Chemotherapy Safe Handling Practices in Ethiopia: A Comprehensive Multi-Center Mixed-Method Evaluation

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Abstract The increasing incidence of cancer and capacity for cancer care in Ethiopia has led to an upsurge in chemotherapy use in the country; however, studies indicate that there is a gap in the safe handling of chemotherapy by healthcare workers. There exists a need to understand if such unsafe practices occur across the diverse Ethiopian health system and what specific areas along the chemotherapy life cycle need the most improvement. This study utilized a mixed-methods design through an online survey administered to health care professionals across Ethiopia and evaluative site visits of cancer units in Addis Ababa, Ethiopia to understand the current conditions of chemotherapy handling. 8 cancer units were evaluated and a total of 67 Ethiopian health care professionals responded to the survey. 55% (n = 21/38) of survey participants disagreed or strongly disagreed that there are systems in place to identify, prevent, and address chemotherapy hazards in their workplace, and 71% (n = 25/35) of respondents denied having an active and effective health and safety committee and/or worker health and safety representative where they work. At evaluative site visits, 30% (n = 26/88) of health care workers met the minimum guidelines for proper hand hygiene, and 20% (n = 8/40) of health care workers used adequate PPE according to guidelines across the chemotherapy lifecycle. Results of this study indicate an urgent need for implementation of evidence-based interventions to improve chemotherapy handling in Ethiopia so that all patients and health care workers are protected from the hazardous toxicities of these drugs.

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