Caring for Health Workers: Addressing Psychosocial Burden of HIV/AIDS on Health Personnel in Zambia
Population Council researchers with the Horizons program examined the HIV/AIDS needs of hospital workers in Zambia.
Known as the “Caring for Caregivers Project,” this intervention aimed to help hospital staff better assess their risk of HIV, understand their options for risk reduction, protect themselves against HIV, and, for those who were infected, live positively with the virus. Because hospitals have a diverse workforce with many nonclinical staff, such a program needed to be audience sensitive. Therefore, the program aimed to be responsive to the needs of administrative and clerical professionals, custodial, maintenance, and catering workers, as well as other technical and nontechnical employees. Because some hospitals are also training institutions linked to universities, the intervention was designed to include these trainees as well.
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.
Based on the baseline data, the provider-centered workplace intervention started in August 2004. Project activities included: sensitization of hospital staff, peer education activities, distribution of behavior change communication materials, peer support groups, care and support for hospital workers living with HIV, promotion of voluntary counseling and testing, education about post-exposure prophylaxis (PEP), and access to condoms. Employees also were encouraged to develop and engage in other activities.
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:
- Those who participated in the intervention would recommend it continue.
- Regression analysis showed strong dose-response associations between the intervention and many beneficial outcomes, including higher HIV knowledge, lower stigma, and greater awareness of PEP.
- The project was associated with increased employee empowerment and social support.
- There was a reduction in reported HIV risk behaviors among employees in the intervention sites.
- HIV testing rates remain low.
- A guaranteed level of resources is necessary to achieve sufficient program intensity.
- Support of management was key.
- Use of peer educators and development of departmental work plans was effective.
- Branding of the program is recommended.
- Peer support groups were important.
- Supportive program monitoring was essential.
- The hospital can offer appropriate flexibility for information dissemination.
- Comprehensive care staff clinics are greatly needed.
- Basing the intervention on behavioral theory facilitated the research and the intervention.
Caring for Caregivers may be the first documented HIV/AIDS workplace program for hospital staff in sub-Saharan Africa, and it provides experience that could benefit other hospitals addressing a similar audience. Although the program ended in Zambia, there are plans to borrow elements of the intervention for hospital workers elsewhere. The project has also identified other overlooked populations in Zambia—for example medical students, nursing students, and others in medical or paramedical training—who could benefit from workplace programs. There is need to recognize that health care workers need the same interventions they provide to the public, and indeed “charity begins at home.” HIV prevention, treatment, and care strategies should involve health care workers not just as a means to reach the community, but as direct and priority beneficiaries as well.
Caring for caregivers: An HIV/AIDS workplace intervention for hospital staff in Zambia--Evaluation results (PDF)
Kiragu,Karusa; Nyumbu,Mutinta; Ngulube,Thabale J.; Njobvu,Panganani; Mwaba,Chilufya; Kalimbwe,Arthur; Bradford,Spike
Horizons Final Report
Publication date: 2008
Sexual risk-taking and HIV testing among health workers in Zambia (abstract)
Kiragu,Karusa; Ngulube,Thabale J.; Nyumbu,Mutinta; Njobvu,Panganani; Eerens,Peter; Mwaba,Chilufya
AIDS and Behavior 11(1): 131-136
Publication date: 2007
Caring for caregivers: The HIV/AIDS needs of hospital workers in Zambia
Kiragu,Karusa; Ngulube,Thabale J.; Nyumbu,Mutinta; Njobvu,Panganani; Eerens,Peter; Mwaba,Chilufya; Kalimbwe,Arthur
Horizons Research Summary
Publication date: 2005
Project Stats
Location: Zambia (Copperbelt and Southern Provinces)
Program(s):
HIV and AIDS
Topic(s):
Behavior change
HIV care, support, and treatment
Duration: 12/2003 - 6/2007
Population Council researchers:
Naomi Rutenberg
Non-Council collaborators:
Chilufya Mwaba (Zambia Health Education and Communication Trust)
Mutinta Nyumbu (Support to the HIV/AIDS Response in Zambia)
Panganani Njobvu (Zambia Medical Association)
Peter Eerens (Zambia Integrated Health Project)
Thabale Ngulube (University of Zambia, Institute of Economic and Social Research)
Donors:
Support to the HIV/AIDS Response in Zambia
US Agency for International Development
Zambia Integrated Health Project
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