Knowledge, Attitudes, Perceived Organisational Conditions, and Self-Reported Adherence to Infection Prevention and Control Practices among Primary Healthcare Workers in Lafia, Nasarawa State, Nigeria

Abstract

Background: Healthcare-associated infections increase morbidity, mortality, antimicrobial resistance, length of hospitalisation, and healthcare costs. Consistent infection prevention and control (IPC) practice is therefore essential, particularly in primary healthcare facilities where resource and staffing constraints may impede implementation. This study assessed IPC knowledge, attitudes, organisational conditions, and self-reported adherence among primary healthcare workers (PHCWs) in Lafia, Nasarawa State, Nigeria. Methods: A quantitative cross-sectional study was conducted among 384 PHCWs selected from primary healthcare facilities through a multistage sampling procedure. Data were collected with a structured questionnaire covering sociodemographic characteristics, IPC adherence, knowledge, attitudes, and organisational conditions. Frequencies, percentages, and item means were calculated. Associations were examined using Pearson chi-square tests or Monte Carlo exact tests where sparse cells were present. Statistical significance was set at p < 0.05. Results: Most respondents were female (63.5%), aged 21-34 years (44.5%), married (63.3%), and educated to bachelor's degree level (57.3%). Poor, moderate, and high adherence were reported by 51.0%, 6.5%, and 42.4% of respondents, respectively. Poor IPC knowledge was recorded in 52.9%, while 47.1% had good knowledge. Although 65.1% met the composite criterion for a favourable attitude, item-level responses identified practical difficulty with standard precautions and misconceptions concerning environmental contamination and presumptive application of standard precautions. Knowledge was strongly associated with adherence (χ² = 153.46, p < 0.001; Cramer's V = 0.632), whereas attitude was not associated with adherence (χ² = 0.091, p = 0.956; Cramer's V = 0.015). No sociodemographic characteristic was significantly associated with knowledge. Conclusion: Self-reported IPC adherence and knowledge were suboptimal among the participating PHCWs. Better knowledge was associated with higher adherence, but favourable attitudes alone were not. The findings support prospective evaluation of competency-based training, reliable IPC supplies and hand-hygiene infrastructure, supportive supervision, monitoring, and workforce-capacity measures. Because the study was cross-sectional and relied on self-report, the findings indicate associations rather than causal effects.