Factors associated with healthcare workers’ compliance to infection prevention and control guidelines in neonatal intensive care units and maternity wards in Kamuli, Iganga and Jinja districts

Abstract

Background: Newborns admitted in neonatal intensive care units (NICUs) are at a high risk of contracting Hospital Acquired Infections (HAIs) and deaths due to lapse in compliance to Infection Prevention and Control (IPC) measures. HAIs are responsible for about 8% to 80% of all neonatal deaths and about 42% of these occur in the first week of life. Healthcare workers’ compliance to standard precautions of IPC is very crucial in preventing infections for both healthcare workers and newborn babies admitted in NICUs and maternity wards. Objective: The aim of this study was to assess the factors associated with Healthcare workers’ compliance to infection prevention and control guidelines in neonatal intensive care units and maternity wards in Kamuli, Iganga and Jinja districts Methods: This was a cross sectional survey utilizing both qualitative and quantitative approaches. Sample size was 120 participants and 14 key informant interviews conducted. Purposive sampling technique was used to select the Health facilities with NICUs and convenience sampling technique for maternity wards. Purposive sampling technique was used to select the participants for the key informant interviews and non-probability quota sampling technique used to select participants for the quantitative part. Quantitative data underwent descriptive analysis, frequencies, cross tabulations and modified Poisson regression at 95% confidence interval. Qualitative data was transcribed, coded and analysed thematically. Results: Over all compliance to IPC guidelines was 45% across all the four IPC components for this study. xiv Healthcare workers working in urban healthcare facilities were significantly less likely to comply with IPC guidelines when compared to the ones from rural health facilities. Healthcare workers from private health facilities were significantly more likely to comply with IPC guidelines than public healthcare facilities. Healthcare workers who received training monthly were significantly more likely to comply with IPC guidelines compared to those who didn’t receive any training. Shortage of staff, lack of required equipment, poor IPC knowledge and poor attitude were some of the challenges affecting IPC compliance as highlighted from the key informant interviews Conclusion and recommendations: Overall compliance for the study was low. The health facility factors associated with IPC compliance were often receive training, location of the healthcare facility and ownership of the healthcare facility. There wasn’t any individual factor that was statistically significant or associated with IPC compliance. Shortage of staff and lack of required equipment stood to affect compliance. Therefore healthcare workers from urban and public healthcare facilities should be trained on available IPC guidelines. Stake holders like MOH should ensure health facilities especially public health facilities have adequate supplies and equipment to facilitate IPC compliance