Mothers' hygiene experiences in confinement centres: A cohort study

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Maternal and Child Health

Background:

• Traditional postpartum confinement at home is evolving with the rise of private confinement centres (CCs).
• CCs are non-healthcare establishments with staff lacking formal healthcare training, raising hygiene concerns.
• Reported infections in CCs necessitate an evaluation of hygiene practices and health outcomes.

Purpose of the Study:

• To describe hand hygiene practices and hygiene resource availability in Malaysian Chinese confinement centres (CCs).
• To assess the prevalence of health-related problems, potentially linked to infection, among mothers and infants in CCs compared to home confinement.
• To investigate the association between confinement setting and infant health problems.

Main Methods:

• A cohort study comparing ethnic Chinese mothers using CCs versus those confined at home post-delivery.
• Structured telephone interviews conducted one month postpartum to gather data on experiences and observed hygiene practices.
• Multiple logistic regression analysis employed to determine the effect of confinement location on infant health problems.

Main Results:

• Mothers in CCs reported inadequate staff hand hygiene (43%), lack of hand basins (66%), and insufficient soap (30%).
• A significant proportion of CC mothers experienced limited time with their infants due to separate nurseries (74%).
• Health problems probably related to infection (HPRI) rates were similar between CCs and home settings (14% vs. 14%), with no statistically significant association found for CCs (aOR 1.28).

Conclusions:

• Unsatisfactory hygiene practices were prevalent in CCs, suggesting a potential risk for infection transmission despite similar HPRI rates.
• There is an urgent need for future research, including intervention studies, to establish and implement appropriate hygiene standards in CCs.
• Training CC staff on hygiene knowledge is crucial for empowering them to contribute to improved standards and infant/maternal health outcomes.