Hepatitis B infection prevention: Audit of selected healthcare facilities in the Greater Accra Region, Ghana

Introduction: The risk of occupational exposure to Hepatitis B Virus (HBV) is high among healthcare workers (HCWs), especially in developing countries like Ghana where the prevalence of HBV is high. Unfortunately, in such regions, HCW protection does not appear to be a priority, and healthcare facilities (HFs) have been reported to have unsatisfactory levels of implementing preventive strategies to protect HCWs from blood-borne infections including HBV. Methods: A cross-sectional and Q audit was performed involving 255 HFs selected by proportional allocation and systematic random sampling. Data was collected using a structured pretested questionnaire with HF managers being the respondents. Data were analysed using IBM ® SPSS® (Statistical Package for the Social Sciences, version 21.0) where univariate, bivariate, and multivariate analysis was done with the level of significance set at <0.05. Results: Overall adherence to recommended strategies, structures, and programs for HBV prevention among the HFs was generally low, with a mean score of 37.02 (95% CI = 33.98–40.05). There was a statistically significant difference in the level of adherence between the HF categories (F = 9.698; P = <0.001). Being a hospital (OR = 3.9: CI = 1.68–9.29), possessing infection, prevention and control (IPC) guidelines (OR = 6.69: CI = 3.29–13.63) as well as having functional IPC committees in place (OR = 7.9: CI = 3.59–17.34) were associated with good adherence to HF-level HBV preventive strategies. Conclusion: Overall adherence to HF-level prevention of HBV is sub-optimal. Higher-level facilities were better resourced with HBV vaccine and Hepatitis B immunoglobulin (HBIG). Adherence to HBV prevention strategies depends on the type of HF and the availability of IPC committees and their respective IPC coordinators.