Strategies to improve compliance to Post Exposure Prophylaxis guidelines for midwifery practitioners at specific hospitals in Gauteng Province, South Africa

Abstract

Background: Midwifery practitioners as frontline healthcare workers remain susceptible to occupational exposure to infections while performing their routine duties. About 90% of occupational exposures occur in the developing world due to a lack of awareness and structured training in the prevention and management of accidental exposures. Midwifery practitioners are regularly exposed to amniotic fluid, vomitus, blood, urine, faeces, sweat, vaginal secretions and breastmilk. The World Health Organisation’s HIV PEP guidelines are an essential instrument for the prevention of occupational HIV infection and have proven to be an effective method to prevent infections among healthcare workers. Purpose: The purpose of the study was to develop strategies to improve compliance with Post Exposure Prophylaxis guidelines for midwifery practitioners in the Gauteng Province of South Africa. Methodology: The study followed the concurrent mixed methods research approach with qualitative nested in quantitative design. The study adopted the non-experimental quantitative research with a cross-sectional descriptive design and a descriptive phenomenological design for the qualitative strand. Sampling, data collection and analysis: A random sampling technique was used to collect quantitative data from seventy-one (71) midwifery practitioners. At the same time, a purposive non-probability sampling technique was used for the qualitative approach with two (2) OHS practitioners and 13 midwifery practitioners. Data was collected through questionnaires and semi-structured interviews. Quantitative data was analysed with SPSS version 24, and thematic analysis was used for the qualitative strand. Results: Maternity units are a high-risk clinical area. The midwifery practitioners have good knowledge about PEP but fail to comply fully with the guidelines. The study revealed the underreporting of accidental exposures to blood and body fluids and the underutilisation of PEP services. The process of obtaining PEP after exposure is tedious, according to participants. Hence, some prefer to seek PEP services elsewhere. Strategies to improve compliance were developed in this study.