Hand Washing Practices Research Articles

Mothers' hand washing practices and associated factors among model and non-model households in the rural community of Bibugn district, north west Ethiopia: The context of the Ethiopian health extension package

BackgroundHand-washing with soap is one of the most cost-effective ways of reducing the global infectious disease burden, particularly diarrhea and acute respiratory infections. The World Health Organization and United Nations Children's Fund report shows that in twenty-eight developing countries, more than one quarter of the population had no hand washing facility at home. This study aimed to assess hand washing practice and associated factors among mothers from model and non-model households in Bibugn district, North West Ethiopia. MethodsA community-based comparative cross-sectional survey was employed. A multi-stage sampling technique was used to select households. Data was collected using a structured interview questionnaire and analyzed using SPSS version 20. A descriptive analysis was presented using texts, tables, and figures. Bi-variable and multivariable logistic regression was used to detect the potential difference between variables. ResultsMothers' hand washing practice with water and soap/ash at critical times was 20.3%. Hand washing practice at critical times shows significant differences between model and non-model households. Mothers' who had knowledge 3.49 times (AOR: 3.49, 95% CI: 2.05, 5.96), access to adequate water 2.22 times (AOR: 2.22, 95% CI: 1.36, 3.77), and hand washing facilities 1.88 times (AOR: 1.88, 95% CI: 1.18, 2.98) were more likely to practice hand washing than their counterparts. ConclusionOne fifth of mothers practice hand washing with water and soap or ash at critical times in the study area. Model households were better at hand washing practice than non-model households’. Expanding the model household program, availing hand-washing facilities, increasing water accessibility, and strengthening awareness creation were important to improving hand-washing practice.

The Effects of Adolescents' Perceived Handwashing Attitudes, Health Beliefs, and Internal Control on Handwashing Practices in the COVID-19 Pandemic Situation

This study aims to provide basic data for developing a hand washing education program to prevent infection by identifying the factors that affect hand washing practice for high school students who need to establish healthy lifestyles in the COVID-19 outbreak situation. Data collection was conducted from December 10 to 31, 2020 for 149 in high school students. The collected data were analyzed using the SPSS 20.0 program. As a result, internal control(p<.05) and hand washing attitude(p<.05) had a significant effect on dependent variables. the result of this study indicates that the internal control means a tendency to attribute the cause or effect of an action to internal factors, such as ability, attitude, and effort of one’s own, educational plans that can increase the hand washing practice rate by cultivating a positive hand washing attitude and improving internal control through education on the importance of personal quarantine should be prepared.

How to sustain best practice in infection control

A new framework aims to encourage hand-washing and other daily practices that prevent and control infection

Efforts to Maintain Health by Implementing Six Step Handwashing for Middle School Students

Efforts to maintain health can be carried out with a clean and healthy lifestyle, including by washing hands 6 steps. Hands are the medium that transmits disease the most, so they must always be clean by washing hands in the 6 steps. The six steps to washing your hands start with pouring soap into your palms, rubbing your palms together, rubbing the back or back of your hands, rubbing between your fingers, rinsing off the soap and drying your hands. The results of observations in the classroom action research on 21 respondents consisting of junior high school students in Bekasi concluded that the majority of respondents (66.67%) had carried out the 6 steps of hand washing correctly. The results of observations of step-by-step hand washing stated that most respondents (72.79%) did the 6-step hand washing properly, in fact all respondents (100%) had carried out step 1 or step 1, namely pouring soap on their palms before washing. Hand. The quality of the implementation of the 6-step hand washing which was mostly good was made possible by the information obtained in the counseling conducted before the respondents carried out the practice of hand washing. The quality of the implementation of the 6-step hand washing which was mostly good was also made possible by the condition of the respondents who were mostly or 85.71% were women

Geographically Weighted Quantile Regression for Assessing the Spatial Variations of the High-Risk Diarrhea on Children Under Five in Bandung, Indonesia

