Developing a process-based model for effective and sustainable work safety analysis for rural hospitals in Chirumanzu district of Midlands Province, Zimbabwe

Abstract

Work safety analysis is essential for the well-being and productivity of healthcare workers, particularly in less developed countries such as Zimbabwe. Nevertheless, existing work safety analysis models inadequately address work safety challenges affecting rural hospitals, leading to high rates of accidents and injuries. As a result of this, this research develops a process based model for effective and sustainable work safety analysis for rural hospitals in Chirumanzu district of Midlands Province, Zimbabwe. A descriptive cross-sectional design incorporating both quantitative and qualitative methods was employed during the study. A total of 109 questionnaires and 68 questionnaires were self-administered at Muvonde Hospital and Driefontein Sanatorium Hospital respectively to reduce margin of error. Data collected using the questionnaire included risks affecting healthcare workers, their causes, effects and methods used to manage risks. The Medical Superintendent, Hospital Manager (Matron), Human Resource Manager, Head of Environmental Health Department (Environmental Health Technician), Nurse in Charge at each hospitals and the District Medical Officer were included as key informant interviewees to collect qualitative data, such as, data on aspects which affect work safety analysis in rural hospitals. Observations were done focusing mainly on essential features of the workplace notably the work environment, workers, tasks performed by workers and equipment used which are likely to cause risks at work. An observational checklist was used. Secondary data regarding risks affecting healthcare workers was obtained from weekly, monthly and annual reports within the rural hospitals. Several risks were identified, including ergonomic, chemical, psychosocial, biological and physical risks at Muvonde Hospital and Driefontein Sanatorium Hospital. At Muvonde Hospital (44%) of the healthcare workers reported ergonomic risks due to the nature of work they performed which involved manual tasks. However, at Driefontein Sanatorium Hospital the majority (30.9%) of the healthcare workers reported biological risks. This is not surprising since the hospital mainly deals with infectious diseases, for example, tuberculosis. Risks which affect healthcare workers within the hospitals expose them to various injuries and diseases. Back injuries were the most common issue reported at both hospitals. The study found that risk challenges were exacerbated by inadequate equipment, shortage of labour, poor training, ineffective management and high workloads as well as negative safety behaviour. Some of the measures used to manage risks include safety training, safety inspection, safety workshops, monitoring worker’s safety and provision of personal protective equipment/cloth however, challenges or gaps related in those current safety approaches were identified. Rural hospitals face significant challenges related to resource scarcity, inadequate infrastructure and limited access to support services and training, all of which negatively affect occupational health and safety. To address these challenges, the study proposes a process-based model for effective and sustainable work safety analysis tailored to the needs of rural hospitals. The model includes factors such as assessment of work safety measures already in place, risk assessment, data collection and analysis, development of control measures, capacity building and continuous monitoring. The model also considers aspects such as stakeholder involvement, management commitment, regular communication, sustainability planning and emergency preparedness. The proposed model’s emphasis on sustainability alludes a long-term approach in enhancing work safety procedures at rural hospitals. By integrating continuous monitoring and improvement, the model aims to create lasting changes that adapt to evolving challenges in rural healthcare settings.