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Abstract
Background: Compliance with occupational health and safety policies, monitoring, and evaluation are critical components of a safe workplace. Occupational hazards among community health workers have rarely been studied. This study aimed to assess compliance with occupational health and safety among community health workers in Western Kenya.
Methods: This cross-sectional study used a quantitative data-collection method. A sample of 309 community health workers and community health extension workers was selected using purposive and simple random sampling from 47 counties in Kenya and community health units, respectively. All community health workers in the sampled community units in the administrative locations were included as study participants. A structured questionnaire was used to collect data from the participants.
Results: Approximately one-third of the participants were females, 211(75.9%). Participants’ ages ranged from 18 to 68 years, with a mean of 36.8 years and a peak of 41-50 years, 113 (40.6%). The mean compliance to occupational level was 15.5, with a standard deviation of 6.7. Nearly three-quarters (76.6%) of the participants had low compliance with occupational health policy. A relatively high compliance score was in the 20-30 age group, with a mean score of 2.86±1.07 SD.
Conclusion: This study provides evidence for the implementation of an occupational health policy to improve the care and safety of community health workers in Kenya.
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References
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- Akagbo, S. E., Nortey, P., & Ackumey, M. M. (2017). Knowledge of standard precautions and barriers to compliance among healthcare workers in the Lower Manya Krobo District, Ghana. BMC Research Notes, 10(1), 432. https://doi.org/10.1186/s13104-017-2748-9
- Baatiema, L., Sumah, A. M., Tang, P. N., & Ganle, J. K. (2016). Community health workers in Ghana: the need for greater policy attention. BMJ Global Health, 1(4), e000141. https://doi.org/10.1136/bmjgh-2016-000141
- Bhuyan A., Jorgensen A., & S. Sharma. (2010). Taking the pulse of policy: the policy implementation assessment tool. Health Policy Initiative, Task Order 1. USAID Health Policy Initiative. http://pdf.usaid.gov/pdf_docs/PNADX728.pdf.
- Campbell J., Admasu K., Soucat K., & Tlou S. (2015). Maximizing the impact of community-based practitioners in the quest for universal health coverage. Bulletin of the World Health Organization, 93(9), 590–590A. https://doi.org/10.2471/BLT.15.162198
- Frontline Health Workers Coalition. (2021). Policy recommendations for sustainable health workforce teams to respond to COVID-19. Frontline Health Workers Coalition https://www.frontlinehealthworkers.org/sites/fhw/files/fhwc_covid-19_recommendations_april_2021.pdf.
- Frontline Health Workers. (2014). Coalition a commitment to community health workers: improving data for decision-making. Frontline Health Workers Coalition. https://www.frontlinehealthworkers.org/sites/fhw/files/uploads/2014/09/CHW-Report.pdf. Accessed 19 Feb 2020.
- Giurgiu D. I., Jeoffrion C., Grasset B., Roland-Levy C., Dessomme B., Moret L., Roquelaure Y. Caubet A., Verger C., Laraqui C E., Lombrail P., Geraut C., & Tripodi D. (2016). Psychosocial and occupational risk perception among health care workers: A Moroccan multi-center study. BMC Res Notes, 8, 408. https://doi.org/10.1186/s13104-015-1326-2
- Global Health Council. Response, (2021). Recovery and resilience: The Power of US Investments in Global Health. Global Health. https://ghbb.globalhealth.org/full-report/.
- Gracia-Zapata M. R., Silva Souza A. C., Guimaraes J. V., Tipple A. F., Prado M. A. & Garcia-Zapata M. T. (2010). Standard precautions: knowledge and practice among nursing and medical students in a teaching hospital in Brazil. International Journal of Infection Control, 6(1). https://doi.org/10.3396/ijic.v6i1.4075
- Hamer D.H., Brooks E.T., Semrau K. (2012). Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers. Pathog Glob Health, 106; 1: 32–39.
- Hardee, K., Laili Irani, Ron MacInnis, and Matthew Hamilton. 2012. Linking Health Policy with Health Systems and Health Outcomes: A Conceptual Framework. Futures Group, Health Policy Project.