Abstract. We investigate the impact of the percentage of clean water access, the percentage of handwashing habit, and the toilet category factors on the upper quantile of toddlers’ diarrhea risks in Bandung city, Indonesia using Geographically Weighted Quantile Regression model. We analyzed districts in Bandung, applying Geographically Weighted Quantile Regression with the predictors are the percentage of clean water access, hand washing habit, and toilet category. We focus on the 75th percentile ( . Breusch-Pagan test was used to detect the spatial heterogeneity. The optimum bandwidth was selected using cross-validation. The results shows that the significance, strength, and direction of the relationship between diarrhea and its risk factors are found to depend on the location. At the upper quantile τ = 0.75, the district named Panyileukan district is predicted to have the highest diarrhea risk. In this district, all of the three predictors are significantly affecting the toddlers’ diarrhea risk with the variable of percentage of houses practicing hand washing habit is observed to reduce diarrhea risk the most. In conclusion, clean water access, handwashing habits, and toilet category are the potential risk factors of high-risk childhood diarrhea. The significance, strength, and direction of the effect varies between districts. This method is powerful as it would allow the decision maker to handle the diarrhea problem aptly based

Bacteriological quality and safety of bottle food and associated factors among bottle-fed babies attending pediatric outpatient clinics of Government Health Institutions in Arba Minch, southern Ethiopia

BackgroundMicrobial contamination of baby bottle food has been identified as a significant public health concern, especially in developing countries, but it remains overlooked. Therefore, this study aimed to determine microbiological hazards, compliance with hygiene practices, and critical control points of contamination in baby bottle food in Arba Minch, southern Ethiopia.ObjectiveTo evaluate the bacteriological quality and prevalence of foodborne pathogens in baby bottle food and to identify associated factors among bottle-fed babies attending three government health institutions in Arba Minch, southern Ethiopia.MethodsA cross-sectional study was conducted between February 24 and March 30, 2022. A total of 220 food samples, comprising four types prepared with different sources of materials, were collected from systematically selected bottle-fed babies attending health facilities. The data on sociodemographic characteristics, food hygiene, and handling practices were solicited by face-to-face interview using a semi-structured questionnaire. Food samples (10 mL) were quantitatively analyzed for total viable counts (TVC) and total coliform count (TCC) and qualitatively for the presence of common foodborne bacterial pathogens. Data were analyzed using SPSS; ANOVA and multiple linear regression analyses were done to identify factors influencing microbial counts.ResultsResults revealed that the means and standard deviations of TVC and TCC were 5.3 ± 2.3 log10 colony forming units (CFU)/mL and 4.1 ± 2.6 log10 CFU/mL, respectively. Of the various food samples analyzed, 57.3 and 60.5% had a TVC and TCC above the maximum acceptable limits, respectively. The result of the ANOVA showed that there was a significant difference in the mean score of TCV and TCC among the four types of food samples (p < 0.001). Enterobacteriaceae were found in the majority of positive food samples (79.13%), followed by Gram-positive cocci (20.8%). Salmonella spp., diarrheagenic Escherichia coli, and Staphylococcus aureus were the common foodborne pathogens detected in 8.6% of tested foods. The regression result revealed that the type of baby food, hand washing practices of mothers or caregivers, and sterilizing and disinfecting procedures of feeding bottles are independent determinants of bacterial contamination (p < 0.001).ConclusionThe high microbial load and the presence of potential foodborne bacterial pathogens in the bottle food samples analyzed indicate unsanitary practices and the potential risk of exposure to foodborne pathogens in bottle-fed babies. Thus, interventions such as educating parents about proper hygiene practices, sterilizing feeding bottles and limiting bottle feeding practices are critical to reducing the risk of foodborne to bottle-fed infants.

Knowledge, Attitude, and Practices towards Needle-stick Injuries among Nurses in a Public Hospital, Malaysia

Needle-stick injuries (NSI) pose a significant occupational hazard for nurses worldwide. With appropriate knowledge, attitudes, and practices (KAP), the occurrence of NSI can be minimized. This study aimed to assess the KAP of Malaysian public hospital nurses towards NSI. A cross-sectional study was conducted involving 208 nurses who completed self-administered questionnaires measuring NSI KAP. Results showed that most nurses had good knowledge, attitudes, and practices towards NSI. The study recommends NSI education, including handwashing, post-prophylaxis, and safe work practices, to increase KAP and reduce NSI incidence among Malaysian public hospital nurses.

The Biosafety Research Road Map: The Search for Evidence to Support Practices in the Laboratory-Shigella spp.

