Abstract
Background: The COVID-19 pandemic has placed great strain on health systems globally. In South Africa, rising health worker infection numbers in an already resource limited health system has raised a growing need to assess the implementation of governing documents for the promotion and protection of health worker wellbeing and safety. The aim of the study is to provide an analysis of the implementation of these governing documents in three South African hospitals.
Methods: The study consisted of 314 health workers in three South African public hospitals located in the Western Cape, Eastern Cape and Gauteng. Convenience and snowball sampling was utilised and questionnaires were distributed electronically via Google Forms and on paper. Data was encoded and analysed with IBM SPSS Statistics Version 26. Frequency tables and Pearson chi-square was utilised during data analysis.
Results: More than a half of participating health workers did not have access to varying items of PPE. A significant association was observed between access to PPE and a positive COVID-19 diagnosis amongst health workers (χ2=8.906, p=0.003). Nearly four out of every five participants re-used PPE and the majority of participants were not screened for COVID-19 symptoms every morning. Moreover, more than half of the participants noted that they were able to enter the workplace despite displaying symptoms of COVID-19. Almost a third of participants did not have access to hand washing facilities and 46.57% of participants were unable to access refresher training courses. Participants in the Western Cape hospital had the lowest rate of non-implementation of various aspects of health and safety guidelines. These participants also had the lowest proportion of positive COVID-19 diagnoses. Conversely, participants in the Eastern Cape based hospital with the highest level of non-implementation of various aspects of health and safety guidelines had the highest proportion of COVID-19 diagnoses.
Conclusion: A greater proportion of SARS-CoV-2 infectivity was observed where non-implementation of guidelines occurred. Moreover, the results call for more stringent implementation of occupational health and safety measures within South African health systems and further investigation of this topic on a larger scale.