KNOWLEDGE, ATTITUDE AND INFECTION PREVENTION AND CONTROL (IPC) PRACTICES AMONG PHC WORKERS

1.1 Introduction

Healthcare Associated Infections are undesirable effects in health services whose risk of its incidence is still increasing. This infection is the most common complication in hospitalized patients and became the fourth cause of death in hospitals (Hapsari et al., 2018). A breach in infection control practices facilitates transmission of infection from patients to health care workers, other patients and attendants. Generally Health service providers in rural areas struggle to maintain primary health services because of some socio-economic factors. The hospital's efforts to prevent and control infection are one of the indicators to assess the quality of hospital services. In principle, the incidence of Healthcare Associated Infections can be prevented if health care facilities consistently implement Infection Prevention and Control (IPC) programs.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

Over the past health workers have been contributing immensely to the primary prevention of disease in both community and health facilities with emphasis on the front-line health workers, these are the health care providers that are available to cater for the immediate health need of the patients, according to (Agyeponget al. 2001) the Interventions to improve quality and responsiveness in healthcare have centered on professionals and frontline workers without recourse to a total system reform.

Differences in health status, based on indices such as infant mortality, young and child mortality and maternal mortality, between developed countries and developing countries have witnessed historical documentation. Unfortunately, the causes of this disturbing reality are illnesses that can be treated and deaths that can be prevented by simple interventions but for which inappropriate structures have constituted a stumbling block. In order to justify the amount of money spent on health and the number of workers employed, serious attention is required in improving quality of healthcare services while containing costs and also in planning of health care activities and carrying out effective management functions relating to health care delivery systems (HCDS).

In the United States of America, hospitals and related health facilities require formal utilization review procedures as condition for participation under health plans and some kind of utilization review process in each institution seeking accreditation. These problems have resulted in inappropriate structures, faulty allocation of resources and incongruent staff scheduling which would not have arisen if potential utilization had formed the bases upon which the establishment of the facilities were initially hinged. This situation is a call to restructuring which can only be facilitated by x-raying the relationship between distribution of resources, health problems and patterns of utilization whereby identified determinants would reveal the services to be provided for the growing population as well as their magnitude.

Carrasquillo (2013) stated that utilization is often reported as the number of services used over a period of time divided by the population denominator. Or the percentage of persons who use a certain service divided by individuals eligible to use the service.

Oladipo (2014) stated that within the developing countries, differences in health status exist, based on indices such as infant mortality, young and child mortality and maternal mortality. Appropriate use of Personal Protective Equipment (PPE) is the easiest way to prevent contact from secretions and transfer of pathogens. It’s important to assess the level of compliance with use of IPC practices among PHC Workers by the various health care workers who make direct contact with patients.

Health Care Utilization according to Carrasquillo (2013) is the quantification or description of the use of services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well-being, or obtaining information about one’s health status and prognosis. Utilization can be described as the use or amount usage per unit population of health services. It stated that in health care, utilization is defined as the consumption of services or supplies such as the number of office visit a person makes per year with a health care provider, the number of prescription made or the number of days a person is hospitalized.

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Knowledge, Attitude and Infection Prevention and Control (IPC) Practices among PHC Workers in the FCT.

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1.3 Statement of Problems

Investigation revealed that utilization of service is the actual coverage and it is categorized into ambulatory medical care services (outpatient and home); inpatient services (hospital); and preventive services. To achieve optimal levels of utilization, all the three categories must enlist the cooperation and initiative of the population as well as those of the health service providers.

In Nigeria, the discrepancy between what the levels of health care utilization are and what they ought to be is easily discernible. This underlines current efforts in relating utilization to resources as well as to past and present planning efforts. It has been said that there is need to review planning efforts and their appropriateness, especially when viewed from the context of utilization of health care services.

Hitherto, the assumption has been that the Health Ministry and other providers of health services knew the demand on their resources, upon which planning was based, by the number of people that demand services. There is at present increasing evidence, especially in the developing world, that many more who attempt to obtain such services are not getting them for a number of reasons.

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1.4 Aim and Objectives of Study

The aim of the study is to examine the Knowledge, Attitude and Infection Prevention and Control (IPC) Practices among PHC Workers in the FCT. In achieving this aim, the following specific objectives were laid out as follows:

1. To identify the factors affecting the implementation of infection prevention and control programs in the FCT hospitals;
2. To examine the corrective actions of infection prevention and control problems among PHC Workers in the FCT hospitals;
3. To examine the knowledge of PHC Workers towards Infection Prevention and Control (IPC); and
4. To estimate the Socio-demographic Characteristics of PHC Workers towards the awareness of Infection Prevention and Control in the FCT Abuja.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What are the factors affecting the implementation of infection prevention and control programs in the FCT hospitals?
• What are the corrective actions of infection prevention and control problems among PHC Workers in the FCT hospitals?
• What are the knowledge of PHC Workers towards Infection Prevention and Control?
• What are the Socio-demographic Characteristics of PHC Workers towards the awareness of Infection Prevention and Control in the FCT Abuja?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant level of awareness among PHC Workers towards Infection Prevention and Control
• H1: There is significant level of awareness among PHC Workers towards Infection Prevention and Control

Hypothesis Two

• H0: There are no significant factors affecting the implementation of infection prevention and control programs in the FCT hospitals
• H1: There are significant factors affecting the implementation of infection prevention and control programs in the FCT hospitals

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1.7 Significance of Study

The findings of this study would provide information on the adequacy or otherwise of health services provided to community residents in FCT Abuja with a view to improving the services. It would help policy makers to understand problems militating against effective utilization of health services among community residents in FCT Abuja and the way forward.

This study will also be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The scope of the research is focused on the Knowledge, Attitude and Infection Prevention and Control (IPC) Practices among PHC Workers in the FCT.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Definition of Terms

Health: Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.