Organizational Factors Associated with Health Worker Protection: A Participatory Mixed-Method Cross-Sectional Analysis in Four Provinces of South Africa
Notice bibliographique
Résumé
Abstract Background: Health workers, in short supply in many low-and-middle-income countries (LMICs), are at increased risk of SARS-CoV-2 infection during their employment. This study aimed to assess how South Africa, an LMIC, prepared to protect its health workers from SARS-CoV-2. Methods: This was a participatory mixed method study conducted in four provinces of South Africa. We used a semi-structured questionnaire and a walkthrough survey 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. For the questionnaire, the participants were provincial OSH managers. For the walkthrough survey, they were frontline health workers, facility managers, and OSH and Infection Prevention and Control (IPC) professionals. We used logistic regression to analyze the relationship between readiness indicators and the actual implementation of protective measures. We also evaluated the association between OSH compliance and hospital infection rates.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. Province A and D Provincial Department of Health (PDoH) had an OSH SARS-CoV-2 provincial coordinating team and a dedicated budget for occupational health. Province A had an occupational health doctor and an occupational health 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 (PPE) was adequate, PPE was often not worn properly. Our study found that having an OSH SARS-CoV-2 policy was significantly associated with higher PPE 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. LMICs may need to pay more attention to OSH systems and consider using tools, such as ILO/WHO HealthWISE tool, to protect health workers' health.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».