Background
Methods
Study population
Health facilities
Sampling and study design
Procedure
Assessment of health care workers
Data management and statistical analysis
Results
Descriptive results
Variables, n (%) | All, 1000 (100%) | Untrained, 290 (29%) | Trained, 710 (71%) | p-value |
---|---|---|---|---|
Gender | ||||
Male | 253 (25.3) | 59 (20.3) | 194 (27.3) | |
Female | 747 (74.7) | 231 (79.7) | 516 (72.7) | 0.021 |
Marital status | ||||
Married/Cohabitating | 588 (58.8) | 152 (52.4) | 436 (61.4) | |
Single | 368 (36.8) | 130 (44.8) | 238 (33.5) | |
Divorced | 10 (1.0) | 2 (0.7) | 8 (1.1) | |
Widow (er) | 34 (3.4) | 6 (2.1) | 28 (3.9) | 0.006 |
Age category | ||||
20–29 | 229 (22.9) | 115 (39.7) | 114 (16.1) | |
30–39 | 379 (37.9) | 114 (39.3) | 265 (37.3) | |
40–49 | 279 (27.9) | 48 (16.6) | 231 (32.5) | |
≥50 | 113 (11.3) | 13 (4.5) | 100 (14.1) | < 0.001 |
Type of health facility | ||||
Public | 640 (64.0) | 201 (69.3) | 439 (61.8) | |
Private | 200 (20.0) | 56 (19.3) | 144 (20.3) | |
Faith-Based | 160 (16.0) | 33 (11.4) | 127 (17.9) | 0.025 |
Category of health facility | ||||
Level 1 (High) | 111 (11.1) | 28 (9.7) | 83 (11.7) | |
Level 2 (Medium) | 411 (41.1) | 130 (44.8) | 281 (39.6) | |
Level 3 (Lowest) | 478 (47.8) | 132 (45.5) | 346 (48.7) | 0.273 |
Employment status | ||||
Permanent | 780 (78.0) | 178 (61.4) | 602 (84.8) | |
On internship | 93 (9.3) | 51 (17.6) | 42 (5.9) | |
Temporary | 127 (12.7) | 61 (21.0) | 66 (9.3) | < 0.001 |
Grade | ||||
Specialists | 184 (18.4) | 47 (16.2) | 137 (19.3) | |
General Practitioners (GP) | 54 (5.4) | 18 (6.2) | 36 (5.1) | |
Registered nurses | 209 (20.9) | 45 (15.5) | 164 (23.1) | |
Midwives | 157 (15.7) | 31 (10.7) | 126 (17.7) | |
Nurse-aids | 249 (24.9) | 103 (35.5) | 146 (20.6) | |
Medical technicians | 147 (14.7) | 46 (15.9) | 101 (14.2) | < 0.001 |
Location | ||||
Urban | 630 (63.0) | 177 (61.0) | 453 (63.8) | |
Semi-urban | 185 (18.5) | 61 (21.0) | 124 (17.5) | |
Rural | 185 (18.5) | 52 (17.9) | 133 (18.7) | 0.419 |
Years of work | ||||
1–9 years | 526 (52.6) | 212 (73.1) | 314 (44.2) | |
10–19 years | 323 (32.3) | 61 (21.0) | 262 (36.9) | |
≥20 years | 151 (15.1) | 17 (5.9) | 134 (18.9) | < 0.001 |
Longevity at PMTCT | ||||
0 years | 207 (20.7) | 102 (35.2) | 105 (14.8) | |
1–9 years | 150 (15.0) | 64 (22.1) | 86 (12.1) | |
10–19 years | 156 (15.6) | 34 (11.7) | 122 (17.2) | |
≥20 years | 487 (48.7) | 90 (31.0) | 397 (55.9) | < 0.001 |
Level of education | ||||
Elementary | 34 (3.4) | 9 (3.1) | 25 (3.5) | |
Secondary | 229 (22.9) | 65 (22.4) | 164 (23.1) | |
High school | 466 (46.6) | 130 (44.8) | 336 (47.3) | |
