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Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology

Wiedenmayer, Karin and Msamba, Vicky-Sidney and Chilunda, Fiona and Kiologwe, James Charles and Seni, Jeremiah. (2020) Impact of hand hygiene intervention: a comparative study in health care facilities in Dodoma region, Tanzania using WHO methodology. Antimicrobial resistance and infection control, 9 (1). p. 80.

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Abstract

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.; 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.; 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Swiss Centre for International Health (SCIH) > Health Systems Support (Prytherch)
UniBasel Contributors:Wiedenmayer, Karin Anne
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:BioMed Central
ISSN:2047-2994
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:17 Jun 2020 11:05
Deposited On:17 Jun 2020 11:05

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