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Awareness and responses to avian influenza among health workforce Vũ Thị Minh Hạnh and colleagues Objectives To examine awareness and response to avian flu (A(H5N1)) among health workforce; To suggest recommendations to enhance information, education, and communication (IEC) activities and to increase knowledge, responsibility, and response capacity of health worker at all levels for A(H5N1) prevention and control. Study subject Including two groups: managers and leaders of the health sector and technical staff including health workers involved in prevention and treatment activities at all levels. Methods Secondary data collection and analysis and a combination of both qualitative (in-depth interview and focus group discussion) and quantitative (survey using semi-structure questionnaire for health workers) approaches Study settings 7 provinces representing 7 ecological regions in Vietnam, including Quảng Ninh, Quảng Bình, Lâm Đồng, Kiên Giang, Sơn La, Ninh Thuận, and Bình Dương. Results •There was a high proportion (80%-95%) of health workers who knew general information on the prevention and control of A(H5N1) such as causes of morbidity, symptom, level of danger, transmission routes, and prevention methods at hospitals and in community. •The majority of health workers of preventive healthcare branch had proper understanding of early diagnosis and treatment for suspicious A(H5N1) cases. However, the proportion of health workers who had detailed knowledge on early detection and treatment was not high. This would limit the chances of early detecting epidemic hotspots in community for timely treatment. •At treatment facilities, the proportion of health workers with master knowledge on diagnosis and treatment schedule as guided by Ministry of Health was very high (>80% and >90%). They also had comprehensive knowledge on prevent methods. •Noticeably, there was a considerable gap between knowledge and practice among health workers in treating suspicious cases and using self-preventive solutions at workplace. only about 50% of respondents sent their patients with suspicious symptoms to isolation wards; 44% of them prescribed tests, and 17% reported to responsible agencies. 97,8% of respondents said that they should use protection equipment when contacting patients but actually only 2% of them used gloves and masks while examing suspicious cases. The main causes of this gap were:subjective attitude of health workers, especially in regions the disease did not occur; lack of knowledge on how to use protection gear (clothes, masks…); lack of protection gear; and time pressure (lacking of time to wear/use protection gear). •Knowledge of health workers at treatment facilities on A(H5N1) treatment protocol was inadequate due to a lack of detailed guidelines/instructions and inexperience with A(H5N1) patients. Their knowledge and skill in operating respirators was insufficient. •Health workers wanted to be updated with the following issues: danger level of the disease; common symptoms, early detection, and treatment methods; transmission prevention methods at hospitals and in community. Preferred IEC channels/activities for health workers included training, seminars, newspaper, books, handbook, TV, pamphlet, and websites. •In recent years, due attention was paid to implementation of many A(H5N1) prevention and control activities in localities such as training for health workers, investment in infrastructure, supplies of medication and equipment, conducting drills, controlling ill poultry, and treating epidemic hotspots. Response capacity of health workers to the disease was however still weak due to a lack of physical conditions including infrastructure, equipment, medication, protection equipment, health workplace, and adequate incentives. Recommendations •IEC on A(H5N1) targeting health workforce should be strengthened. oFocal IEC messages: danger level of the disease, common symptoms, methods of early detection and treatment; methods of transmission prevention at hospitals and in community, IEC skills on A(H5N1)prevention. oIEC channels should be mobilized: training health worker on A(H5N1) prevention, organizing training of trainers course for provincial staff, organizing seminars, reporting relevant information on mass media including TV and websites, compiling and delivering IEC material broadly. •Sufficient provision of medication and protection equipment of good quality to health workers should be ensured. Some policies on the epidemic prevention should be issued including allowance for those working in toxic environment (e.g. allowance for drivers of district/provincial preventive medicine centers who were directly involved in preventive activities).
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