- Huang W., Long H., Li J., Tao S., Zheng P., Tang S. & Abdullah A.S. (2018). Delivery of public health services by community health workers (CHWs) in primary health care settings in China: A systematic review (1996–2016). Global Health Research and Policy. 3:18. https://doi.org/10.1186/s41256-018-0072-0.
- Jhpiego B.O., Orji B., Brieger W., & Innocentia L. (2018). Association between socio-demographic characteristics of community health workers with compliance to quality delivery of integrated community case management of febrile illness service in Nigeria. International Journal of Public Health, 6(2):136-147.
- Kondor V.D. (2018). Health worker compliance with infection prevention and control policy in Ghana: A case study of La General Hospital [Master's thesis, University of Ghana]. University of Ghana Digital Collections. http://ugspace.ug.edu.gh/handle/123456789/26153
- Liese B. & Dussault G. (2004). The State of the health workforce in Sub-Saharan Africa: Evidence of crisis and analysis of contributing factors. https://documents1.worldbank.org/curated/en/412051468002680722/pdf/328040Health0workforce0AFHD0No175.pdf.
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- Njororai F., Ganu D. & Nyaranga K. C. (2020). Perception of risk exposure and occupational hazards of community health workers in a rural county of Western Kenya. Journal of Applied Social Science, Human Development and Technology. 1(1), 50- 59.
- Njororai F., Ganu D., Kogutu C. N., & Cholo W. (2021). Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya. Int. J. Environ. Res. Public Health, 18, 11707. https://doi.org/10.3390/ ijerph182111707.
- Owie H., & Apanga P. (2016). Occupational Health Hazards Prevailing among Healthcare Workers in Developing Countries. Journal of AIDS & Clinical Research, 7(8), 1-5.
- Pappa S., Ntella V., Giannakas T., Giannakoulis V. G., Papoutsi E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020.05.026
- Perry B. H., Zullingre R., & Rogers M.M. (2014). Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness. Annual Review of Public Health, 35, 399–421.
- Perry, H. B., & Hodgins, S. (2021). Health for the people: past, current, and future contributions of national community health worker programs to achieving global health goals. Global Health, Science and Practice, 9(1), 1–9. https://doi.org/10.9745/GHSP-D-20-00459
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- Timilshina N., Ansari M.A., & Dayal V. (2011). Risk of infection among primary health workers in the western development region, Nepal: Knowledge and compliance. J Infect Dev Countries, 5(1), 18–22.
- World Health Organization [WHO] Online Workshop. (2020). Caring for those who care: National programs for occupational health and safety for health workers, Lessons learned from countries. World Health Organization. https://apps.who.int/iris/handle/10665/351107.
- World Health Organization [WHO] (2007). Community health workers: What do we know about them? World Health Organization. http://www.who.int/hrh/documents/community_health_workers.pdf.
- World Health Organization [WHO] (2010). Global experience of community health workers for delivery of health-related Millennium Development Goals: A systematic review, country case studies, and recommendations for integration into National Health Systems. World Health Organization. https://www.who.int/workforcealliance/knowledge/resources/chwreport/en/.
- World Health Organization [WHO]. (2020a). Health policy and system support to optimize community health workers programs for HIV, TB, and malaria services: An evidence guide. World Health Organization. https://www.who.int/publications/i/item/9789240018082.
- World Health Organization [WHO]. (2020b). What do we know about community health workers? A review of existing reviews. World Health Organization. https://www.who.int/publications/i/item/what-do-we-know-about-community-health-workers-a-systematic-review-of-existing-reviews.
- World Health Organization [WHO]. (2021a). WHO/ILO joint estimates of the work-related burden of disease and injury. World Health Organization. https://www.who.int/publications/i/item/9789240034945.
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References
Abubakar, S.M., Haruna, H., Teryila, K.R., Hamina, D., Ahmadu, I., Babaji, M., & Bulama, K. U. (2015). Assessment of knowledge and practice of standard precautions among nurses working at federal medical center Gombe, Nigeria. Direct Res J Health Pharmacology (DRJHP), 3(1), 1-11.