Shigella bacteria cause shigellosis, a gastrointestinal infection most often acquired from contaminated food or water. In this review, the general characteristics of Shigella bacteria are described, cases of laboratory-acquired infections (LAIs) are discussed, and evidence gaps in current biosafety practices are identified. LAIs are undoubtedly under-reported. Owing to the low infectious dose, rigorous biosafety level 2 practices are required to prevent LAIs resulting from sample manipulation or contact with infected surfaces. It is recommended that, before laboratory work with Shigella, an evidence-based risk assessment be conducted. Particular emphasis should be placed on personal protective equipment, handwashing, and containment practices for procedures that generate aerosols or droplets.

Prevalence and Associated Risk Factors of Intestinal Parasites among Children under Five Years of Age Attended at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia: A Cross-Sectional Study.

In regions of the world with low resources, such as Ethiopia, intestinal parasite diseases are still highly prevalent, especially in children. Poor personal and environmental hygiene, as well as unsafe and low-quality drinking water, are the main causes of this. This investigation aimed to determine the frequency of intestinal parasites and risk factors among children under 5 years age at Bachuma Primary Hospital in 2022. : A cross-sectional study was carried out from October 2022 to December 2022 at Bachuma Primary Hospital, West Omo Zone, Southwest Ethiopia. Stool sample was collected from randomly selected children who were ordered to have their stool examined at the hospital laboratory and wet mount was prepared using normal saline to detect the different stage of intestinal parasites microscopically. Moreover, data related to the sociodemographic and associated risk factors was collected using a structured questionnaire. Descriptive statistics were computed to describe the characteristics of the study participants and determine the prevalence of intestinal parasites. Data were entered into Epi-data manager and analysed using statistical packages for social sciences (SPSS) version 25.0, respectively. Bivariate and multivariate logistic regression analyses were performed, with variables with a p value of <0.05 considered statistically significant. : Infection with at least one intestinal parasite among children was 29.4% (95% CI: 24.5-34.7). Ascaris lumbricoide and Giardia lamblia were responsible for 8% (26/323) and 4% (13/323) of the prevalence of helminth and protozoans, respectively. A multivariate logistic regression analysis revealed that children whose residence was rural had an adjusted odds ratio (AOR) of 5.048 (p=0.001), those who did not wash their hands before meals had an AOR of 7.749 (p=0.001), a child with not trimmed fingernails had an AOR of 2.752 (p=0.010), a child who frequently experienced stomach pain and whose source of water was pond had an AOR of 2.415 (p=0.028) and 3.796 (p=0.040), respectively. In this study, the prevalence of intestinal parasites recorded was low. Rural residency, absence of child hand washing practice before meal, and not trimming fingernail were among factors significantly associated with intestinal parasite infection.

Preventive Measures against Ebola and COVID-19 and Their Impact on Human Dirty-Hand Disease Mitigation in Côte d’Ivoire

Hygiene is the most useful public health measure for preventing infections of important endemic and emerging diseases of global significance. This study aimed to assess the impact of these public health preventive measures on dirty hand diseases. A retrospective survey was conducted in the rural general hospitals of Taabo (south-central Côte d’Ivoire) and Marcory (urban Abidjan) to collect clinical data on dirty hand diseases in the patients’ records from 2013 to 2020. In addition, focus group discussions (N = 8) were conducted in the communities in both settings to identify the sociocultural and economic hindering or fostering factors that affected the adoption of and the compliance with handwashing and disinfection practices. A total of 3245 and 8154 patients’ records were examined in the general hospitals of Taabo and Marcory, respectively. Compared with women, men were more affected by typhoid fever (OR, 0.68 [95%CI, 0.53–0.88]) and influenza (OR, 0.87 [95%CI, 0.75–1]). Hygiene measures promoted during Ebola and COVID-19 outbreaks had no impact on the prevalence of typhoid fever in both settings; however, a positive impact was observed regarding influenza infections. Populations were aware of the importance of handwashing for public health but had difficulties adhering due to financial constraints, access to drinking water, and the absence or scarcity of handwashing facilities.

