Abstract:

The objective of this study was to assess Community health workers (CHW) compliance to WHO guideline of safe injection steps in community settings. The cross sectional descriptive study design using structured observation checklist was adopted to collect injection safety steps data. The CHWs trained to provide injectable contraceptive were direct observed by reproductive health nurse while administering intramuscular injection to women in need of injectable contraceptiveas part of family planning program in Kilombero district, Tanzania. About 1704 women received injection from 35 trained CHW. In this study we assessed if intramuscular injection and infection prevention steps taken complied to WHO based best practices for safe injections when CHW interacted with client.

Results: Majority of CHW complied to WHO best practice for safe injection: Over 89 % steps for infection prevention measures and over 91% steps for intramuscular injection technical performance complied to WHO safe injection guideline. The result also shows that CHW are likely to comply to WHO safety when they conduct injection at their own homes compared to other locations; infection prevention at CHW’s home -90.7%, health centre -80%, client home - 77% and 59.4% in other settings, while intramuscular injection steps; CHW’s home -89.6%, health centre- 83.1%, patient’s home -84% and other places -81%. Young CHW aged 18-25 years are highly likely to comply to the guideline for infection prevention steps by 79.3% compared to 77.2% CHWs aged 25 years and above, while for safe intramuscular steps -91.7% for CHW aged 17-24, and 82.4% for CHW aged over 25 years.

Keywords: WHO Compliance, Safe injection procedures, community health workers, Blood borne infection, intramuscular injection technical performance, infection prevention.

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