Access to occupational postexposure prophylaxis for primary health care workers in rural Africa: A cross-sectional study

Background For many primary health care workers in developing countries, the limited availability and cost of public transport hinders timely access to occupational postexposure prophylaxis (PEP) at referral hospitals. Adapted PEP training and a starterʹs kit (for human immunodeficiency virus, hepatitis B virus, and syphilis prophylaxis) could improve access. Methods The evaluation method, based on the 12 steps of the decentralized phase of PEP management, calculated different scores from the responses for 51 anonymous surveys and allowed comparison among different groups. Listed obstacles and clinic visits provided further information. Results Respondents who received in-service PEP training had significantly higher mean knowledge and confidence scores but no different mean attitude scores than those who did not. The mean total score for those who received the adapted PEP training (10.7 of 12) was significantly higher (P = .008) than for those who did not (8.8 of 12). Conclusion Decentralizing the first phase of PEP management for primary health care workers in rural Zimbabwe attends to an unmet need. The evaluation facilitates checking completeness of course contents, stresses the need to pay equal attention to attitudes toward the referral and reporting system, and identifies specific challenges for delivering PEP in rural settings. The finding may inspire to improve access to PEP for other health care workers and phlebotomists employed in remote areas.