title: Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.
abstract: OBJECTIVE
  Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures.
  
  
  METHODS
  Focus group discussion. Analysis according content method.
  
  
  METHODS
  Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff.
  
  
  RESULTS
  HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures.
  
  
  CONCLUSIONS
  HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.
authors.affiliation: Health Alliance International, Technical Assistance Unit, Maputo, Mozambique.
authors.forename: Miranda
authors.initials: M
authors.lastname: Brouwer
authors.affiliation: Ministry of Health, Maputo, Mozambique.
authors.forename: Eliana
authors.initials: E
authors.lastname: Coelho
authors.affiliation: Ministry of Health, Provincial Directorate, Tete, Mozambique.
authors.forename: Carla das Dores
authors.initials: Cd
authors.lastname: Mosse
authors.affiliation: Independent Consultant, Edinburgh, United Kingdom.
authors.forename: Luciana
authors.initials: L
authors.lastname: Brondi
authors.affiliation: Social Anthropology, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Laura
authors.initials: L
authors.lastname: Winterton
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: van Leth
mesh_terms: D000328:Adult; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D009726:Nurses; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D010820:Physicians; D012307:Risk Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D055815:Young Adult