An observational study of midwives' practices to prevent peripartum sepsis in Zimbabwe

Danda, Grace; Dube, Kushupika; Dube, Peggy; Mudokwenyu–Rawdon, Christina; Bedwell, Carol

doi:10.12968/ajmw.2015.9.1.17

Cited by 8 publications

(13 citation statements)

References 6 publications

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“… 23 In Zimbabwe, a study found that 62% of midwives never washed their hands before procedures. 24 HH definitions vary in these studies, making direct comparison with our results challenging. However, all studies highlight extremely poor HH behavior.…”

Section: Discussionmentioning

confidence: 74%

Hands washing, glove use, and avoiding recontamination before aseptic procedures at birth: A multicenter time-and-motion study conducted in Zanzibar

Gon

Bruin

Barra

et al. 2019

American Journal of Infection Control

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HighlightsTo our knowledge, this is the first study to systematically examine recontamination after hand hygiene in a low- and middle-income country.Hand hygiene compliance before aseptic procedures was low (9.6%) among birth attendants in Zanzibar.Birth attendants did not avoid recontamination half of the time after hand rubbing/washing or glove donning.Recontamination should be investigated further to inform better behavior-change strategies.

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Section: Discussionmentioning

confidence: 74%

Hands washing, glove use, and avoiding recontamination before aseptic procedures at birth: A multicenter time-and-motion study conducted in Zanzibar

Gon

Bruin

Barra

et al. 2019

American Journal of Infection Control

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“…The prevalence of appropriate hand hygiene by HCW during labour and delivery has been found to be generally low [ 17 , 28 , 32 , 44 ]. This study finds that HCW maintain inadequate hand hygiene practices into the post-natal care period.…”

Section: Discussionmentioning

confidence: 99%

“…Many HCF-based studies on hand hygiene practices during maternal and newborn care in LMIC have focused on HCW hand hygiene during labour and delivery or high-risk environments such as the neonatal intensive care units [16][17][18][19][20]. Community-based studies have generally focused on caregiver hygiene practices for newborns who are born outside the health facility or during the late post-natal period (> 7 days after birth) [18,[21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria

Nalule

Buxton

Flynn

et al. 2020

BMC Pregnancy Childbirth

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Background Newborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility–based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care. Methods This exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first 6 hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge. Results Maternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn. Conclusions In this setting, hand hygiene practices during post-natal care and the first 6 hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.

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“…The prevalence of appropriate hand hygiene by HCW during labour and delivery has been found to be generally low (17,27,39,40). This study nds that HCW maintain inadequate hand hygiene practices into the post-natal care period.…”

Section: Discussionmentioning

confidence: 69%

Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria

Nalule

Buxton

Flynn

et al. 2020

Preprint

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Background Newborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility–based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care. Methods This exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first six hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge. Results Maternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn. Conclusions In this setting, hand hygiene practices during post-natal care and the first six hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.

show abstract

An observational study of midwives' practices to prevent peripartum sepsis in Zimbabwe

Cited by 8 publications

References 6 publications

Hands washing, glove use, and avoiding recontamination before aseptic procedures at birth: A multicenter time-and-motion study conducted in Zanzibar

Hands washing, glove use, and avoiding recontamination before aseptic procedures at birth: A multicenter time-and-motion study conducted in Zanzibar

Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria

Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria

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