Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology
Abstract Background Compliance with guidelines on hand hygiene (HH) is pivotal to prevent and control health-care associated infections and contributes to mitigating antimicrobial resistance. A baseline assessment in Dodoma region, Tanzania in March 2018 showed inadequate HH levels across health car...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-020-00743-4 |
| _version_ | 1818451274241146880 |
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| author | Karin Wiedenmayer Vicky-Sidney Msamba Fiona Chilunda James Charles Kiologwe Jeremiah Seni |
| author_facet | Karin Wiedenmayer Vicky-Sidney Msamba Fiona Chilunda James Charles Kiologwe Jeremiah Seni |
| author_sort | Karin Wiedenmayer |
| collection | DOAJ |
| description | Abstract Background Compliance with guidelines on hand hygiene (HH) is pivotal to prevent and control health-care associated infections and contributes to mitigating antimicrobial resistance. A baseline assessment in Dodoma region, Tanzania in March 2018 showed inadequate HH levels across health care facilities. We evaluated the impact of training in HH as part of a water, sanitation and hygiene (WASH) interventions of “Maji kwa Afya ya Jamii” (MKAJI) project. Methods A comparative HH assessment was conducted in June 2019 involving health care facilities under MKAJI project (n = 87 from which 98 units were assessed) vs non-MKAJI facilities (n = 85 from which 99 units were assessed). Irrespective of MKAJI interventional status, baseline assessment in March 2018 were compared to re-assessment in June 2019 in all health care facility units (unpaired comparison: 261 vs 236 units, respectively), and in facilities assessed in both surveys (paired comparison: 191 versus 191 units, respectively). The ‘WHO HH Self-Assessment Framework Tool, 2010’ with five indicators each counting 100 points was used. The cumulative scores stratified each health facility’s unit into inadequate (0–125), basic (126–250), intermediate (251–375) or advanced (376–500) HH level (score). The HH compliance rates were also assessed and compared. Results The overall post-intervention median HH score [interquartile range (IQR)] was 187.5 (112.5–260). MKAJI health facilities had significantly higher median HH scores (IQR) [190 (120–262.5)] compared with non-MKAJI facilities [165 (95–230); p = 0.038]. Similarly, the HH compliance rate of ≥51% was significantly higher in MKAJI than non-MKAJI facilities [56.1% versus 30.3%; chi2 = 13.39, p < 0.001]. However, the recommended WHO compliance rate of ≥81% was only reached by 6.1 and 3.0% units of MKAJI and non-MKAJI facilities, respectively. Both paired and unpaired comparisons during baseline and re-assessment surveys showed increase in HH level from inadequate to basic level. Conclusion The overall HH level after the combined WASH and training intervention was at basic level. Higher median HH scores (IQR) and HH compliance rates were evident in health facilities of the MKAJI project, underscoring the impact of the intervention and the potential value of a national roll-out. |
| first_indexed | 2024-12-14T21:04:35Z |
| format | Article |
| id | doaj.art-65313cb10b414c4998b1bce8e748ee7a |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-14T21:04:35Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-65313cb10b414c4998b1bce8e748ee7a2022-12-21T22:47:31ZengBMCAntimicrobial Resistance and Infection Control2047-29942020-06-01911910.1186/s13756-020-00743-4Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodologyKarin Wiedenmayer0Vicky-Sidney Msamba1Fiona Chilunda2James Charles Kiologwe3Jeremiah Seni4Health Promotion and System Strengthening/Tuimarishe Afya ProjectHealth Promotion and System Strengthening/Tuimarishe Afya ProjectHealth Promotion and System Strengthening/Tuimarishe Afya ProjectDodoma Regional Medical Officer’s OfficeDepartment of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied SciencesAbstract Background Compliance with guidelines on hand hygiene (HH) is pivotal to prevent and control health-care associated infections and contributes to mitigating antimicrobial resistance. A baseline assessment in Dodoma region, Tanzania in March 2018 showed inadequate HH levels across health care facilities. We evaluated the impact of training in HH as part of a water, sanitation and hygiene (WASH) interventions of “Maji kwa Afya ya Jamii” (MKAJI) project. Methods A comparative HH assessment was conducted in June 2019 involving health care facilities under MKAJI project (n = 87 from which 98 units were assessed) vs non-MKAJI facilities (n = 85 from which 99 units were assessed). Irrespective of MKAJI interventional status, baseline assessment in March 2018 were compared to re-assessment in June 2019 in all health care facility units (unpaired comparison: 261 vs 236 units, respectively), and in facilities assessed in both surveys (paired comparison: 191 versus 191 units, respectively). The ‘WHO HH Self-Assessment Framework Tool, 2010’ with five indicators each counting 100 points was used. The cumulative scores stratified each health facility’s unit into inadequate (0–125), basic (126–250), intermediate (251–375) or advanced (376–500) HH level (score). The HH compliance rates were also assessed and compared. Results The overall post-intervention median HH score [interquartile range (IQR)] was 187.5 (112.5–260). MKAJI health facilities had significantly higher median HH scores (IQR) [190 (120–262.5)] compared with non-MKAJI facilities [165 (95–230); p = 0.038]. Similarly, the HH compliance rate of ≥51% was significantly higher in MKAJI than non-MKAJI facilities [56.1% versus 30.3%; chi2 = 13.39, p < 0.001]. However, the recommended WHO compliance rate of ≥81% was only reached by 6.1 and 3.0% units of MKAJI and non-MKAJI facilities, respectively. Both paired and unpaired comparisons during baseline and re-assessment surveys showed increase in HH level from inadequate to basic level. Conclusion The overall HH level after the combined WASH and training intervention was at basic level. Higher median HH scores (IQR) and HH compliance rates were evident in health facilities of the MKAJI project, underscoring the impact of the intervention and the potential value of a national roll-out.http://link.springer.com/article/10.1186/s13756-020-00743-4Hand hygieneHealth care facilitiesTanzania |
| spellingShingle | Karin Wiedenmayer Vicky-Sidney Msamba Fiona Chilunda James Charles Kiologwe Jeremiah Seni Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology Antimicrobial Resistance and Infection Control Hand hygiene Health care facilities Tanzania |
| title | Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology |
| title_full | Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology |
| title_fullStr | Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology |
| title_full_unstemmed | Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology |
| title_short | Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology |
| title_sort | impact of hand hygiene intervention a comparative study in health care facilities in dodoma region tanzania using who methodology |
| topic | Hand hygiene Health care facilities Tanzania |
| url | http://link.springer.com/article/10.1186/s13756-020-00743-4 |
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