A

Research report

To investigate and describe Health

Worker’s level of knowledge about

HIV/AIDS

A Study Conducted in Biswan Blocks of Sitapur District

This Dissertation Synopsis submitted for the partial fulfillment of

MSW Degree for IGNOU.

Submitted by Research Supervisor

Manoj Kumar Singh DR. Rupesh Kumar

Enrolment No. – 120632555 Reader, Social work Deptt.

Mob. 9450375294 University of Lucknow

Indira Gandhi National Open University

Special Study Centre (2720)

Christian Degree College, Lucknow

INTRODUCTION

Human Immune Deficiency Syndrome (HIV) is a major public health challenge with an

estimated 2.24 million persons living with HIV (PLHIV) in India. On the Asian sub-continent,

an estimated 4.87million people were living with HIV in 2012. Health education, particularly

Information Education & Communication (IEC) and Behavior Change Communication (BCC)

are the key strategies for controlling this epidemic. In the light of evidence that HIV/AIDS cases

are continuously increasing in the developing countries like India, healthcare professionals are

required to be adequately trained, so that they can play a vital role in combating this pandemic.

Even though it is widely accepted that healthcare professionals play a crucial role in prevention

and control of HIV/AIDS, less attention has been given to assess knowledge and attitude of the

healthcare professionals. A study conducted by the me of people living with HIV/AIDS

(APN+)in the Biswan (all CHCs & PHCs ) Block, Sitapur, U.P reported Ignorance,

Unawareness, stigma & discrimination by healthcare professionals when treating HIV- positive

patients.

Results of the study revealed that about one sixth of HIV- positive patients were denied

treatment. Similarly, lack of knowledge about transmission of HIV was observed among the

healthcare professionals in these hospitals in India. That study had identified serious knowledge

gaps among medical practitioners leading to refusal of treatment to persons living with

HIV(PLHIV).

Doctors, paramedical staff, BHW, Anum from Biswan are strategically placed to be sensitized

on the factual knowledge pertaining to HIV/AIDS transmission and prevention. It is also

necessary that healthcare workers should inculcate healthy attitude towards persons living with

HIV/AIDS. However, there are limited studies which have explored knowledge and attitudes of

healthcare professionals pertaining to HIV/AIDS. Keeping this in view, a study was conducted to

assess the knowledge & attitudes related to HIV/AIDS among medical and allied health sciences

students.

Review of Literature

There were many previous researches in this context which proved to be very helpful in preparing a research scenario for me some of them are described as following.

Knowledge, Beliefs and Attitudes about HIV/AIDS related issues, and the Sources of Knowledge among Health Care Professionals in Southern Nigeria.

Chiamaka N. Umeh, M.D., M.P.H,1 E. James Essien, M.D., Dr.P.H, 1,2 Emmanuel N. Ezedinachi, M.D,3 and Michael W. Ross, Ph.D1

The sample was composed of 426 participants. Of this, 277 (65%) were females and 135 (31.7%) males. There were 307 (72.1%) nurses, 53 (12.4%) laboratory workers and 35 (8.2%) doctors. Data on occupation were missing for 31 (7.3%), age was missing for 57 people (13.4%) and gender for 14 (3.3%) of the participants respectively.

The mean age of the study sample was 35.8 years (SD= 8.1) with a median of 35.0 years, range = 19 - 60 or 41 years. The age groups were split into 4 different age categories; group 1=19 - 29, group 2=30 - 39, group 3=40 - 49, and group 4=50 - 60 years and were compared. Among the study population, 86 people (23.3%) fell into group 1, 170 (46.1%) in group 2, 85 (23.0%) in group 3, and 28 (7.6%) in group 4. The ages were summarized according to occupational group. The oldest groups were doctors (mean age = 38.0; SD= 7.3) followed by nurses (mean age = 35.9; SD= 7.8). The laboratory workers were the youngest (mean age = 33.9; SD= 9.3). There was no statistically significant difference in the mean ages of the occupational categories by hospital setting category (data not shown). At all 3 levels of hospital, (Tertiary/Specialist Hospital, Government Hospital, and Community Health Center), the greatest number of respondents was in the 30 - 39 age group.

