Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting and Sampling
2.2. Quantitative Methods
2.2.1. Data Collection
2.2.2. Data Analysis
2.3. Qualitative Methods
2.3.1. Data Collection
2.3.2. Data Analysis
3. Results
3.1. Maternity Setting Hand Hygiene Conditions
3.2. Structured Observations (PNC Room)
3.2.1. Participant Characteristics
3.2.2. Hygiene Opportunities and Actions
3.3. Structured Observations (Home)
3.3.1. Home Characteristics
3.3.2. Participant Characteristics
3.3.3. Hygiene Opportunities and Actions
3.4. Qualitative Results
3.4.1. Participant Information
3.4.2. Behaviour Setting for Newborn Care
3.4.3. Brain and Body Factors
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Primary Health Centre (N = 6) | Referral Hospital (N = 2) | |
---|---|---|
Functional hand hygiene facilities at all points of care in maternity setting | 0 | 0 |
Handwashing facilities within maternity setting (not staff-restricted) | ||
Available | 2 | 2 |
Soap and water/ABHR available | 0 | 1 |
Handwashing station at toilet | ||
Available | 6 | 2 |
Soap and water/Alcohol based rub available | 4 | 2 |
Handwashing stations in delivery room | ||
Available | 6 | 2 |
Soap and water/Alcohol based rub available | 6 | 2 |
Handwashing facilities inside PNC room | ||
Available | 0 | 1 |
Soap and water/Alcohol based rub available | 0 | 0 |
Facility Type | Primary Health Centre (n = 22) | Referral Hospital (n = 24) |
---|---|---|
Post-natal care room | Mean (range) | Mean (range) |
Age | 28 (21–40) | 28 (21–38) |
Previous live births | 1.4 (0–6) | 1.6 (0–6) |
Time travelled to HCF (min) | 17 (5–40) | 22 (5–40) |
Time elapsed since birth (hours) | 1.4 (1–3) | 1.5 (1–5) |
Number of PNC visitors | 4 (1–8) | 4 (2–7) |
Number of healthcare workers | 1 (0–4) | 1 (0–3) |
Home | Mean (range) | Mean (range) |
Days elapsed since birth | 2 (1–3) | n/a |
Days spent at home since discharge | 0 (0–1) | |
Number of visitors present | 7 (2–13) |
Hand Hygiene Opportunities (N) | Hand Hygiene Category N (%) | ||
---|---|---|---|
Adequate 1 | Inadequate 2 | ||
All newborn care | |||
Healthcare workers | 22 (3%) | 0 (0%) | 22 (100%) |
Mothers | 251 (31%) | 0 (0%) | 251 (100%) |
Fathers | 73 (9%) | 0 (0%) | 73 (100%) |
Non-parental caregivers | 464 (57%) | 0 (0%) | 465 (100%) |
Total | 811 | 0 (0%) | 811 (100%) |
Newborn care (cord contact) 3 | |||
Non-parental caregivers | 3 (100%) | 0 (0%) | 3 (100%) |
Total | 3 | 0 (0%) | 3 (100%) |
N (N = 22) | % | |
---|---|---|
Hand hygiene items available in household | ||
Soap | 21 | 95.5 |
Detergent | 21 | 95.5 |
Handwashing facility | ||
Available | 17 | 77.3 |
Soap/Detergent available at site | 11 | 64.7 |
Has hand drying materials | 1 | 5.88 |
Handwashing type | ||
Sink with tap | 2 | 11.8 |
Bucket to pour over hands | 13 | 76.5 |
Bowl to wash hands in | 2 | 11.8 |
Hand Hygiene Opportunities | Hand Hygiene Category N (%) | ||
---|---|---|---|
N | Adequate | Inadequate | |
All newborn care | |||
Mothers | 246 | 0 (0%) | 246 (100%) |
Fathers | 35 | 0 (0%) | 35 (100%) |
Non parental care-givers | 227 | 0 (0%) | 227 (100%) |
Total | 508 | 0 (0%) | 508 (100%) |
Newborn care (cord contact) | |||
Mothers | 1 | 0 (0%) | 1 (100%) |
Non parental caregivers | 11 | 0 (0%) | 11 (100%) |
Total | 12 | 0 (0%) | 12 (100%) |
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Nalule, Y.; Buxton, H.; Macintyre, A.; Ir, P.; Pors, P.; Samol, C.; Leang, S.; Dreibelbis, R. Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia. Int. J. Environ. Res. Public Health 2021, 18, 4416. https://doi.org/10.3390/ijerph18094416
Nalule Y, Buxton H, Macintyre A, Ir P, Pors P, Samol C, Leang S, Dreibelbis R. Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia. International Journal of Environmental Research and Public Health. 2021; 18(9):4416. https://doi.org/10.3390/ijerph18094416
Chicago/Turabian StyleNalule, Yolisa, Helen Buxton, Alison Macintyre, Por Ir, Ponnary Pors, Channa Samol, Supheap Leang, and Robert Dreibelbis. 2021. "Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia" International Journal of Environmental Research and Public Health 18, no. 9: 4416. https://doi.org/10.3390/ijerph18094416