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Hand hygiene during facility-based childbirth in Cambodia: a theory-driven, mixed-methods observational study
Yolisa Nalule1, Helen Buxton2, Por Ir3
1Disease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK. Yolisa.Nalule@lshtm.ac.uk.
BMC Pregnancy and Childbirth
|June 18, 2021
Summary
Birth attendants showed low hand hygiene compliance (18%), influenced by factors like workload and knowledge gaps. Interventions addressing these determinants are crucial for improving safety in healthcare settings.
Area of Science:
- Healthcare-associated infections
- Behavioral science in healthcare
- Maternal and newborn health
Background:
- Low compliance with hand hygiene among birth attendants persists despite current improvement strategies.
- Existing strategies inadequately address specific behavioral determinants of hand hygiene.
- Formative research is needed to design effective interventions for healthcare facilities.
Purpose of the Study:
- Investigate context-specific behaviors and determinants of handwashing among birth attendants during labor and delivery.
- Inform the design of a facility-based hand hygiene behavior change intervention in Cambodia.
Main Methods:
- Sequential explanatory mixed-methods design across eight healthcare facilities.
- Direct observation of hand hygiene practices for 45 women's labor and delivery.
- Semi-structured interviews with 20 healthcare workers to explore behavioral drivers.
Main Results:
- Birth attendants' hand hygiene compliance was 18% before procedures.
- Compliance varied by shift, with lower rates during night shifts.
- Factors influencing hand hygiene included habits, norms, workload, knowledge, and risk perception.
Conclusions:
- A multi-component intervention targeting key behavioral determinants is recommended for labor and delivery rooms.
- Intervention strategies may include environmental nudges, participatory education, and social norm promotion.
- These interventions aim to increase birth attendants' hand hygiene compliance in study settings.
Keywords:
Formative researchHand hygieneInfection prevention and controlIntervention designMaternal infectionMore Related Videos
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