University/Postgraduate | 271 (27.1) | 86 (29.7) | 185 (26.1) | 0.704 |
Trained others? | ||||
No | 424 (42.4) | 284 (97.9) | 140 (19.7) | |
Yes | 576 (57.6) | 6 (2.1) | 570 (80.3) | < 0.001 |
Have the means to apply what you were trained to do? | ||||
No | 391 (39.1) | 239 (82.4) | 152 (21.4) | |
Yes | 609 (60.9) | 51 (17.6) | 558 (78.6) | < 0.001 |
Conducive environment to carry out PMTCT of HIV? | ||||
No | 371 (37.1) | 158 (54.5) | 213 (30.0) | |
Yes | 629 (62.9) | 132 (45.5) | 497 (70.0) | < 0.001 |
Received training hand-outs? | ||||
No | 469 (46.9) | 280 (96.6) | 189 (26.6) | |
Yes | 531 (53.1) | 10 (3.4) | 521 (73.4) | < 0.001 |
Working in PMTCT services | ||||
No | 201 (20.1) | 94 (32.4) | 107 (15.1) | |
Yes | 799 (79.9) | 196 (67.6) | 603 (84.9) | < 0.001 |
Variable | All | Untrained | 18 monthsa | 24 monthsb | 36 monthsc | p-value |
---|---|---|---|---|---|---|
n (%) | 1000 | 290 (29.0) | 237 (23.7) | 267 (26.7) | 206 (20.6) | |
Number of participants with a mean score ≤ 50, n (%) | 572 (57.2) | 120 (41.4) | 161 (67.9) | 171 (64.0) | 120 (58.3) | < 0.0001 |
Mean score, x̅ (SD) | 50.7 (16.6) | 43.7 (16.2) | 54.8 (16.3) | 53.9 (15.7) | 51.7 (15.6) | 0.0001d |
Gender | ||||||
Male | 54.7 (16.1) | 46.9 (15.7) | 58.7 (14.9) | 59.9 (15.1) | 52.1 (15.3) | |
Female | 49.4 (16.6) | 42.9 (16.3) | 53.7 (16.5) | 51.5 (15.3) | 51.6 (15.8) | 0.0001e |
Marital status | ||||||
Married/Cohabitating | 52.0 (16.0) | 43.2 (15.3) | 55.9 (15.8) | 55.5 (14.9) | 53.5 (14.3) | |
Single | 48.9 (17.3) | 44.7 (17.0) | 52.9 (17.3) | 51.2 (16.4) | 48.9 (17.6) | |
Divorced | 43.0 (24.0) | 20.0 (28.3) | 60.0 (−-) | 45.0 (23.4) | 60.0 (−-) | |
Widow (er) | 51.3 (14.5) | 45.0 (14.9) | 54.0 (13.2) | 55.6 (13.6) | 46.3 (15.8) | 0.0171 |
Age category | ||||||
20–29 | 48.4 (16.9) | 43.7 (17.3) | 56.9 (13.4) | 47.6 (13.1) | 54.6 (21.5) | |
30–39 | 51.3 (16.4) | 45.3 (15.6) | 54.7 (17.2) | 55.4 (15.3) | 51.2 (15.5) | |
40–49 | 52.1 (17.4) | 41.4 (15.1) | 55.1 (17.3) | 55.3 (17.8) | 52.4 (15.7) | |
≥50 | 50.2 (14.4) | 38.9 (15.4) | 48.7 (15.3) | 54.1 (13.3) | 50.5 (13.0) | 0.5360 |
Type of HF | ||||||
Public | 52.2 (17.1) | 45.1 (16.6) | 55.9 (17.3) | 57.0 (15.8) | 53.1 (15.9) | |
Private | 48.0 (16.0) | 40.2 (14.9) | 55.7 (14.5) | 48.5 (16.4) | 47.5 (13.9) | |
Faith-Based | 48.4 (14.5) | 41.4 (15.3) | 49.5 (14.1) | 50.7 (12.4) | 50.3 (15.8) | 0.0004 |
Category of HF | ||||||
Level 1 (High) | 47.7 (17.3) | 41.4 (16.1) | 51.5 (18.2) | 50.7 (17.2) | 47.9 (16.9) | |
Level 2 (Medium) | 52.7 (17.4) | 45.2 (17.6) | 58.2 (16.9) | 56.5 (16.7) | 53.5 (14.4) | |
