Background: Maintenance of hand hygiene among health care workers (HCWs) is the cornerstone of infection prevention and control programmes in a health care facility. Poor hand hygiene amongst HCWs is the single most common cause of cross-transmission of infections between patients and HCWs in the hospital. The objective of this study was to identify the risk factors for non-adherence and assess the knowledge regarding maintenance of hand hygiene amongst health care workers at a tertiary health care centre in Western India. Methods: A descriptive, cross-sectional study was conducted on HCWs-doctors, undergraduate students and staff nurses at a tertiary care hospital and postgraduate institute in western India after ethical committee clearance. A selfreport questionnaire by the World Health Organisation (WHO) for the Hand Hygiene Knowledge Survey (2009), which consisted of ten questions and "My 5 moments of hand hygiene", was answered by the study participants after their written/informed consent. Data was analysed using one-way Anova and Student"s t-tests. Results: 317 participants responded to the survey which included 131 doctors, 111 medical students and 75 staff nurses. 90.85% participants routinely used an alcohol-based hand rub (ABHR) but their overall hand hygiene knowledge score was only 61.04%. Prior formal training in hand hygiene significantly improved the knowledge of HCWs (P<0.001). There was a significant difference between the knowledge and actual practice of "My 5 Moments of hand hygiene". Conclusions: Hand hygiene knowledge remains unsatisfactory till date amongst HCWs. There is a need to educate HCWs through frequent training session"s right from the time of undergraduate medical study.
In the context of growing recognition of health as a vital component of human capital and the need for evolving sustainable health care system (HCS), an epidemiologic study was conducted in an area in rural AP in 2006. The empirical results show a higher level of sickness than at the state level and poor access and utilisation of existing HCF. It further reveals public-private differential orienting to the private sector in the post- Reform period. The growth is uni-dimensional in modern medicine. It further reveals that they are less satisfied with HCS in public as well as private. The respondents ‘ perspectives are: a mounting dissatisfaction of existing public as well as private services, need for preventive rather than curative approach including health education and a re- look at the grass root level increasingly demanding more by way of quality in public health services and greater regulation of the private sector to ensure cost-saving, increasing the access and in overall, a health policy in tune with a holistic approach.
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