The lasting influence of Ebola: a qualitative study of community-level behaviors, trust, and perceptions three years after the 2014-16 Ebola epidemic in Liberia

The majority of disease transmission during the 2014-16 West Africa Ebola epidemic was driven by community-based behaviors that proved difficult to change in a social paradigm of misinformation, denial, and deep-seated distrust of government representatives and institutions. In Liberia, perceptions and beliefs about Ebola during and since the epidemic can provide insights useful to public health strategies aimed at improving community preparedness. In this 2018 study, we conducted nine focus groups with Liberians from three communities who experienced Ebola differently, to evaluate behaviors, attitudes, and trust during and after the epidemic. Focus group participants reported that some behaviors adopted during Ebola have persisted (e.g. handwashing and caretaking practices), while others have reverted (e.g. physical proximity and funeral customs); and reported ongoing distrust of the government and denial of the Ebola epidemic. These findings suggest that a lack of trust in the biomedical paradigm and government health institutions persists in Liberia. Future public health information campaigns may benefit from community engagement addressed at understanding beliefs and sources of trust and mistrust in the community to effect behavior change and improve community-level epidemic preparedness.

Assessment of Hand Hygiene Knowledge and Practices among Private Dental Clinics in Munshiganj, Bangladesh: A Cross-Sectional Study

Introduction: The study was performed to assess knowledge about infection control through hand-washing practices among dentists and paramedical professionals working at private dental clinics and provide help to identify and overcome obstruction towards proper hand hygiene pattern. Method: A questionnaire-based study was supervised at 15 different private dental clinics situated in the Munshiganj district of Bangladesh. Data on handwashing practices and other factors were collected from 60 samples during the months of November and December 2020. Site inspections of and washing facilities were also supervised. The data was analyzed on SPSS. Result: Majority (78.3%, 50.0% &amp;amp; 35.0%) of the respondents strongly agreed that hand washing helps to prevent spread of infection to the patients. Less than half (48.3%) of the respondents washed their hands before wearing gloves. 31 doctors claimed that hand washing is done after termination of duty while 10 claims that they wash hands after each examination (p&lt; 0.001). And most of the doctors use antibacterial soap (p=0.004). Conclusion: The study wraps up that most of the health care providers had the education about the advantage of handwashing, but proper technique was not followed. The reasons given for not adopting handwashing practices were shortage of time, being busy with a greater number of patients, a skin reaction, and an unsuitable atmosphere. Update Dent. Coll. j: 2023; 13(1): 23-26

Clean Hands, Dirty Truths: A Qualitative Study of Healthcare Professionals' Hand Hygiene in Public Hospitals of Lahore Before and During COVID-19

This qualitative research investigates the hand hygiene knowledge and practices of healthcare professionals in public hospitals, as well as how the COVID-19 pandemic affected their knowledge and practices in this area. The study conducted 20 in-depth interviews with medical staff working in public tertiary care facilities in Lahore, Pakistan. The results show that while healthcare workers possess a basic understanding of hand hygiene, they exhibit lower compliance with hand-washing practices, which is attributed to inadequate hand hygiene facilities and a heavy workload. Despite increased funding to hospitals during the pandemic, the findings suggest that the COVID-19 pandemic increased healthcare practitioners' awareness of hand hygiene and its importance, but it did not lead to a significant improvement in hygiene practices due to increased workload and inadequate facilities.

RISK FACTORS OF SOIL TRANSMITTED HELMINTHS AMONG ELEMETARY SCHOOL STUDENTS IN CENTRAL SUMBA – WEST NUSA TENGGARA

Background: Soil Transmitted Helminhs (STH) infection is one of health issues in Indonesia. Helmintiasis is a disease commonly found among elementary school. Purpose: To identify risk factor related to the transmission of infection STH in Central Sumba Regency, East Nusa Tenggara Province. Method: The research was done by analytical description based on cross-sectional study. Primary data on risk factors were colleted by which qustionnaire for students fourth to sixth grade, age ranged 8-15 years old. Diagnosis was established using Kato Katz modification method. The data were is analyzed using by cross-sectional of Chi-square test with confidence interval 95% or p-value &lt;0.05 categorized as significant. Result: The proportion of infection in male was 47.1% and in females was 50.9%. The proportion of STH infections was 83.3%, mostly found in fifth grade children (36.6%) and aged 8-11 years (66.6%). The most common type of worm egg infection found in feces was mixed infection of Ascaris lumbricoides and Trichuris trichiura (35.6%), followed by a single infection with T. trichiura (32.8%) and the least number was A. lumbricoides (14. 9%).STH infections have significant related to some risk factors such as defecating not in the latrine, not washing hand with water and soap before eating and after defecated, not practicing hand washing properly, biting nails, sucking fingers, not cutting nails once a week, and barefood. The highest risk factor of STH infection in Central Sumba was defecating not in the latrine (PR=135.500; CI 95% (34.062 - 539.020)). Conclusion: The proportion of STH infections is still quite high due to low personal hygiene and open defecation.