Of the participants working at the teaching hospital, 18(4.5%) were male and 79 (19.6%) were females. Of the 4 participants in community health centers (CHC), all 4 were females (1%). Of the government hospital participants, 114 (28.3%) were male and 186 (46.2%) were females. When examining the sample by gender and by age, there was no statistically significant difference found between the ages of the males and females (male mean = 35.2 years, SD=8.3 and female mean = 36.1 years, SD=8.1). In general there was a preponderance of females and nurses in the sample, which is representative of the Nigerian health care professional demographics where nurses are generally more common than other workers and the nursing profession is female dominated.

Attitude of health-care workers to HIV/AIDS.

by A E Sadob, A O Fawole, W E Sadoh, A O Oladimeji, O S Sotiloye The current 5% prevalence rate of HIV in Nigeria represents a significant population of people living with HIV/AIDS (PLWHA). Discrimination against PLWHA has profound impact on the

care and support required for their optimal management particularly in resource-constrained settings. The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients' HIV sero-status and review the factors that may contribute to such attitude. Self-administered semi-structured questionnaires were administered to respondents who were selected by multi-stage sampling technique. The questionnaires explored the respondents' knowledge about HIV and their attitude and practice regarding PLWHA. Three hundred and forty-five questionnaires were completed. Only 77.1% correctly identified breastfeeding as a source of HIV transmission; 5.2%and 2.6% respectively thought transmission was possible through mosquito bite and handshake. About 10% and 15% respectively among trained nurses and auxiliary nurses were unaware that HIV could be transmitted to the child during delivery. Some 13.9% and 12.7% of respondents respectively were unwilling to take vital signs and carry out physical examination on PLWHA. Compared to physicians, trained nurses and auxiliary nurses were more likely to deny services based on HIV sero-status. Negative attitude was more likely if the source of the HIV infection was from homosexual exposure or bisexual indiscretion. The health-care workers studied manifested certain attitudes that are potentially discriminatory of PLWHA. Well-coordinated continuing education of HIV/AIDS for all categories of health-care workers is recommended as a vital strategy in the crusade against the epidemic.

Knowledge of HIV/AIDS among health care workers in China.

by Z Wu, G Qi, Y Zeng, R Detels

This study was designed to assess knowledge of AIDS among health professionals in China via a cross-sectional survey. A self-administered questionnaire requesting demographic characteristics and basic AIDS knowledge was given to health professionals in 11 provinces, cities, and autonomous regions. Questionnaires were completed by 1,400 of 1,500 (93%) health professionals surveyed. The percentages of correct answers ranged from 3% to 68%. Findings included that public health workers had more knowledge than clinicians; having attended training workshops was not associated with an adequate levels of knowledge; and knowledge differed by professional level and by the geographic region in which they worked. Although most health professionals questioned knew that AIDS is caused by an infectious agents, their knowledge of transmission routes, the "window period" and the length of the incubation period is still inadequate. Thus, health professionals in China urgently need both more training and more effective training. The effectiveness of future HIV/AIDS workshops should be evaluated.

Disclosure of health care workers with HIV or AIDS.

by M Scheerhorn

Every health care organization should have clear policies about how employees with HIV/AIDS are to be accommodated under employment laws. Managers should be knowledgeable about discrimination laws in order to handle reactions of co-workers. Administrators must ensure that

educational sessions are provided for all levels of staff. Informational brochures on HIV/AIDS should be available to families and to businesses and other community organizations.

Needlestick injuries among health care workers.

by C Porta, E Handelman, P McGovern

Needlestick injuries among health care workers are a recognized health hazard, with 400,000 needlesticks occurring annually among the 4 million health care workers in the United States. Existing needlestick injury literature primarily focuses on hospital sites and may not be generalizable to other health care settings such as nursing homes, home health care sites, clinics, and emergency response units. Nurses were at high risk of needlestick injury from syringes and i.v. equipment relative to the other health care workers. Recapping, prohibited by the OSHA Bloodborne Pathogens Standard, continues to be an identified cause of injury. The literature supports comprehensive injury prevention and control strategies in conjunction with the use of safer needle devices. Health care organizations should assess their worksites to identify hazards and select products and strategies to correct the problem. Future research should clarify accurate needlestick injury rates (e.g., establish consistent denominators), address non-hospital setting risks, validate self reported data, and evaluate comprehensive interventions that employ engineering strategies to minimize the risk.

