TB infection prevention and control at public health facilities in //Karas region, Namibia.

Objectives: To evaluate healthcare workers' (HCWs) providing tuberculosis (TB) services knowledge, attitudes, and practices (KAP) regarding infection prevention and control (IPC), assess barriers and facilitators to TB IPC implementation and adherence, and evaluate existing TB IPC policies at public health facilities in Namibia's //Karas region. Design: Concurrent mixed-methods design. Setting: Public healthcare facilities in Namibia's //Karas region. Methods: Quantitative data were collected using an online questionnaire distributed via email and social media platforms to HCWs providing TB services. Descriptive statistics were used to summarize respondent characteristics and KAP scores, followed by bivariate analysis using the Pearson χ2 test (P < .05) to assess associations between knowledge scores and respondent characteristics. Focus group discussions (FGDs) were conducted with TB focal persons from District Coordinating Committees, transcribed, and analyzed thematically using a 6-phased approach. Data collection spanned 8 months (April 17-November 10, 2023). Results: HCWs demonstrated good knowledge (91.2%) and positive attitudes (85.3%) toward TB IPC, with practice scores less optimal (61.8%). Knowledge was associated with district (P = .001), department (P = .036), and education level (P = .010). Staff shortages were the most cited barrier, and training emerged as a key facilitator. FGDs confirmed the implementation of TB IPC policies at institutional level and revealed barriers, including inadequate infrastructure, limited resources, stigmatization, and lack of managerial support. Facilitators included effective communication, health education, and personal protective equipment availability. Conclusion: Strengthening TB IPC requires investment in infrastructure, training, consistent monitoring, and policy enforcement. Targeted IPC interventions can address key barriers and improve adherence across public health facilities.