Hand hygiene practices and perceptions among healthcare workers in Ghana: A WASH intervention study

  • Appiah Labi Department of Microbiology, Korle-Bu Teaching Hospital, Accra, Ghana
  • Noah Obeng-Nkrumah Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
  • Benjamin Demah Nuertey Public Health Department, Tamale Teaching Hospital, Tamale, Ghana
  • Sheila Issahaku Department of Obstetrics and Gynaecology, Tamale Teaching Hospital, Tamale, Ghana
  • Ndeye Fatou Ndiaye United Nations Children’s Fund, Accra, Ghana
  • Peter Baffoe United Nations Children’s Fund, Accra, Ghana
  • David Duncan United Nations Children’s Fund, Accra, Ghana
  • Priscilla Wobil United Nations Children’s Fund, Accra, Ghana
  • Christabel Enweronu-Laryea Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
Keywords: hand hygiene, infection control, perception survey

Abstract

Introduction: We aimed to investigate whether the provision of water, sanitation, and hand hygiene (WASH) interventions were associated with changes in hand hygiene compliance and perceptions of healthcare workers towards infection control.

Methodology: The study was conducted from June 2017 through February 2018 among healthcare workers in two Northern districts of Ghana. Using a pretest-posttest design, we performed hand hygiene observations and perception surveys at baseline (before the start of WASH interventions) and post-intervention (midline and endline). We assessed adherence to hand hygiene practice using the WHO direct observation tool. The perception study was conducted using the WHO perception survey for healthcare workers. Study outcomes were compared between baseline, midline and endline assessments.

Results: The hand hygiene compliance significantly improved from 28.8% at baseline through 51.7% at midline (n = 726/1404; 95% CI: 49.1-54.2%) to 67.9% at endline (n = 1000/1471; 95% CI: 65.6-70.3%). The highest increase in compliance was to the WHO hand hygiene moment 5 after touching patients surrounding (relative increase, 205%; relative rate, 3.05; 95% CI: 2.23-4.04; p < 0.0001). Post-intervention, the top three policies deemed most effective at improving hand hygiene practice were: provision of water source (rated mean score, n = 6.1 ± 1.4), participation in educational activities (rated mean score 6.0 ± 1.5); and hand hygiene promotional campaign (6.0 ± 1.3).

Conclusion: Hand hygiene compliance significantly improved post-intervention. Sustaining good hand hygiene practices in low resource settings should include education, the provision of essential supplies, and regular hand hygiene audits and feedback.

Published
2019-12-31
How to Cite
1.
Labi A, Obeng-Nkrumah N, Nuertey BD, Issahaku S, Ndiaye NF, Baffoe P, Duncan D, Wobil P, Enweronu-Laryea C (2019) Hand hygiene practices and perceptions among healthcare workers in Ghana: A WASH intervention study. J Infect Dev Ctries 13:1076-1085. doi: 10.3855/jidc.11045
Section
Emerging Problems in Infectious Diseases