Innovative Fibreglass Mobile Sink Basin: An Intervention for Hand Washing in an Era of Pandemics

The purpose of the study was to undertake an innovative project of producing a mobile sink basin from fibreglass as an intervention for hand washing in Ghana. The qualitative research approach with the arts-based descriptive research design guided the study. Fifty-five (55) study participants in the Kwame Nkrumah University of Science and Technology, Ghana were purposively sampled to evaluate the project in the context of handwashing in this era of pandemics. Data were primarily gathered via semi-structured interviews, observations and photographs. Detailed account on the tools and materials as well as the procedural steps for the production of the innovative fibreglass mobile sink by meticulously following the rules in arts-based descriptive research design. The qualitative data were analysed using the qualitative thematic analysis. The study found that the fibreglass mobile sink would be useful for handwashing and proper hand hygiene at homes, schools, healthcare facilities, workplaces, and marketplaces to prevent the spread of infectious diseases. In the face of the global COVID-19 pandemic and future pandemics, the study suggests the scaling up of this innovative mobile sink due to its convenience, cost-effectiveness, accessibility and portability that would encourage the Ghanaian citizenry to practice handwashing. The study recommends that the Ghana government via the Ministry of Health in Ghana should seek for funding avenues to support the mass production of this innovative project. Also, the Ministry of Health must collaborate with higher education institutions in organizing and funding projects of staff and students targeted at arresting the daunting health-related issues such as handwashing to curb the spread of infectious diseases.

Evaluation of Handwashing Facilities in Basic Schools in Ejura-Sekyeredumase Municipality, Ghana

Hand washing has been recognized as an effective measure against the transmissions of different communicable diseases. This article provided insights into hand washing facilities, students’ knowledge, and patronage of the facilities in basic schools in Ejura-Sekyeredumase Municipality of Ghana motivated by the Covid-19 pandemic. We pointed out the current state of handwashing facilities and knowledge of proper handwashing among basic schools in the second Covid-19 hotspot region. The study spanned between November 2019 to March 2020. From pre Covid-19 period to the time (month) Ghana recorded its first case of Covid-19. The study was undertaken using well designed structured questionnaire, observation checklist and interviews. It involved randomly sampling 25 public schools and 5 private schools. From each of these 30 schools, 19 students and a teacher were selected randomly and purposively making a total of 600 respondents. Data obtained from the students and staff were compared for their effective relationships using Statistical Package for Social Sciences (SPSS) Version 20. The Pearson Chi-Square test was used to show the effect size and the strength of relationship between variables. The results showed that the handwashing facilities were not enough for students and teachers. Many students rated availability of handwashing materials as good (66. 70%). There was a statistically significant difference (p&lt;0.05) between the availability of hand washing materials and patronage of the facility. Most students claimed water flowed always ( =1.27) with few reporting intermittent water availability (26.70%, SD=0.45). Generally, more students (76.80%) washed their hands with soap and water after visiting the toilet. There was a significant difference between students who knew germs and the number of times they practiced hand washing, X2(4, N=546) =13.26, P=0.01). However, the effect size was relatively small (Cramer’s V=0.15). Inadequate handwashing materials (42.13%) and forgetfulness from students (37.07%) were hindrances to effective handwashing. The government through the ministry of education should ensure all year- round provisions of hand washing facilities and materials coupled with continuous education and awareness to strengthen hand washing habit among the students.

Prevalence and associated factors of intestinal parasitic infection in basic school children in Sana'a Yemen

Background: Intestinal parasitic infection is the most common endemic infection worldwide and represent major public health problems, mainly in developing countries like Yemen.Aim: The study aim is to identify the prevalence and associated factors of intestinal parasitic infection among basic school children in Sana'a city Yemen.Methods: A crosssectional descriptive study involved 500 basic school children was conducted from April to May 2013. 500. Stool specimens were collected from all participants and examined for intestinal parasitic infection using direct microscopy, wet concentration method then sedimentation method. Data entered and analyzed using SPSS software. Results: The overall prevalence of intestinal parasite infection among the participants was 31.2% and it was higher in Azal district 35.5%. The predominant parasites were Giardia Lambela 48%. The highest prevalence of intestinal parasitic infection 34.4% was among participants from public school and lesser 10.4% among participants from private school. The result was statistically significant (P&gt;0.001). Prevalence of intestinal parasite infection was found among participants for illiterate mothers to be 35.1%, it was high 36% if there is only one bath room in house and the result was statistically significant (P&gt;0.001). Prevalence of intestinal parasite infection 63% was among participants who did not follow hand washing practice after defecation and the result was statistically significant (P&gt;0.001). Most of participants 70.6% don’t have water supply during observation. Conclusions: Intestinal parasites were prevalent in varying magnitude among the schoolchildren. The prevalence of infections were higher for protozoa compared to helminthes. Measures including education on personal hygiene, environmental sanitation, water supply and treatment should be taken into account to reduce the prevalence of intestinal parasites

