Organizational factors associated with health worker protection during the COVID-19 pandemic in four provinces of South Africa.

Autor: Zungu M; National Institute for Occupational Health, a division of the National Health Laboratory Service, Johannesburg, 2000, South Africa. MuzimkhuluZ@nioh.ac.za.; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa. MuzimkhuluZ@nioh.ac.za., Voyi K; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa., Mlangeni N; National Institute for Occupational Health, a division of the National Health Laboratory Service, Johannesburg, 2000, South Africa., Moodley SV; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa., Ramodike J; National Institute for Occupational Health, a division of the National Health Laboratory Service, Johannesburg, 2000, South Africa.; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa., Claassen N; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.; School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia., Wilcox E; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada., Thunzi N; National Institute for Occupational Health, a division of the National Health Laboratory Service, Johannesburg, 2000, South Africa.; Department of Community Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, 0208, South Africa., Yassi A; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada., Spiegel J; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada., Malotle M; National Institute for Occupational Health, a division of the National Health Laboratory Service, Johannesburg, 2000, South Africa.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2021 Oct 11; Vol. 21 (1), pp. 1080. Date of Electronic Publication: 2021 Oct 11.
DOI: 10.1186/s12913-021-07077-w
Abstrakt: Background: Health workers, in short supply in many low-and-middle-income countries, are at increased risk of SARS-CoV-2 infection. This study aimed to assess how South Africa, prepared to protect its health workers from SARS-CoV-2 infection.
Methods: This was a cross-sectional study design applying participatory action research in four provinces of South Africa. A semi-structured questionnaire and a qualitative observational HealthWISE walkthrough risk assessment was carried out to collect data on occupational safety and health (OSH) systems in 45 hospitals across four provinces to identify factors associated with health worker protection. Adapting the International Labour Organization (ILO) and World Health Organization (WHO) HealthWISE tool, we compiled compliance scores through walkthrough surveys. We used logistic regression to analyze the relationship between readiness indicators and the actual implementation of protective measures.
Results: We found that health facilities in all four provinces had SARS-CoV-2 plans for the general population but no comprehensive OHS plan for health workers. Provincial Departments of Health (PDoH) varied in how they were organized to respond: Provinces A and D had an OSH SARS-CoV-2 provincial coordinating team and a dedicated budget for occupational health; Province A had an occupational health doctor and nurse; while Province B had an occupational health nurse; Province A and D PDoHs had functional OSH committees; and Province D had conducted some health risk assessments specific to SARS-CoV-2. However, none of the assessed health facilities had an acceptable HealthWISE compliance score (≥ 75%) due to poor ventilation and inadequate administrative control measures. While the supply of personal protective equipment was adequate, it was often not worn properly. Our study found that having an OSH SARS-CoV-2 policy was significantly associated with higher personal protective equipment and ventilation scores. In addition, our analysis showed that hospitals with higher compliance scores had significantly lower infection rates (IRR 0.98; 95% CI: 0.97, 0.98).
Conclusions: Despite some initial preparedness, greater effort to protect health workers is still warranted. Low-and-middle-income countries may need to pay more attention to OSH systems and consider using tools, such as ILO/WHO HealthWISE tool, to protect health workers' health.
(© 2021. The Author(s).)
Databáze: MEDLINE
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