TY - JOUR
T1 - Barriers and opportunities for sustainable hand hygiene interventions in rural liberian hospitals
AU - Tantum, Lucy K.
AU - Gilstad, John R.
AU - Bolay, Fatorma K.
AU - Horng, Lily M.
AU - Simpson, Alpha D.
AU - Letizia, Andrew G.
AU - Styczynski, Ashley R.
AU - Luby, Stephen P.
AU - Arthur, Ronan F.
N1 - Funding Information:
This research was funded by the Uniformed Services University Center for Global Health Engagement (award no. HU0001-17-2-0076) and managed by the Henry M Jackson Foundation for the Advancement of Military Medicine, Inc. The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government. J.R.G. and A.G.L. are military service members or GS employees. This work was prepared as part of their official duties. Title 17, U.S.C., §105 provides that copyright protection under this title is not available for any work of the U.S. Government. 355 Title 17, U.S.C., §101 defines a U.S. Government work as a work prepared by a military Service member or employee of the U.S. Government as part of that person’s official duties.
Funding Information:
Funding: This research was funded by the Uniformed Services University Center for Global Health Engagement (award no. HU0001-17-2-0076) and managed by the Henry M Jackson Foundation for the Advancement of Military Medicine, Inc. The views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government. J.R.G. and A.G.L. are military service members or GS employees. This work was prepared as part of their official duties. Title 17, U.S.C., §105 provides that copyright protection under this title is not available for any work of the U.S. Government. 355 Title 17, U.S.C., §101 defines a U.S. Government work as a work prepared by a military Service member or employee of the U.S. Government as part of that person’s official duties.
Funding Information:
Staff reported that hospitals received funding from the Liberian government and international organizations for hand hygiene materials. However, government funding allotments were often delayed or insufficient for hospital hand hygiene needs, and half of the interview respondents (n = 37) named financial constraints as a barrier to hand hygiene. When funding was unavailable, hospitals were unable to restock hand hygiene supplies. Several hospitals participated in a performance-based financing scheme, wherein good health worker performance led to increased hospital funding [46]. As performance-based financing funding varied with each quarter, so did the amount of funding available to purchase hand hygiene materials.
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/8/2
Y1 - 2021/8/2
N2 - Hand hygiene is central to hospital infection control. During the 2014–2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March–May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% (n = 42) of hospital wards, piped running water in 23% (n = 11), and soap in 62% (n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers (n = 8) and 95% of pocket-size dispensers (n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement.
AB - Hand hygiene is central to hospital infection control. During the 2014–2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March–May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% (n = 42) of hospital wards, piped running water in 23% (n = 11), and soap in 62% (n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers (n = 8) and 95% of pocket-size dispensers (n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement.
KW - Hand hygiene
KW - Hospital safety
KW - Infection prevention and control
KW - Liberia
KW - Mixed methods
KW - Sustainability
UR - http://www.scopus.com/inward/record.url?scp=85112379568&partnerID=8YFLogxK
U2 - 10.3390/ijerph18168588
DO - 10.3390/ijerph18168588
M3 - Article
C2 - 34444337
AN - SCOPUS:85112379568
SN - 1661-7827
VL - 18
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
IS - 16
M1 - 8588
ER -