Research Methodology

Objectives of Research Report

Main Objective

The aim of the study is to investigate and describe Health Worker’s ‟ level of knowledge

about HIV/AIDS and their attitudes towards people with the syndrome.

Sub Objectives

To get information about causes and prevention of AIDS.

To Study Geographical profile of Biswan Block.

To get knowledge various Doctors, paramedical staff, Anums, Ward boys, BHW working

in various CHCs & PHCs.

To understand causes of ignorance of staff towards people living with HIV other than

lack of knowledge, like religion, community problem.

Need of the Study

HIV is a severe problem in the world, which continues to grow. In 2011 it was estimated

that the number of people suffering from HIV worldwide was 33.4 million (UNAIDS & WHO,

2012). HIV is a relatively new disease and the knowledge about and attitudes against the disease

have changed a lot since the first cases were reported in the early 80s. However, research has

shown that st igmatizing attitudes against HIV/AIDS is still present among health care personnel

and students. Previous research has also shown that there is lack of knowledge about HIV/AIDS

among health care workers and nursing staff . And the need for more education on the topic is

frequently expressed.

Doctors and Co-workers have a central role in prevention, care and treatment of people

living with HIV/AIDS (Durkin, 2004). It is of great importance to assess Health Workers ‟

knowledge and attitudes towards people living with HIV/AIDS since they will have an important

role to halt this epidemic in the coming years (Durkin).

Importance of study

By this research we will get a full profile of the Biswan block and various Health Workers

associated to government hospitals. This report will also provide knowledge about various

Health Workers at this place.

This research will not only provide data related to their ignorance about HIV / AIDS but will

also provide them knowledge in the areas they do not have knowledge . So project becomes

important.

Research design

The study used a prospective design, where participants’ knowledge, attitudes and perceptions

towards HIV/AIDS were assessed at baseline. Then a health education intervention was

implemented followed by a post – intervention assessment.

Research Design Type :

The present study is exploratory in nature, as it seeks to discover ideas and insight to bring out new

relationship. Research design is flexible enough to provide opportunity for considering different aspects

of problem under study. It helps in bringing into focus some inherent unawareness in Health Workers

about HIV/AIDS regarding which in depth study can be conducted by me.

Hypothesis

1. Health workers in Government hospitals at Biswan do not have full knowledge about

AIDS/HIV.

2. Health workers are not fulfilling their duties and works.

TYPES OF RESEARCH

EXPLORATORY

RESEARCH DESIGN

DESCRIPTIVE

&

DIAGNOSTIC

EXPERIMENTAL RESEARCH DESIGN

Methods

A comprehensive literature review was undertaken by searching the MEDLINE database,

Psychlit, ISI Web, EBSCOHost, and Sabinet on line, for English language literature published

between 1985 and 2004. The database search terms included keywords such as fear/s, barrier/s,

concern, HIV, AIDS, attitudes, physician/s (doctor/s), practice, treatment, care and knowledge. A

variety of combinations of these words were entered. All duplicate articles were removed and

only studies that used doctors as the sample population were considered. Titles expressing

comment, news items, opinion pieces or letters were rejected.

TOOLS OF DATA COLLECTION

For any study there must be data for analysis purpose. Without data there is no means of

study. Data collection plays an important role in any study. It can be collected from various

sources. I have collected the data from two sources which are given below:

1. Primary Data

Personal Investigation (Questionnaire)

Observation Method

Information from correspondents

Information from superiors of the organization

2. Secondary Data

Published Sources such as Journals, Government Reports, Newspapers and Magazines

etc.

Unpublished Sources such as Company Internal reports prepare by them given to their

analyst & trainees for investigation.

