Barriers to Universal Precautions compliance among primary health care workers in Kaduna State, Nigeria: A qualitative study

  • Grace Awawu Nmadu University of the Western Cape
  • Sabitu Kabir University of Western Cape
  • Joshua Anekoson Istifanus University of the Western Cape


Background: Establishment of good infection control practices in Primary Health Care (PHC) facilities is critical to prevent the transmission of infectious pathogens among Primary Health Care Workers (PHCWs). The implementation of Universal Precautions (UP) in PHC centers in Kaduna has not been explored to identify barriers to good practice. The aim of this study is to explore the barriers to UP compliance among PHCWs in Kaduna State, Nigeria.

Methods: A qualitative exploratory study was carried out between September 2011 and May 2012 among 32 PHCWs purposively selected from two Local Government Areas (LGAs) in Kaduna State, Nigeria. Four focus group discussions were conducted with PHCWs in two LGAs. The Theory of Planned Behavior (TPB) was used as the theoretical framework for development of questions for the focus group discussion guide. Thematic analysis was performed manually to identify barriers to UP compliance.

Results: Factors related to UP compliance could be mapped into individual, job related, and organizational factors. Individual factors to poor UP compliance were lack of knowledge and the perception of negative influence of Personal Protective Equipment (PPE). The job-related factors were heavy workload and emergency situations. The organizational factors were the lack availability of PPE, lack of training and lack of support from management.

Conclusion: There is urgent need to develop effective interventions to address the individual, job related and organizational factors influencing the compliance of PHCWs to Universal Precautions.

Key words: Compliance, Nigeria, Primary Health Care Workers, Universal Precautions.


Author Biographies

Grace Awawu Nmadu, University of the Western Cape

Department of Community Medicine, Kaduna State University, Kaduna, Nigeria

Sabitu Kabir, University of Western Cape

Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria

Joshua Anekoson Istifanus, University of the Western Cape

Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria


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