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UBC Theses and Dissertations

If you build it, will they be protected? : the evaluation of an occupational health and infection control capacity building program for healthcare workers in Free State, South Africa Liautaud, Alexandre


Infection control and occupational health training among healthcare workers (HCWs) is insufficient in under-resourced systems. This is especially concerning in systems with high HIV and tuberculosis (TB) burdens where HCW exposure risk can be considerable. There is an urgent need to understand how to best develop and deliver effective capacity building programs for healthcare workers in these fields. This research examined a one-year certificate program in Free State, South Africa that aimed to empower HCWs to act as agents of change by building their capacity to conduct workplace-based HIV and TB prevention interventions. A mixed method approach was utilized. First, quantitative data were collected from self-reported Likert-style questionnaires administered to HCWs pre, mid, and post enrolment in the program. Questionnaire components included reactions to the program, and learning assessments (i.e., Knowledge, Attitudes, Skills, and Practices [KASPs]). Additionally, individual interviews, participant observations, and group project evaluations were used in the analysis. Questionnaire data were analyzed using the Wilcoxon signed-rank test. Interview data were thematically coded and analyzed based on the Kirkpatrick framework. Projects were descriptively analyzed. Participatory observations supplemented and contextualized these data. Participants (n=32) were mostly female (81%) nurses (56%). Findings from the questionnaires demonstrated that pre to post mean scores improved in Knowledge (+12%,Z=3.1,p=0.002) and Skills/Practices (+14%,Z=-3.1,p=0.002). Attitudes scores did not change. Interview data revealed that participants had been empowered and showed attitudinal improvements regarding HIV, TB, infection control and occupational health. Project evaluations, however, showed that participants had acquired only moderate-low proficiency in applying the subject matter to their interventions, although the projects did affect meaningful improvements in some workplaces. Participatory observations and interviews highlighted the resource-intensive nature of the program. Workplace training can strengthen HCWs’ occupational health and infection control KASPs. This capacity building initiative did result in the implementation of positive changes in workplaces, and empowered participants to be agents of change within their communities. However, the resources needed for this program, coupled with the low baseline skill levels of participants were challenges. When designing an intervention, baseline educational levels, institutional politics, sustainability, and resource effectiveness are important determinants of success.

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