Attitudes and Practice of Health Promotion for Non-communicable Diseases Among Healthcare Workers at Kenyatta National Hospital

Abstract

Introduction: The rising burden of non-communicable diseases poses a great health system challenge in Kenya. Healthcare workers have a critical role to play in health promotion, in addressing patients’ lifestyle risk factors. However, their own lifestyle habits can influence their attitude and practices towards patient care. Opportunistic counselling of patients by health professionals signifies one of the most cost effective medical interventions in combatting non-communicable diseases. Objective: To determine the attitudes and practice of health promotion for the prevention and management of non-communicable diseases among healthcare workers at the Kenyatta national hospital. Methods: A cross-sectional mixed method study was carried out from June to July 2016 at Kenyatta National Hospital. For the quantitative method, one hundred and eighty five doctors and nurses in the department of reproductive health and medicine were recruited through stratified sampling. Data on healthcare workers; socio-demographic characteristics, lifestyle practice, attitude, and practice of health promotion was collected through self-administered questionnaires. Frequency and percentage distributions tables were used to initially describe the study population while, Chi- square test of significance was used to evaluate the association between healthcare workers attitudes and practice of health promotion and their socio-demographic features. Secondly, a total of 12 doctors and nurses were purposively selected based on age, gender and profession of participants for the qualitative method. Data on healthcare workers perspective on health promotion and organizational support factors were collected through in-depth interviews. The recorded interviews were transcribed and data analysis was done using content analysis of thematic areas. A verbatim approach was used to describe study findings. Results: 69.2% of the respondents were females, mean age was 36 years and the median years in profession was 12 years. The respondents exhibited good lifestyle practices with alcohol and tobacco prevalence at 30.8 %and 3.8% respectively. 72% of the respondents demonstrated a positive attitude towards health promotion while, 31% showed good health promotion practices. Less than half of the respondents inquired about a patient’s lifestyle practices during routine visit. The study found that healthcare workers with a positive attitude were four times more likely to have good health promotion practices (OR = 3.54, p<0.001). Lastly findings from the in depth interviews revealed that staff had no written guidelines on health promotion and that the hospital management had abolished the health promotion unit. Conclusion: The results indicated that a positive health professional attitude is a precursor to good health promotive practices. Recommendation: Efforts to build capacity and support for health promotion in health services should be encouraged. Additionally, health Promotion programs for non-communicable disease should not only target the health of general population but also the health of health care workers.