Level 3 (lowest) | 49.8 (15.6) | 42.8 (14.8) | 53.0 (15.0) | 52.5 (14.4) | 51.5 (16.1) | 0.0009 |
Employment status | ||||||
Permanent | 52.1 (16.4) | 44.7 (16.1) | 55.6 (16.1) | 54.9 (15.4) | 52.2 (15.8) | |
Intern | 45.7 (17.6) | 40.0 (16.3) | 53.0 (17.5) | 54.2 (15.6) | 47.8 (18.9) | |
Temporary | 46.0 (15.7) | 44.2 (16.3) | 49.8 (16.3) | 44.7 (15.5) | 49.0 (13.3) | 0.0055 |
Grade | ||||||
Specialists | 51.9 (15.6) | 47.1 (15.3) | 52.4 (15.7) | 53.6 (15.6) | 55.0 (15.3) | |
General Practitioners (GP) | 50.9 (18.5) | 40.2 (15.2) | 58.7 (20.3) | 59.8 (15.4) | 40.6 (11.6) | |
Registered nurses | 54.9 (14.8) | 48.0 (11.0) | 59.7 (14.9) | 56.7 (15.4) | 54.4 (14.8) | |
Midwives | 53.5 (17.2) | 51.6 (19.4) | 53.9 (18.4) | 54.1 (16.3) | 53.9 (16.1) | |
Nurse-aids | 46.7 (16.5) | 39.7 (16.4) | 52.4 (15.9) | 50.9 (14.0) | 51.3 (14.5) | |
Medical technicians | 47.2 (16.9) | 41.3 (16.4) | 55.2 (15.3) | 48.9 (16.6) | 42.9 (16.1) | 0.0071 |
Location | ||||||
Urban | 50.1 (16.6) | 42.8 (15.6) | 54.2 (16.8) | 53.4 (16.3) | 50.7 (15.2) | |
Semi-urban | 49.5 (17.1) | 42.7 (18.2) | 54.8 (14.0) | 53.7 (14.1) | 49.8 (18.3) | |
Rural | 54.3 (15.6) | 48.4 (15.5) | 56.4 (16.4) | 57.3 (14.7) | 56.4 (13.8) | 0.0500 |
Years of work | ||||||
1–9 years | 49.4 (17.1) | 43.7 (16.4) | 54.5 (15.5) | 53.3 (16.6) | 50.7 (18.3) | |
10–19 years | 51.9 (16.2) | 44.5 (16.5) | 56.0 (17.8) | 53.1 (15.0) | 52.1 (14.6) | |
≥20 years | 52.9 (15.2) | 41.8 (13.0) | 53.4 (16.5) | 57.1 (14.5) | 52.4 (14.1) | 0.8026 |
Longevity at PMTCT | ||||||
0 years | 45.8 (18.1) | 42.5 (17.5) | 54.1 (18.0) | 47.8 (18.5) | 45.9 (17.7) | |
1–9 years | 51.6 (16.8) | 44.5 (16.4) | 55.7 (13.6) | 57.4 (16.8) | 58.5 (15.8) | |
10–19 years | 51.6 (15.5) | 41.6 (15.1) | 54.5 (15.7) | 54.1 (10.6) | 53.9 (12.9) | |
≥ 20 years | 52.3 (15.8) | 45.4 (15.0) | 54.9 (17.4) | 54.6 (15.1) | 52.2 (14.9) | 0.0039 |
Level of education | ||||||
Elementary | 48.9 (18.6) | 45.5 (16.9) | 45.4 (25.1) | 56.7 (15.9) | 49.5 (12.1) | |
Secondary | 46.5 (16.2) | 39.7 (15.9) | 49.7 (14.3) | 48.8 (16.5) | 49.1 (15.6) | |
High school | 51.1 (16.2) | 43.2 (17.2) | 55.2 (15.3) | 54.5 (14.1) | 52.5 (14.8) | |
University/PG | 54.0 (16.7) | 47.4 (14.3) | 59.4 (16.4) | 57.4 (16.5) | 53.2 (17.9) | < 0.0001 |
Trained others? | ||||||
No | 45.3 (15.9) | 43.7 (16.3) | 53.2 (15.2) | 47.8 (13.9) | 46.0 (14.9) | |
Yes | 54.8 (15.9) | 47.2 (11.4) | 55.1 (16.5) | 55.5 (15.8) | 53.6 (15.5) | 0.0001 |
Have the means to apply what you were trained to do? | ||||||
No | 46.1 (16.9) | 43.3 (16.9) | 51.8 (16.7) | 50.8 (15.4) | 49.1 (16.2) | |