Akagbo, S. E., Nortey, P., & Ackumey, M. M. (2017). Knowledge of standard precautions and barriers to compliance among healthcare workers in the Lower Manya Krobo District, Ghana. BMC Research Notes, 10(1), 432. https://doi.org/10.1186/s13104-017-2748-9
Baatiema, L., Sumah, A. M., Tang, P. N., & Ganle, J. K. (2016). Community health workers in Ghana: the need for greater policy attention. BMJ Global Health, 1(4), e000141. https://doi.org/10.1136/bmjgh-2016-000141
Bhuyan A., Jorgensen A., & S. Sharma. (2010). Taking the pulse of policy: the policy implementation assessment tool. Health Policy Initiative, Task Order 1. USAID Health Policy Initiative. http://pdf.usaid.gov/pdf_docs/PNADX728.pdf.
Campbell J., Admasu K., Soucat K., & Tlou S. (2015). Maximizing the impact of community-based practitioners in the quest for universal health coverage. Bulletin of the World Health Organization, 93(9), 590–590A. https://doi.org/10.2471/BLT.15.162198
Frontline Health Workers Coalition. (2021). Policy recommendations for sustainable health workforce teams to respond to COVID-19. Frontline Health Workers Coalition https://www.frontlinehealthworkers.org/sites/fhw/files/fhwc_covid-19_recommendations_april_2021.pdf.
Frontline Health Workers. (2014). Coalition a commitment to community health workers: improving data for decision-making. Frontline Health Workers Coalition. https://www.frontlinehealthworkers.org/sites/fhw/files/uploads/2014/09/CHW-Report.pdf. Accessed 19 Feb 2020.
Giurgiu D. I., Jeoffrion C., Grasset B., Roland-Levy C., Dessomme B., Moret L., Roquelaure Y. Caubet A., Verger C., Laraqui C E., Lombrail P., Geraut C., & Tripodi D. (2016). Psychosocial and occupational risk perception among health care workers: A Moroccan multi-center study. BMC Res Notes, 8, 408. https://doi.org/10.1186/s13104-015-1326-2
Global Health Council. Response, (2021). Recovery and resilience: The Power of US Investments in Global Health. Global Health. https://ghbb.globalhealth.org/full-report/.
Gracia-Zapata M. R., Silva Souza A. C., Guimaraes J. V., Tipple A. F., Prado M. A. & Garcia-Zapata M. T. (2010). Standard precautions: knowledge and practice among nursing and medical students in a teaching hospital in Brazil. International Journal of Infection Control, 6(1). https://doi.org/10.3396/ijic.v6i1.4075
Hamer D.H., Brooks E.T., Semrau K. (2012). Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers. Pathog Glob Health, 106; 1: 32–39.
Hardee, K., Laili Irani, Ron MacInnis, and Matthew Hamilton. 2012. Linking Health Policy with Health Systems and Health Outcomes: A Conceptual Framework. Futures Group, Health Policy Project.
Huang W., Long H., Li J., Tao S., Zheng P., Tang S. & Abdullah A.S. (2018). Delivery of public health services by community health workers (CHWs) in primary health care settings in China: A systematic review (1996–2016). Global Health Research and Policy. 3:18. https://doi.org/10.1186/s41256-018-0072-0.
Jhpiego B.O., Orji B., Brieger W., & Innocentia L. (2018). Association between socio-demographic characteristics of community health workers with compliance to quality delivery of integrated community case management of febrile illness service in Nigeria. International Journal of Public Health, 6(2):136-147.
Kondor V.D. (2018). Health worker compliance with infection prevention and control policy in Ghana: A case study of La General Hospital [Master's thesis, University of Ghana]. University of Ghana Digital Collections. http://ugspace.ug.edu.gh/handle/123456789/26153
Liese B. & Dussault G. (2004). The State of the health workforce in Sub-Saharan Africa: Evidence of crisis and analysis of contributing factors. https://documents1.worldbank.org/curated/en/412051468002680722/pdf/328040Health0workforce0AFHD0No175.pdf.
