Comprehensive AIDS Management

See Also

• Zambia

• Horizons Program

• HIV and AIDS

• HIV and AIDS/Consequences for Individuals, Families, and Society

• HIV and AIDS/Policy Development

• HIV and AIDS/Prevention

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