Yes | 53.7 (15.7) | 45.7 (12.9) | 55.5 (16.2) | 54.9 (15.6) | 52.6 (15.4) | 0.0073 |
Conducive environment to carry out PMTCT of HIV? | ||||||
No | 49.2 (17.0) | 43.5 (16.6) | 53.9 (17.7) | 54.8 (14.9) | 51.2 (15.9) | |
Yes | 51.7 (16.3) | 44.0 (15.8) | 55.1 (15.8) | 53.5 (16.0) | 52.1 (15.5) | 0.8191 |
Received training handouts? | ||||||
No | 46.9 (16.8) | 43.7 (16.4) | 54.6 (17.6) | 49.3 (16.5) | 51.3 (13.7) | |
Yes | 54.1 (15.7) | 45.3 (8.3) | 54.9 (15.9) | 55.5 (15.1) | 51.9 (16.4) | 0.0512 |
Working in PMTCT services | ||||||
No | 46.3 (17.5) | 43.1 (16.8) | 52.3 (17.3) | 49.4 (17.5) | 45.3 (18.0) | |
Yes | 51.9 (16.2) | 44.0 (15.9) | 55.3 (16.1) | 54.8 (15.2) | 52.9 (14.9) | 0.0013 |
Variable | Group | Contrast | Tukey p-value | Tukey 95% CI |
---|---|---|---|---|
Marital status | Married vs single | −3.9 | 0.012 | −7.2 to −0.6 |
Type of HF | Private vs Public | −4.4 | 0.010 | −7.9 to −0.8 |
Faith-based vs Public | −5.2 | 0.003 | −8.9 to −1.5 | |
Category of HF | Level 2 vs Level 1 | 6.4 | 0.004 | 1.7–11.0 |
Level 3 vs level 1 | − 3.7 | 0.009 | −6.7 to − 0.8 | |
Employment status | Temporary vs Permanent | −6.6 | 0.004 | −11.4 to − 1.8 |
Grade | Nurse-aids vs Registered Nurses | −5.3 | 0.040 | −10.4 to −0.1 |
Medical technicians vs Registered nurses | −6.9 | 0.007 | −12.7 to − 1.3 | |
Zone | Rural vs Urban | 3.7 | 0.046 | 0.05–7.4 |
Level of education | High school vs secondary school | 4.9 | 0.005 | 1.1–8.8 |
University/PG vs secondary school | 7.9 | 0.000 | 3.6–12.3 |
Correlates of knowledge retention
Univariate analysis
Multivariable logistic regression
Univariate logistic analysis | Multivariable logistic analysis | ||||||||
---|---|---|---|---|---|---|---|---|---|
Factors | OR | 95% CI | p-value | UOR | 95% CI | p-value | AOR | 95% CI | p-value |
Gender | |||||||||
Male | Ref | Ref | Ref | ||||||
Female | 0.61 | 0.43–0.87 | 0.007 | 0.60 | 0.41–0.89 | 0.012 | 0.66 | 0.44–0.98 | 0.044 |
Marital status | |||||||||
Married/Cohabitating | Ref | Ref | Ref | ||||||
Single | 0.69 | 0.49–0.96 | 0.027 | 0.90 | 0.63–1.29 | 0.578 | 0.86 | 0.58–1.26 | 0.436 |
Divorced | 1.48 | 0.29–7.42 | 0.634 | 3.15 | 0.55–17.93 | 0.197 | 4.49 | 0.77–26.21 | 0.095 |
Widow (er) | 0.57 | 0.26–1.23 | 0.151 | 0.63 | 0.28–1.43 | 0.266 | 0.67 | 0.29–1.56 | 0.353 |
Age category | |||||||||
20–29 | Ref | ||||||||
30–39 | 0.97 | 0.61–1.53 | 0.887 | ||||||
40–49 | 1.06 | 0.66–1.69 | 0.808 | ||||||
≥50 | 0.66 | 0.38–1.15 | 0.140 | ||||||
Type of health facility | |||||||||
Public | Ref | Ref | Ref | ||||||
Private | 0.57 | 0.39–0.84 | 0.005 | 0.78 | 0.50–1.21 | 0.261 | 0.82 | 0.51–1.32 | 0.408 |
