Nalule, Yolisa;
Buxton, Helen;
Macintyre, Alison;
Ir, Por;
Pors, Ponnary;
Samol, Channa;
Leang, Supheap;
(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
, Article 4416. 10.3390/ijerph18094416.
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Abstract
Background: Globally, infections are the third leading cause of neonatal mortality. Pre-dominant risk factors for facility-born newborns are poor hygiene practices that span both facilities and home environments. Current improvement interventions focus on only one environment and target limited caregivers, primarily birth attendants and mothers. To inform the design of a hand hygiene behavioural change intervention in rural Cambodia, a formative mixed-methods observational study was conducted to investigate the context-specific behaviours and determinants of handwashing among healthcare workers, and maternal and non-maternal caregivers along the early newborn care continuum. Methods: Direct observations of hygiene practices of all individuals providing care to 46 newborns across eight facilities and the associated communities were com-pleted and hand hygiene compliance was assessed. Semi-structured interactive interviews were subsequently conducted with 35 midwives and household members to explore the corresponding cognitive, emotional and environmental factors influencing the observed key hand hygiene behav-iours. Results: Hand hygiene opportunities during newborn care were frequent in both settings (n = 1319) and predominantly performed by mothers, fathers and non-parental caregivers. Compliance with hand hygiene protocol across all caregivers, including midwives, was inadequate (0%). Practices were influenced by the lack of accessible physical infrastructure, time, increased workload, low infection risk perception, nurture-related motives, norms and inadequate knowledge. Conclu-sions: Our findings indicate that an effective intervention in this context should be multi-modal to address the different key behaviour determinants and target a wide range of caregivers.
| Type: | Article |
|---|---|
| Title: | Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3390/ijerph18094416 |
| Publisher version: | https://doi.org/10.3390/ijerph18094416 |
| Language: | English |
| Additional information: | © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Environmental Sciences, Public, Environmental & Occupational Health, Environmental Sciences & Ecology, neonatal infection, hand hygiene, behaviour change, Cambodia, post-natal care, newborn care, formative research, intervention design, health facility, household, WATER-TREATMENT, NEWBORN-CARE, HANDWASHING BEHAVIOR, BIRTH ATTENDANTS, CENTERED DESIGN, PROMOTION, MOTHERS, INTERVENTIONS, INTEGRATION, INFECTIONS |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10149495 |
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