Original Research

The effect of phlebotomy training on blood sample rejection and phlebotomy knowledge of primary health care providers in Cape Town: A quasi-experimental study

Mumtaz Abbas, Fidele K. Mukinda, Mosedi Namane
African Journal of Primary Health Care & Family Medicine | Vol 9, No 1 | a1242 | DOI: https://doi.org/10.4102/phcfm.v9i1.1242 | © 2017 Mumtaz Abbas, Fidele K. Mukinda, Mosedi Namane | This work is licensed under CC Attribution 4.0
Submitted: 02 July 2016 | Published: 13 April 2017

About the author(s)

Mumtaz Abbas, Department of Family Medicine and Public Health, University of Cape Town, South Africa
Fidele K. Mukinda, Centre for Health Systems and Services Research and Development (CHSSRD), Department of Interdisciplinary Health Sciences, Stellenbosch University, South Africa
Mosedi Namane, Vanguard Community Heath Centre and Department of Family Medicine and Public Health, University of Cape Town, South Africa


Background: There is an increasing amount of blood sample rejection at primary health care facilities (PHCFs), impacting negatively the staff, facility, patient and laboratory costs.
Aim: The primary objective was to determine the rejection rate and reasons for blood sample rejection at four PHCFs before and after a phlebotomy training programme. The secondary objective was to determine whether phlebotomy training improved knowledge among primary health care providers (HCPs) and to develop a tool for blood sample acceptability.
Study setting: Two community health centres (CHCs) and two community day centres (CDCs) in Cape Town.
Methods: A quasi-experimental study design (before and after a phlebotomy training programme).
Results: The sample rejection rate was 0.79% (n = 60) at CHC A, 1.13% (n = 45) at CHC B, 1.64% (n = 38) at CDC C and 1.36% (n = 8) at CDC D pre-training. The rejection rate remained approximately the same post-training (p > 0.05). The same phlebotomy questionnaire was administered pre- and post-training to HCPs. The average score increased from 63% (95% CI 6.97‒17.03) to 96% (95% CI 16.91‒20.09) at CHC A (p = 0.039), 58% (95% CI 9.09‒14.91) to 93% (95% CI 17.64‒18.76) at CHC B (p = 0.006), 60% (95% CI 8.84‒13.13) to 97% (95% CI 16.14‒19.29) at CDC C (p = 0.001) and 63% (95% CI 9.81‒13.33) to 97% (95% CI 18.08‒19.07) at CDC D (p = 0.001).
Conclusion: There is no statistically significant improvement in the rejection rate of blood samples (p > 0.05) post-training despite knowledge improving in all HCPs (p < 0.05).


Phlebotomy; primary health care; health care costs; blood sample rejection; community health centres


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