Confessionary or Faith based | 0.58 | 0.39–0.87 | 0.009 | 0.61 | 0.39–0.94 | 0.026 | 0.54 | 0.34–0.86 | 0.009 |
Category of health facility | |||||||||
Level 1 (High) | Ref | Ref | Ref | ||||||
Level 2 (Medium) | 2.08 | 1.26–3.43 | 0.004 | 1.72 | 1.01–2.93 | 0.047 | 1.47 | 0.83–2.62 | 0.189 |
Level 3 (Lowest) | 1.39 | 0.86–2.24 | 0.185 | 1.09 | 0.63–1.87 | 0.761 | 1.13 | 0.63–1.99 | 0.688 |
Employment status | |||||||||
Permanent | Ref | Ref | Ref | ||||||
On internship | 0.86 | 0.45–1.63 | 0.641 | 0.92 | 0.45–189 | 0.822 | 0.88 | 0.42–1.85 | 0.732 |
Temporary | 0.49 | 0.29–0.83 | 0.007 | 0.51 | 0.29–0.90 | 0.020 | 0.47 | 0.26–0.84 | 0.011 |
Grade | |||||||||
Specialists | Ref | ||||||||
General Practitioner (GP) | 1.36 | 0.59–2.88 | 0.507 | ||||||
Registered nurses | 1.43 | 0.88–2.32 | 0.148 | ||||||
Midwives | 0.87 | 0.59–1.44 | 0.595 | ||||||
Nurse-aids | 0.89 | 0.55–1.45 | 0.659 | ||||||
Medical technicians | 0.78 | 0.46–1.31 | 0.343 | ||||||
Location | |||||||||
Urban | Ref | Ref | Ref | ||||||
Semi-urban | 0.93 | 0.62–1.39 | 0.732 | 0.97 | 0.63–1.51 | 0.923 | 1.04 | 0.66–1.65 | 0.862 |
Rural | 1.91 | 1.23–2.95 | 0.004 | 2.01 | 1.24–3.26 | 0.005 | 1.69 | 1.00–2.88 | 0.049 |
Years of work | |||||||||
1–9 years | Ref | ||||||||
10–19 years | 1.06 | 0.75–1.49 | 0.732 | ||||||
≥20 years | 1.09 | 0.72–1.67 | 0.660 | ||||||
Longevity at PMTCT services | |||||||||
0 years | Ref | Ref | Ref | ||||||
1–9 years | 4.03 | 2.13–7.62 | 0.000 | 2.75 | 1.09–6.89 | 0.031 | 2.23 | 0.85–5.81 | 0.101 |
10–19 years | 2.34 | 1.37–4.01 | 0.002 | 1.66 | 0.71–3.89 | 0.244 | 1.70 | 0.69–4.15 | 0.242 |
≥ 20 years | 2.03 | 1.31–3.14 | 0.001 | 1.27 | 0.57–2.81 | 0.562 | 1.13 | 0.47–2.59 | 0.773 |
Level of education | |||||||||
Elementary | Ref | ||||||||
Secondary | 0.85 | 0.36–2.00 | 0.714 | ||||||
High school | 1.20 | 0.52–2.75 | 0.667 | ||||||
University/PG | 1.54 | 0.65–3.63 | 0.328 | ||||||
Trained others? | |||||||||
No | Ref | Ref |
Ref
| ||||||
Yes | 1.89 | 1.29–2.75 | 0.001 | 1.71 | 1.13–2.59 | 0.011 |
1.55
|
1.00–2.40
|
0.050
|
Had the means to apply what you were trained to do? | |||||||||
No | Ref | Ref | Ref | ||||||
Yes | 1.62 | 1.13–2.34 | 0.009 | 1.46 | 0.98–2.18 | 0.064 | 1.55 | 1.02–2.35 | 0.040 |
Conducive environment to carry out PMTCT of HIV? | |||||||||
No | Ref | ||||||||
Yes | 1.11 | 0.79–1.55 | 0.540 | ||||||
Received training handouts? | |||||||||
No | Ref | ||||||||
Yes | 1.25 | 0.89–1.76 | 0.197 | ||||||
Presently working at PMTCT services | |||||||||
No | Ref | Ref | Ref | ||||||
Yes | 2.18 | 1.44–3.30 | < 0.001 | 1.69 | 0.77–3.70 | 0.190 | 1.67 | 0.74–3.78 | 0.216 |