Health Facility Staff: Staff Needs and Support (Tier 2)
From the perspective of health facility staff, the indicator measures institutional drivers of HIV stigma and discrimination. It measures if health facility staff perceive that there are adequate supplies (e.g. gloves), and protocols and standards to reduce their risk of HIV infection in their healthcare facility.
This indicator addresses institutional drivers of stigma that can reduce HIV stigma and discrimination in a healthcare facility. It also addresses health facility staff’s needs for support in order to offer safe and welcoming services to patients living with HIV. For example, health facility staff need information, training, supplies, supervision and support that allows them to skillfully perform their duties while practicing universal precautions and prevention of HIV transmission. If staff perceive that supplies are unavailable, or that procedures or protocols to reduce their risk of workplace HIV exposure are not present, in their facility, irrespective of whether they actually exist or whether they are made available to staff, this will affect how they interact with HIV positive clients.
Number of health facility staff interviewed who disagree with at least one statement
Number of all health facility staff who answered at least one statement
Numerator / Denominator
Any type of facility-based surveys, e.g. Service Provision Assessment or Quality Assurance Survey
This indicator is constructed from the responses to the following set of prompted questions:
- Do you strongly agree, agree, disagree or strongly disagree with the following statements?
- There are adequate supplies in my facility that reduce my risk of becoming infected with HIV.
- There are standardized procedures/protocols in my health facility that reduce my risk of becoming infected with HIV.
Every 3-5 years
The perception of adequate supplies (e.g. gloves) to protect health facility staff from the risk of HIV is an important measure because it captures the facility environment that health facility staff are working in. When the facility environment does not provide the necessary equipment for workers to safeguard themselves from HIV infection, stigmatizing behaviors towards HIV positive patients result. These behaviors may include the use of unnecessary precautions or an unwillingness to treat an HIV positive patient.
The standards that are in place to reduce risk of health facility staff workers would include guidelines on how to safely draw blood or handle blood of a patient living with HIV, surgical procedures and practices, what to do in the event of a needle stick, availability and procedures for accessing post-exposure prophylaxis (PEP) and universal precautions.
In some settings this indicator may suffer from social desirability bias because respondents do not want to put their facility in a poor light by reporting lack of supplies. Where possible, having an independent measure of availability of supplies will allow for a check on whether the indicator is suffering from this type of social desirability bias.
Depending on available resources and data collection objectives, this indicator could be paired with a facility audit of available supplies. The results of the facility audit may indicate that supplies are available to staff. However, if staff perceives supplies to be unavailable, then there is a clear disconnect in knowledge of where supplies are housed and/or how supplies are made available to staff, among other factors. This creates an opportunity to explore this issue in more detail and identify resolutions.
For further information on the methodology and survey instruments, visit http://www.healthpolicyproject.com/index.cfm?ID=publications&get=pubID&p....
Jain, A., and L. Nyblade. 2012. “Scaling Up Policies, Interventions, and Measurement for Stigma-Free HIV Prevention, Care, and Treatment Services.” Working Paper #3. Washington, DC: Futures Group, Health Policy Project. http://www.healthpolicyproject.com/index.cfm?id=publications&get=pubID&p...
Nyblade, L., Stangl, A., Weiss, E., & Ashburn, K. (2009). Combating HIV stigma in health care settings: what works?. Journal of the International AIDS Society,12(1), 15.
Nyblade, L. Jain, A. et al. Journal of the International AIDS Society 2013, 16(Suppl 2):18718
http://www.jiasociety.org/index.php/jias/article/view/18718 | http://dx.doi.org/10.7448/IAS.16.3.18718