Sample Size :-

Questionnaire is filled by 75 Respondents which includes Doctors, BHW, Paramedicals Staff,

Anums, ward Boys etc

The questionnaire was filled in the office and vital information was collected which was then

subjects to:-

A pilot survey was conducted before finalizing the questionnaire.

Data collection was also done with the help of personal observation.

After completion of survey the data was analysed and conclusion was drawn.

At the end all information was compiled to complete the project report.

Collection of Data

Most of the data collected by the researcher is primary data through personal interview,

where the researcher and the respondent operate face – to – face.

Research Instrument

The researcher has used a structured questionnaire as a research instrument tool which

consists of open ended questions, multiple choice and dichotomous questions in order to

get data. Thus, Questionnaire is the data collection instrument used in the study. All the

questions in the questionnaire are organized in such a way that elicit all the relevant

information that is needed for the study

Sampling

Population: - Respondents which includes Doctors, BHW, Paramedicals Staff, Anums, ward

Boys at Biswan

Sampling Process:- A probability sampling is one in which every unit in the population has a

chance (greater than zero) of being selected in the sample, and this probability can be accurately

determined. The combination of these traits makes it possible to produce unbiased estimates of

population totals, by weighting sampled units according to their probability of selection.

My Project is based on probability Sampling

Tabulation and Statistical Tools

The statistical tools used for analyzing the data collected are percentage method, chi

square, bar diagrams and pie diagrams.

Analysis of Data

Sitapur The data collected by the researcher are tabulated and analyzed in such a way to

make interpretations.

Various steps, which are required to fulfill the purpose, i.e., editing, coding, and tabulating.

Editing refers to separate, correct and modify the collected data. Coding refers to assigning

number or other symbols to each answer for placing them in categories to prepare data for

tabulation refers to bring together the similar data in rows and columns and totaling them in an

accurate and meaningful manner

The collected data are analyzed and interrupted using statistical tools and techniques.

Attentive Chapter Scheme

1. Introduction

2. Review of Literature

3. Research Methodology

4. Objectives of the Project

5. Scope of the Project

6. Data Analysis & Interpretations

7. Findings

8. Conclusion

9. Suggestions

Bibliography

Annexure

Questionnaire

References

1177 Råd om vård på webb och telefon. (2008). HIV och AIDS: Översikt. Retrieved April 7, 2010, from 1177 Råd om vård på webb och telefon, http://www.1177.se/allakapitel.asp?CategoryID=33278&AllChap=True&PreView=

AIDS Prevention and Control. (2009). HIV/AIDS FAQs. Retrieved 12 April, 2010, from AIDS Prevention and Control, http://www.apacvhs.com/FAQs_HIV_AIDS.html

Andersen, F. & Britton, S. (2008). HIV och AIDS: Vad finns det för behandling och vilken medicin kan ges? Retrieved 9 April, 2010, from Netdoktor, http://www.netdoktor.se/forkylning-infektion/?_PageId=434

Aschberg, J. & Sjöblom, E. (2009). Sjuksköterskestudenters attityder till personer med HIV: En enkätundersökning. C-uppsats, Röda Korsets Högskola, Institutionen för omvårdnad.

Belz, C. A. M., Wilson, I. B., Wanke, C. A., Selvakumar, A., John, K. R. & Isaacs, R. (2009). Knowledge, beliefs, and health care practices relating treatment of HIV in Vellore, India. AIDS Patient Care and STDs. 23(6), 477-483. Retrieved from EBSCO Host with Full Text .

Bristol-Myers Squibb. (2008). Fakta om virus, hiv och aids. Retrieved 13 April, 2010, from Läkemedelsindustriföreningen, http://www.lif.se/cs/Publik%20webb/Sidinnehall/Publik_Dokument/Pressmeddelanden/Fakta%20om%20HIV%20dec%2007.pdf

Questionnaire

Name………………………..….…..

Qualification …………….…………

Post …………………………………

Years of Services …………………..

CHC/PHC Name……………….…..

Date:

Place: Signature