Identifying COVID-19 Prevention Practices among Health Students

This study aimed to discover how health students practice COVID-19 prevention methods, particularly hand washing, wearing masks and social distancing. This study was a non-experimental quantitative descriptive research. Data was collected using a COVID-19 prevention practice questionnaire distributed to students. The population in this study were regular and professional health students at the University of Muhammadiyah Malang. The sampling technique used was accidental sampling and included 208 students. 76% of students were found to have preventive practices in the low-risk category, 21% moderate risk, and 3% high risk for transmission. 98% of the practice of wearing masks answered YES. Hand washing practices are 90% in the good category, 10% moderate, and 0% low. The social distancing practice is 55% good, 37% moderate, and 8% low.&#x0D; Keywords: preventive practices, COVID-19, health students

Knowledge and Practice of Handwashing by School Students in Kamrup Metropolitan, Assam, India: A Cross Sectional Survey

Abstract Objective The aim of this study was to understand the level of handwashing knowledge, and handwashing practices as well as to determine the availability of handwashing facilities in the schools. Materials and Methods A survey was conducted on 17th October 2019 to determine the availability of handwashing facilities along with the level of handwashing knowledge and practices among school students of Borsojai High School situated in Kamrup Metropolitan City, Guwahati, Assam. The study population consisted of randomly selected students of 9th and 10th classes during the academic year 2019 to 2020. The quantitative data were analysed using the IBM-SPSS, version 20.0. Result Fifty-six school students from classes 9 to 10th of mean age 15.53 years participated in the current study. It is evident that school-aged students have sufficient knowledge of handwashing, and they widely recognise the importance of handwashing (94.6%) to prevent diseases (39.3%) and to remove germs (48.2%). Conclusion To encourage hand hygiene in school students, parents can also be sensitised through the parents teacher meeting. This will improve the health and reduce the absenteeism from school due to infectious diseases.

A qualitative study exploring hand hygiene practices in a neonatal unit in Blantyre, Malawi: implications for controlling healthcare-associated infections

Background: Neonatal sepsis is responsible for a considerable burden of morbidity and mortality in sub-Saharan African countries. Outcomes from neonatal sepsis are worsening due to increasing rates of antimicrobial resistance. Sub-optimal Infection Prevention and Control (IPC) practices of health care workers and caregivers are important drivers of infection transmission. The Chatinkha Neonatal Unit at Queen Elizabeth Central Hospital, Blantyre, Malawi has experienced multiple outbreaks of neonatal sepsis, associated with drug resistant Klebsiella pneumoniae. We aimed to understand the barriers to implementation of optimal IPC focusing on hand hygiene practice. Methods: We used a qualitative research methodology to meet the study aim. Combining participant observation (PO) over a seven-month period with semi structured interviews (SSI) to provide an in-depth understanding of activities relating to hygiene and IPC existing on the ward. Results: While most staff and some caregivers, had a good understanding of ideal IPC and understood the importance of good handwashing practices, they faced substantial structural limitations, and scarce resources (both material and human) which made implementation challenging. For staff, the overwhelming numbers of patients meant the workload was often unmanageable and practicing optimal IPC was challenging. Caregivers lacked access to basic amenities, including linen and chairs, meaning that it was almost impossible for them to maintain good hand hygiene. Limited access to soap and the erratic water supply for both caregivers and healthcare workers further worsened the situation. Communication challenges between different cadres of staff and with patient caregivers meant that those handling neonates and cleaning the wards were often unaware of outbreaks of drug resistant infection. Conclusion: For IPC to be improved, interventions need to address the chronic shortages of material resources and create an enabling environment for HCWs and patient caregivers.