Factors Associated with Compliance with Infection Prevention and Control Measures Among Healthcare Workers to minimize the Risk of Covid-19 Infection In Nakawa Division, Kampala, Uganda

Abstract

Background In the context of the COVID-19 pandemic that originated in China in December 2019 and spread around the world, Kampala city had witnessed a high number of infections and deaths among healthcare workers (HCWs). Research objective To assess factors associated with IPC compliance among HCWs to minimize the risk of COVID-19 infection in Nakawa division, Kampala city. Methodology A concurrent mixed methods study was conducted between March and May 2022 in Nakawa Division, using a cross-sectional design among 240 HCWs and 14 key informants (KIs). Multistage sampling was used to select HCWs and purposive sampling to select KIs in government health facilities (HFs) and private not-for-profit HFs. The outcome variable was IPC compliance which was composed of the use of masks, the use of gloves, and hand hygiene. Data was analyzed in STATA 14.0 using Modified Poisson regression to obtain factors associated with IPC compliance at 95% confidence interval (CI). Qualitative data was coded in Atlas.ti 8 using a newly generated codebook and thematic analysis was carried out. Results Forty-six (19.2%) respondents were compliant with all the IPC measures, and that was associated with the presence of a COVID-19 patients’ ward in the HF [Adjusted Prevalence Ratio (APR):2.51, 95%CI:1.24-5.07]. KIs reported that facilitators of IPC compliance were the fear of contracting COVID-19, the social pressure and moral obligation, and the provision of enough IPC supportive equipment by the HF. The barriers to IPC compliance included the lack of knowledge on IPC, the workload, lack of resources to buy PPE, being vaccinated against COVID-19, and inaccessibility of hand washing facilities. Conclusion IPC compliance among HCWs was low compared to what was found in other regions, and depended on the perceived risk of being infected with COVID-19. There is a need to sustain IPC in HFs and to improve the knowledge of HCWs for their safety. Adequate PPE and IPC supportive requirements for hand hygiene are needed, such as accessible hand washing stations, soap, and hand sanitizers.