Mogakwe, L. J., Ally, H., & Magobe, N. B. D. (2020). Reasons for non-compliance with quality standards at primary healthcare clinics in Ekurhuleni, South Africa. African Journal of Primary Health Care & Family Medicine, 12(1), e1–e9. https://doi.org/10.4102/phcfm.v12i1.2179
Murphy J.P, Moolla A., Kgowedi S., Mongwenyana C., Mngadi S., Ngcobo N., Miolt J., Evans D., & Pascoe, S. (2021). Community health worker models in South Africa: A qualitative study on policy implementation of the 2018/19 revised framework. Health Policy and Planning, 36(4) 384-396.
Mwai G.W., Mburu G., Torpey K., Frost P., Ford N., & Seeley J. (2013). Role and outcomes of the community health workers in HIV care in Sub-Saharan Africa: A systematic review. Journal of the International AIDS Society, 16(1), 18586. https://doi.org/10.7448/IAS.16.1.18586
Njororai F., Ganu D. & Nyaranga K. C. (2020). Perception of risk exposure and occupational hazards of community health workers in a rural county of Western Kenya. Journal of Applied Social Science, Human Development and Technology. 1(1), 50- 59.
Njororai F., Ganu D., Kogutu C. N., & Cholo W. (2021). Role of Socio-Demographic and Environmental Determinants on Performance of Community Health Workers in Western Kenya. Int. J. Environ. Res. Public Health, 18, 11707. https://doi.org/10.3390/ ijerph182111707.
Owie H., & Apanga P. (2016). Occupational Health Hazards Prevailing among Healthcare Workers in Developing Countries. Journal of AIDS & Clinical Research, 7(8), 1-5.
Pappa S., Ntella V., Giannakas T., Giannakoulis V. G., Papoutsi E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020.05.026
Perry B. H., Zullingre R., & Rogers M.M. (2014). Community health workers in low-, middle-, and high-income countries: An overview of their history, recent evolution, and current effectiveness. Annual Review of Public Health, 35, 399–421.
Perry, H. B., & Hodgins, S. (2021). Health for the people: past, current, and future contributions of national community health worker programs to achieving global health goals. Global Health, Science and Practice, 9(1), 1–9. https://doi.org/10.9745/GHSP-D-20-00459
Rai R., El-Zaemey S., Dorji N., Rai B.D., & Fritschi L. (2021). Exposure to Occupational Hazards among Health Care Workers in Low- and Middle-Income Countries: A Scoping Review. International Journal of Environmental Research and Public Health, 18(5), 2603. https://doi.org/10.3390/ijerph18052603
Timilshina N., Ansari M.A., & Dayal V. (2011). Risk of infection among primary health workers in the western development region, Nepal: Knowledge and compliance. J Infect Dev Countries, 5(1), 18–22.
World Health Organization [WHO] Online Workshop. (2020). Caring for those who care: National programs for occupational health and safety for health workers, Lessons learned from countries. World Health Organization. https://apps.who.int/iris/handle/10665/351107.
World Health Organization [WHO] (2007). Community health workers: What do we know about them? World Health Organization. http://www.who.int/hrh/documents/community_health_workers.pdf.
World Health Organization [WHO] (2010). Global experience of community health workers for delivery of health-related Millennium Development Goals: A systematic review, country case studies, and recommendations for integration into National Health Systems. World Health Organization. https://www.who.int/workforcealliance/knowledge/resources/chwreport/en/.
World Health Organization [WHO]. (2020a). Health policy and system support to optimize community health workers programs for HIV, TB, and malaria services: An evidence guide. World Health Organization. https://www.who.int/publications/i/item/9789240018082.
World Health Organization [WHO]. (2020b). What do we know about community health workers? A review of existing reviews. World Health Organization. https://www.who.int/publications/i/item/what-do-we-know-about-community-health-workers-a-systematic-review-of-existing-reviews.
World Health Organization [WHO]. (2021a). WHO/ILO joint estimates of the work-related burden of disease and injury. World Health Organization. https://www.who.int/publications/i/item/9789240034945.
World Health Organization [WHO] COVID-19: (2021b). Occupational health and safety for Health workers. World Health Organization. https://www.who.int/publications/i/item/WHO-2019-nCoV-HCW_advice-2021-1.