Maternal & Child Survival Program (MCSP): Water, Sanitation, and Hygiene (WASH) and Maternal and Newborn Sepsis Prevention in Nigeria (2017)

The purpose of this study was to understand health care worker hygiene during labour and delivery and to understand the implications for infection risk. The study was incorporated with the larger MCSP-supported initiative to improve quality of care for maternal and child health in Nigeria. The study took place in health care facilities in Kogi and Ebonyi state, Nigeria. In each, one primary health care facility, one secondary facility, and one referral hospital were selected. Women who met eligibility requirements (at least 18 years of age, presenting to the facility before stage 2 of labour, and able to provide consent) were recruited for participation. Up to 6 hours of observation were completed during labour. Trained enumerators recorded all hand hygiene actions and procedures completed by health care staff. Data were then analysed in order to develop a time-specific measure of individual hand hygiene, and measures were translated grouped into five categories: proper hygiene protocol (sterile gloves, handwashing with soap and no recontamination), handwashing with soap and no recontamination, glove change only and no recontamination, hands not washed or recontaminated, and hands not washed or recontamination following select high risk events (contact with another patient, contact with stools or body fluids, contact with surfaces or objects contaminated with stools or body fluids). Hygiene category was assessed for all moment during labour requiring aseptic technique. Results from this study are available at: https://www.mdpi.com/1660-4601/16/7/1301