Knowledge, Risk Perception and Practice of Health Care Associated Infections (HAIs) Prevention and Control among Primary Health Care Workers in Cross River State, Nigeria

Monday, 9 November 2015

Olaide Bamidele Edet, BSc, MPH, PhD, RN, RM, RNE, FWACN
Department of Nursing Science, Faculty of Allied Medical Sciences, College of Medical Sciences,, University of Calabar, Cross River State, Nigeria, CALABAR, Nigeria
Comfort E. Ekanem, PhD, MPH, RN
DEPARTMENT OF CLINICAL GOVERNANCE, SERVICOM and E-health, Ministry of Health, Cross River State, Nigeria, CALABAR, Nigeria
Margaret Akpan, BSc, MPH, RN, RM, FWACN
Iquo Okon, BSc, MPH, RN, RM, FWACN
FHI(360) CALABAR, Family Health International (FHI 360), CALABAR, Nigeria


Infection control refers to all policies, procedures and activities which is aimed at preventing or minimizing the risk of transmission of infectious disease at health care facilities to workers and general community. The emerging of life threatening infectious diseases have underscored the need for efficient infection control programs in all health care setting and capacity building for healthcare workers to prevent/reduce the transmission of pathogens within health care setting. Primary Care workers are highly susceptible to Healthcare Associated Infections (HAIs) in health care and community settings. In the past 20 years, the overall incidence of health-care associated infection has increased by 36 percent. Health-care Associated Infection occurs worldwide and affects both developed and developing countries. About 5% -10% patients acquire one or more infections in health care setting worldwide. It is also estimated that more than 1.4 million people worldwide are suffering from infections acquired in hospitals. Developing countries were reported to have up to 20 times the risk of contracting a nosocomial infection compared with developed countries (Hopmans, Blok, Troelstra, Bonten, 2007); World Health Organization, 2008).) Very few studies have focused on risk perception, knowledge and practices of HAIs’ prevention and control among primary care/ first contact level health care workers. Nurses provide leadership for most of the health facilities at this level care.  This study determined risk perception, knowledge and reported practice of infection control measures among Primary Health Care workers as a basis for planning continuing education for health care workers at the primary level. Specifically the objectives of the study were to:

  1. Explore Health Care Workers (HCW) perception about susceptibility to nosocomial infections in the work place
  2. Determine HCW’ s level of knowledge universal and  standard precautions HCW at the primary for protecting self and patients from nosocomial infections
  3. Assess preventive and control measures utilized by Examine
  4. Identify facilitators and barriers to effective practice of IPC measures


A descriptive cross sectional design was used.  The study population consisted of 104 primary care workers selected through a purposive sampling technique, from all the LGAs in Cross River State. Responses to a validated 52-item self- reporting, semi-structured questionnaire provided the source of data. The questionnaire was tested for face and content validity by experts on the field. Consent was obtained from the respondents to administer the questionnaire.


The mean age of the participants and years of practice were 39.2 +/- 9.1, and 16.8 +/- 9.0.  Risk perception for acquiring HIV/AIDS was perceived high by 79(76.0%); HBV by 76(73.1%) and Ebola by 88(84.6%). Findings show that 40(38.5%) had poor knowledge of standard precautions while 64(61.5%) had good knowledge, 62(59.6%) had poor knowledge of hand hygiene while 42(40.4%) had good knowledge; 9(8.7%) had poor knowledge of EBOLA while 95(91.3%) had good knowledge. The major barrier for infrequent use of IPC measures was non-availability of PPE and other resources on a regular basis.


Study has shown that risk perception is high; gaps exist in critical aspects of IPC knowledge and practice. PHC workers would benefit from continuing professional education on prevention and control of HAIs including Ebola. This should be organized by professional associations, while government provides the funding. There is urgent need for employers to make available to worker at the primary level regular supply of personal protective equipment. Creating an enabling environment which include provision of wash basins, good hand hygiene agents, masks and frequent monitoring and feedback in addition to knowledge updates should be emphasized to enable health care workers comply withe infection control recommendations consistently (Kamulegeya, Kizito, Balidawa, 2013; Mukerji, A, Narciso, J, et al., 2013).


  1.  Hopmans T.E, Blok, H. E, Troelstra A, Bonten, M. J. (2007): Prevalence of hospital-acquired infections during successive surveillance surveys conducted at a university hospital in the Netherlands. Infect Control Hosp Epidemiol,, 28:459-465.  

         2. World Health Organization (2008). 10 facts on patient safety. Available from:  

3.         Mukerji A, Narciso J, et al. (2013). An observational study of the hand hygiene initiative: a comparison of pre intervention and outcomes. BMJ Open, 3:003018. Doi: 10.1136/bmjopen-2013-003


 4. Kamulegeya,A., Kizito, A.N., Balidawa, H. (2013). Ugandan medical and health sciences interns’ infection control knowledge and practices. J. Infect in Dev Ctries, 7(10):726- 733.