Impact of a Peer-Group Intervention on Occupation-Related Behaviors for Urban Hospital Workers in Malawi

Abstract

Using a pre- and post-test design with no control group, we evaluated the impact of a peer group intervention on work-related knowledge and behavior for health workers at an urban hospital in Malawi. We surveyed unmatched random samples of health workers, observed workers on the job, and interviewed clients about hospital services at baseline and at 6 months after the intervention. Universal precautions (UP) knowledge, reported hand washing, and reported client teaching were significantly higher at the final evaluation. The outcome differences remained robust in multivariate analyses with controls for demographic factors of age, gender, education, food security, and job category. Observations found consistently greater use of UP, more respectful interactions, and more client teaching at final evaluation. Patient surveys reported more discussion with health workers about HIV at the final evaluation. Peer-group interventions can prepare health workers in Malawi for HIV prevention and offer a potential model for other African countries.

Mano a Mano for Health Professions Students in Chile: A Pilot HIV Prevention Program

“…Findings from our pilot study were consistent with previously reported observational studies, in which the knowledge of HIV in students and health professionals from Chile and other countries has been weak in several domains (Chimango et al, 2009; Ferrer et al, 2007; Kaponda et al, 2009; Norr et al, 2006). In addition, interventions for health professions university students have also shown significant improvement in knowledge and positive attitudes after education (Pickles et al, 2009; Valois et al, 2001; Yiu et al, 2010).…”

“…An HIV intervention for rural health workers in Malawi was found to be effective in improving both personal and job-related HIV knowledge, attitudes, and behaviors for rural and urban health workers, including more use of standard precautions, more HIV prevention teaching, and respectful interactions with clients (Chimango et al, 2009; Kaponda et al, 2009; Norr et al, 2006). Participants’ general knowledge of universal precautions (cleaning, glove wearing, hand washing, and sharps) improved from 77.43% at baseline to 79.23% at postintervention, a small yet statistically significant development (Chimango et.…”

“…The intervention successfully used in Malawi (Chimango et al, 2009) has been tailored to fit the Chilean cultural context, applied to various populations such as health workers and vulnerable men and women, and is now called Mano a Mano [Hand to Hand] (Norr, 2004–2010; Norr et al, 2006). The Mano a Mano intervention is based on adult learning theories supported by Bandura (1994), Freire (1970), and Knowles (2003), who posited that learning occurs through social interaction and modeling.…”

Peer Group Intervention for HIV Prevention Among Health Workers in Chile

“…The intervention, Mano a Mano Para Trabajadores de Salud , is a professionally-assisted peer group intervention adapted from a peer group intervention successfully used for health workers in Malawi (Chimango et al, 2009; Mbeba et al, in press). The intervention's conceptual framework and cultural tailoring to Chile based on a formative evaluation were described above.…”

“…The U.S.-based coauthors and their colleagues in Malawi have developed and tested a peer group intervention in Malawi that improved health workers' personal and work-related knowledge, attitudes, and behaviors (Chimango et al, 2009; Jere et al, 2010; Kaponda et al, 2009, Mbeba et al, 2011). The intervention's delivery was based on the WHO primary health care model of health worker-community collaboration to address health issues.…”