Occupational hazards exist wherever health care is practised. However, there is dearth of information on the status of occupational safety among hospital workers in Tanzania. This study was therefore carried to assess the current status of occupational health and safety (OHS) in Tanzanian hospitals and identify key areas for intervention. Data was collected using a self-administered questionnaire randomly distributed to the health service providers (HSPs) working in 14 district, regional and referral hospitals in Tanzania. A total of 430 HSPs (mean age = 42±8.8 years) were involved in the study. Female workers accounted for the majority (71%) of the respondents. None of the 430 respondents had received training on OHS as a profession. Most of the supervisors were holders of certificates (54.4%). Only 42.9% (6/14) of the hospitals, had at least a supervisor with post-graduate degree. Needlestick injuries accounted for the largest part of the most common accidents (52.9%); followed by splash of blood from patients (21.7%); burn injury from chemicals (10.6%); and slippery floors (5.9%). There was lack of qualified personnel for OHS in all hospitals. Most of the hazardous activities were carried out by nurses and attendants. Chemicals used in hospitals were mainly antiseptics and disinfectants, which causes skin burns during handling and use. Seminars and workshops were the major source (N = 429; 33%) of information on OHS. The seven major hazardous activities were injection, cleaning, patient care, bedding, dressing of wounds, medication and surgical operation. The largest proportion of HSPs involved in hazardous activities was found at referral hospitals. The mostly available antiseptics were 70-90% alcohol, 3% aqueous iodine, chlorhexidine gluconate and cetrimide. In conclusion, the OHS was observed to be inadequate in most workplaces in Tanzanian hospitals. Special efforts including training, exposure to information and creation of awareness, are recommended for improving occupational health and safety in hospitals in Tanzania. _________________________________________________________________________________________
Purpose – The purpose of this paper is to identify factors that influence the implementation of the rollout of the 5S approach in public hospitals in Tanzania, and share the way to scale this up for similar setting in developing countries. Design/methodology/approach – The effect size was calculated from pre- and post-assessment results of Training of Trainers (ToT) to examine the effectiveness of ToT. A questionnaire with 14 explanatory variables was developed and completed based on information collected during Consultation visits (CVs) and progress report meetings (PRMs). Then, data were analysed to identify the influencing factors in relation to outcome variables (CV average score). Findings – Among 14 explanatory variables, five explanatory variables showed statistical significant association with the CV average score. Those are: “Feedback and information sharing,” (p=0.031), “Quality Improvement Team roles and responsibility” (p=0.002), “5S knowledge,” “Involvement and commitment,” and “5S guidelines use and availability,” (p=0.000). When the explanatory variables were controlled by levels of hospitals; “involvement and commitment” was the only explanatory variable for national level hospitals. For regional referral hospitals, “QIT roles and responsibility” (p=0.02) and “5S knowledge” (p=0.03) were statistically significant. For district hospitals, “involvement and commitment” (p=0.01) and “availability of guideline (p=0.001)” were statistically significant. Research limitations/implications – This study has the following limitations. The data were collected from existing reports and presentation materials only. There might be reporting bias, as PRM data is self-reported from the hospitals. Caution is therefore needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for designing and implementing QI programs in Tanzania and in other African countries. Originality/value – The authors' conceptual framework is based on the existing literature on the science of diffusion and scale up of innovation in the health sector. Few studies are known from resource constrain settings in Africa which assess the determinants of the process of nationwide scale-up of proven interventions.
Purpose – The purpose of this paper is to assess causal relations between the implementation of the 5S approach and the reduction of patients’ waiting time at out patient departments (OPDs) of hospitals in Tanzania. Design/methodology/approach – Patients’ waiting time was measured under the cluster randomized control trial (c-RCT). In all, 16 hospitals were chosen and divided into treatment and control groups using block randomization. Before the intervention, a baseline study was conducted at OPDs in all 16 hospitals. After one year of the intervention, the end-line study was carried out in both the groups. A comparison of the average waiting time reduction and Difference-in-Difference (DID) analysis was carried out to see the effect of the 5S approach on the reduction of patients’ waiting time. Findings – Statistical significance in reduction of patients’ waiting time was seen in the medical records sections (p=0.002) and consultation rooms (p=0.020) in the intervention group. The same trend was also seen using DID analysis (−15.66 min in medical record, −41.90 min in consultation rooms). Research limitations/implications – This study has the following limitations in terms of the data. The data were collected for only three days at the time of baseline survey, and again for three days at the time of the end-line survey from 16 hospitals. Moreover, piloted areas for the implementation of the 5S approach vary from hospital to hospital. There might be a bias in the measurement of a patient’s waiting time. Caveats are therefore needed in extrapolating the study results to other settings. Despite these caveats, the findings will provide important insights for implementing quality improvement programs in Tanzania and in other African countries for improvement of time factors. Originality/value – This study used c-RCT, and has proven the effectiveness of the 5S approach in improving the working environment and reducing patients’ waiting time at OPDs in several hospitals at district level in Tanzania.
Objective To identify contextual factors associated with quality improvements in primary health-care facilities in the United Republic of Tanzania between two star rating assessments, focusing on local district administration and proximity to other facilities. Methods Facilities underwent star rating assessments in 2015 and between 2017 and 2018; quality was rated from zero to five stars. The consolidated framework for implementation research, adapted to a low-income context, was used to identify variables associated with star rating improvements between assessments. Facility data were obtained from several secondary sources. The proportion of the variance in facility improvement observed at facility and district levels and the influence of nearby facilities and district administration were estimated using multilevel regression models and a hierarchical spatial autoregressive model, respectively. Findings Star ratings improved at 4028 of 5595 (72%) primary care facilities. Factors associated with improvement included: (i) star rating in 2015; (ii) facility type (e.g. hospital) and ownership (e.g. public); (iii) participation in, or eligibility for, a results-based financing programme; (iv) local population density; and (v) distance from a major road. Overall, 20% of the variance in facility improvement was associated with district administration. Geographical clustering indicated that improvement at a facility was also associated with improvements at nearby facilities. Conclusion Although the majority of facilities improved their star rating, there were substantial variations between facilities. Both district administration and proximity to high-performing facilities influenced improvements. Quality improvement interventions should take advantage of factors operating above the facility level, such as peer learning and peer pressure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.