Water availability at hospitals in low- and middle-income countries: implications for improving access to safe surgical care

Chawla, Sumit; Gupta, Shailvi; Onchiri, Frankline; Habermann, Elizabeth B.; Kushner, Adam L.; Stewart, Barclay T

doi:10.1016/j.jss.2016.06.040

Cited by 32 publications

(14 citation statements)

References 48 publications

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“…Other key findings included first, the substantial lack of a reliable and constant water supply, with half of facilities operating without basic water infrastructure. This is consistent with research on water availability in facilities in low- and middle-income countries (LMICs) ( Chawla et al 2016 ) and specifically in maternities in Tanzania ( Benova et al 2014 ; Gon et al 2016 ). A recent review ( Bain et al 2014 ) of water quality in LMICs found very few studies based in health facilities, highlighting the importance of our data in this field.…”

Section: Discussionsupporting

confidence: 89%

Unpacking the enabling factors for hand, cord and birth-surface hygiene in Zanzibar maternity units

Gon

Ali

Towriss

et al. 2017

Health Policy and Planning

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Recent national surveys in The United Republic of Tanzania have revealed poor standards of hygiene at birth in facilities. As more women opt for institutional delivery, improving basic hygiene becomes an essential part of preventative strategies for reducing puerperal and newborn sepsis. Our collaborative research in Zanzibar provides an in-depth picture of the state of hygiene on maternity wards to inform action. Hygiene was assessed in 2014 across all 37 facilities with a maternity unit in Zanzibar. We used a mixed methods approach, including structured and semi-structured interviews, and environmental microbiology. Data were analysed according to the WHO ‘cleans’ framework, focusing on the fundamental practices for prevention of newborn and maternal sepsis. For each ‘clean’ we explored the following enabling factors: knowledge, infrastructure (including equipment), staffing levels and policies. Composite indices were constructed for the enabling factors of the ‘cleans’ from the quantitative data: clean hands, cord cutting, and birth surface. Results from the qualitative tools were used to complement this information.Only 49% of facilities had the ‘infrastructural’ requirements to enable ‘clean hands’, with the availability of constant running water particularly lacking. Less than half (46%) of facilities met the ‘knowledge’ requirements for ensuring a ‘clean delivery surface’; six out of seven facilities had birthing surfaces that tested positive for multiple potential pathogens. Almost two thirds of facilities met the ‘infrastructure (equipment) requirement’ for ‘clean cord’; however, disposable cord clamps being frequently out of stock, often resulted in the use of non-sterile thread made of fabric. This mixed methods approach, and the analytical framework based on the WHO ‘cleans’ and the enabling factors, yielded practical information of direct relevance to action at local and ministerial levels. The same approach could be applied to collect and analyse data on infection prevention from maternity units in other contexts.

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Section: Discussionsupporting

confidence: 89%

Unpacking the enabling factors for hand, cord and birth-surface hygiene in Zanzibar maternity units

Gon

Ali

Towriss

et al. 2017

Health Policy and Planning

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“…Another study identified poor hand hygiene as a barrier to delivering safe care in health facilities [ 32 ]. These observations are also supported by studies from other LMICs [ 13 , 33 , 34 ]. In one of these studies carried out in Zanzibar, for every of the ‘cleans’ examined, overall performance across all enabling factors was poor [ 34 ].…”

Section: Discussionsupporting

confidence: 86%

Water, sanitation, and hygiene (WASH) facilities and infection control/prevention practices in traditional birth homes in Southwest Nigeria

Arowosegbe

Ojo

Shittu

et al. 2021

BMC Health Serv Res

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Background Poor environmental conditions and hygiene practices at the time of childbirth is linked to life-threatening infections and death in mothers and babies. Improvements in water, sanitation, and hygiene (WASH) have been identified as a means through which the lives of mothers and babies could be saved. This study was carried out to explore WASH conditions and infection prevention and control (IPC) practices in traditional birth homes/centers in Abeokuta, Southwest Nigeria. A total of 50 traditional birth centers and attendants (TBAs) were enrolled in the study. Sociodemographic characteristics of the TBAs and features of the birth centers were obtained using a semi-structured questionnaire. Assessment of WASH conditions and IPC practices was based on established protocols. Results Findings revealed that majority of the centers operated under poor WASH conditions and IPC practices; none met with the WHO minimum standards for environmental health. Conclusions Adequate WASH facilities and IPC practices remain a critical component of maternal and child health even in non-facility birth. As the transition to facility births continues in many countries, the large number of non-facility births demands their inclusion in WASH-related strategies, if global goals of reducing deaths of newborns and women deaths will be achieved.

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“…However, the extent of use of health services among immigrants may vary depending on their health care needs, health care seeking behaviors, the organization of health care in their home country, practical barriers to access in the host country, health literacy, migrant's status, education level and other socioeconomic factors [15,[18][19][20][21][22][23][24][25]. Examining issues of accessibility to healthcare among immigrants including understanding their experiences in accessing health care, is essential to improving their health.…”

Section: Introductionmentioning

confidence: 99%

Access to Norwegian healthcare system – challenges for sub-Saharan African immigrants

Mbanya

Terragni

Gele

et al. 2019

Int J Equity Health

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Background: Immigrants face barriers in accessing healthcare services in high-income countries. Inequalities in health and access to healthcare services among immigrants have been previously investigated. However, little is known on the sub-Saharan African immigrants' (SSA) access to the Norwegian healthcare system. Methods: The study had a qualitative research design. We used the snowball technique to recruit participants from networks including faith-based organizations and cultural groups. Forty-seven qualitative in-depth interview and two focus group discussions with immigrants from sub-Saharan African were conducted from October 2017 to July 2018 in Oslo and its environs. Interviews were conducted in Norwegian, English or French, audio-recorded and transcribed verbatim into English. The analysis was based on a thematic approach, using NVivo software. Interview data were analyzed searching for themes and sub-themes that emerged inductively from the interviews. Results: Our findings reveal barriers in two main categories when accessing the Norwegian healthcare services. The first category includes difficulties before accessing the healthcare system (information access, preference for doctors with an immigrant background, financial barriers, long waiting time and family and job responsibility). The second category includes difficulties experienced within the system (comprehension/expression and language, the black elephant in the room and dissatisfaction with healthcare providers). Conclusion: Healthcare is not equally accessible to all Norwegian residents. This ultimately leads to avoidance of the healthcare system by those most in need. Lack of seeking healthcare services by immigrants from Sub Saharan Africa may have significant implications for the long-term health of this group of immigrants. Therefore measures to address the issues raised should be prioritized and further examined.

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Water availability at hospitals in low- and middle-income countries: implications for improving access to safe surgical care

Cited by 32 publications

References 48 publications

Unpacking the enabling factors for hand, cord and birth-surface hygiene in Zanzibar maternity units

Unpacking the enabling factors for hand, cord and birth-surface hygiene in Zanzibar maternity units

Water, sanitation, and hygiene (WASH) facilities and infection control/prevention practices in traditional birth homes in Southwest Nigeria

Access to Norwegian healthcare system – challenges for sub-Saharan African immigrants

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