Hygiene During Childbirth: An Observational Study to Understand Infection Risk in Healthcare Facilities in Kogi and Ebonyi States, Nigeria

Helen Buxton, Erin Flynn, Olutunde Oluyinka, Oliver Cumming, Joanna Esteves Mills, Tess Shiras, Stephen Sara and Robert Dreibelbis
Additional contact information
Helen Buxton: Disease Control Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Erin Flynn: Infection and Immunity, South Australian Health and Medical Research Institute, Adelaide 5000, Australia
Olutunde Oluyinka: Maternal and Child Survival Program (MCSP)/Save the Children Nigeria, Abuja, Nigeria
Oliver Cumming: Disease Control Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Joanna Esteves Mills: Disease Control Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Tess Shiras: Disease Control Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
Stephen Sara: Maternal and Child Survival Program (MCSP)/Save the Children US, Washington, DC 20036, USA
Robert Dreibelbis: Disease Control Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK

IJERPH, 2019, vol. 16, issue 7, 1-14

Abstract: Background : Infections acquired during labour and delivery are a significant cause of maternal and child morbidity and mortality. Adherence to hand hygiene protocols is a critical component of infection prevention strategies, but few studies have closely examined the hand hygiene of health care providers with sufficient detail to understand infection risks and prioritize prevention strategies. Methods : This observational study was conducted in six healthcare facilities in Nigeria. In each, five women were observed from the onset of labour through to delivery of the placenta. Hand hygiene infection risk was estimated for all procedures requiring aseptic technique compared against adherence to proper hand hygiene protocol and potential recontamination events. Results : Hands were washed with soap and sterile gloves applied with no observed recontamination before only 3% of all observed procedures requiring aseptic technique. There was no significant difference in hygiene compliance between midwives and doctors nor facilities or states. Adherence to proper hygiene protocol was observed more in morning compared to afternoon and night shifts. Conclusions : This study highlights that hand hygiene remains a barrier to delivering high-quality and safe care in health facilities. Improving hygiene practices during labour and delivery will require strategies that extend beyond infrastructure provision.

Keywords: labour; child-birth; maternal infection; neonatal infection; infection prevention and control; hand hygiene (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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