Occupational Sharps Injuries Among Healthcare Workers in Sub-Saharan Africa: Safety Practices, Risk Factors, and Professional Disparities at a Namibian Referral Hospital
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Abstract
Background: Safe handling of medical sharps is essential to prevent occupational exposure to blood-borne pathogens among healthcare workers. Despite the high burden of needlestick and sharps injuries in sub-Saharan Africa, evidence on provider-specific practices and associated risk factors in Namibian healthcare settings remains limited. This study assessed sharps-handling practices, the prevalence and factors associated with sharps injuries, and professional differences in safety compliance among healthcare workers at Intermediate Hospital Oshakati, Namibia.
Methods: A cross-sectional study involving 490 healthcare workers (134 doctors and 356 nurses) was conducted in 2020 using a self-administered questionnaire. Logistic regression was used to generate crude and adjusted odds ratios (AORs) with 95% confidence intervals, adjusting for age, gender, marital status, and education level.
Results: Sharps injuries were reported by 54.7% of participants. The most commonly reported annual frequency was one to three injuries (38.4%). Doctors reported higher injury frequency at intermediate levels and were more likely to attribute injuries to long working hours (AOR = 1.67, 95% CI: 1.06--2.61) and poor lighting (AOR = 1.88, 95% CI: 1.19--2.97). Doctors demonstrated lower adherence to universal precautions (AOR = 0.37, 95% CI: 0.14--0.98) and lower awareness of biomedical waste management protocols (AOR = 0.23, 95% CI: 0.06--0.83) compared with nurses. Improper sharps disposal, including disposal into non-sharps waste bags, was more common among doctors (OR = 2.47, 95% CI: 1.02--6.01). Most participants (84.3%) reported incidents to hospital authorities, and 91.2% reported accessing post-exposure prophylaxis.
Conclusion: Targeted occupational safety interventions and stronger compliance monitoring are urgently needed. Reducing occupational sharps injuries requires interventions that extend beyond awareness alone. Sustainable improvements in healthcare worker safety depend on stronger institutional systems, safer workplace environments, improved compliance monitoring, and contextually relevant occupational health policies.
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