Healthcare Workers’ Knowledge, Attitudes, and Practices on the Use of the Electronic Application to Report Notifiable Medical Conditions - North West Province, South Africa, 2023

Abstract

Introduction: The compliance of healthcare workers in disease reporting using electronic, real-time surveillance systems is crucial for effective monitoring and control of Notifiable Medical Conditions (NMCs). North West Province has low reporting rate (3.1%) and low number of active App users (4.3%) with fluctuations over time among all the other provinces, despite being the 4th province whereby the NMC Reporting App was first launched in 2018. Hence it is imperative that this study assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) and factors associated with the use of the NMC Reporting App to report Notifiable Medical Conditions in North West Province in 2023. Methods: This cross-sectional study utilized a structured, interviewer-administered questionnaire. Stratified random sampling was used to stratify the population by district, with the target sample size for each district calculated proportionally to the number of healthcare workers in that district. Healthcare facilities were randomly selected. Data was collected between September 6 and November 10, 2023. Data were captured on REDCap and analyzed using Stata®18. Descriptive statistics, frequency and percentages were used to summarize participants demographic characteristics. To assess the level of KAP, scores were calculated and categorized into binary outcome variable for each KAP domain. Adjusted Bloom’s cut-off value of 75% was used to classify participants’ KAP categories into two levels: adequate/ inadequate knowledge (for scores ≥6 or <6 out of 8), positive/negative attitude (for scores ≥9 or <9 out of 12) and good/poor practice (for scores ≥12 or <12 out of 16). To assess the association between overall KAP categories and independent variables, Pearson Chi-square or Fisher’s exact test (as appropriate) was used. Factors associated with KAP were determined through bivariate and multivariable logistic regression analysis. Independent variables with a p-value ≤0.2 in the bivariate analysis were included into the multivariable logistic regression using stepwise method. A p-value of ≤0.05 was considered statistically significant. Results: A total of 343 HCWs’ participated, with 81% response rate. Majority of HCWs were aged 30-49 years (55%), with a mean age of 42 years (SD±10.5). A high proportion were females (82%), professional nurses (62%), and from Ngaka Modiri Molema district (47%). Overall, 80% of HCWs had inadequate knowledge, 50% had negative attitudes, and 96% exhibited poor practices towards the NMC Reporting Page | v App utilization. Factors associated with inadequate knowledge were being in the other nurse category (aOR: 2.83, 95% CI: 1.05-7.60, p=0.038). conversely, being male (aOR: 0.38, 95% CI: 0.19-0.73, p=0.004) was associated with lower odds of having inadequate knowledge. Significant association was found between inadequate knowledge and poor NMC Reporting App practices (aOR 7.03, 95% CI: 2.04-24.22, p=0.002) in North West province. Conclusions This study revealed inadequate knowledge, negative attitudes, and poor NMC Reporting App practices in North West Province. Inadequate knowledge was a key factor in poor App utilization. Tailored trainings and continued technical support are recommended to improve HCWs’ knowledge of App usage and reporting processes, as well as further studies to explore HCWs’ perceptions and leadership buy-in of NMC reporting through the App.