Assessment of Essential Environmental Health Standards in some Health Care Settings in Alexandria, Egypt

Abstract

Health-care-associated infections (HAI) cause severe loss in health sector resources worldwide. Application of appropriate environmental health standards within the health care setting (HCS) can significantly reduce the transmission of these infections. This study were conducted in Alexandria with the objective of assessing the environmental health standards in some HCS in order to identify the degree of compliance with the guidelines set by the World Health Organization (WHO) and with the infection control measures set by the Ministry of Health (MOH), for the purpose of identifying major areas that require improvement within the health care sector. Ten hospitals were randomly selected in Alexandria Governorate to constitute the study sample: five hospitals were belonging to the private sector and five were public ones. Data collection were conducted using an assessment checklist pre-designed by the WHO, in addition to the chemical and bacteriological analysis of 30 water samples collected from the 10 hospitals. Results of the study revealed the absence of a water quality monitoring system within the HCS, poor maintenance in the plumbing system, lack of sufficient handwashing facilities, absence of suitable puncture-proof containers for sharp waste collection, inadequate laundry and catering services, absence of a High Efficiency Particulate Air (HEPA) filter, and a pressure gradient in all operating theaters and poor vector control especially in public hospitals. According to the WHO checklist, scores for hospital water supply (quality and quantity), water facilities, excreta disposal, health care waste management, laundry, food storage and preparation, vector control and the HCS construction and management were 69%, 62.5%, 63%, 72%, 64%, 89%, 78%, 63% and 44%, respectively. It is worth mentioning that at 95% level of significance, there was no statistical difference between the scores obtained by private hospitals and those obtained by public ones. Consequently, the study concluded that improvement is required in all hospitals and recommended some corrective measures.