Hand hygiene compliance and its associated factors among health care providers in primary hospitals of Waghimira Zone, Northeast Ethiopia: a mixed study design

Abstract

Introduction: Hand hygiene compliance is the problem of developing nations particularly in Sub-Saharan Africa including Ethiopia. Despite a lot of efforts have been employed, healthcare-associated infections are the existing health care problems, leading to impaired quality of life, prolonged hospital stays, increased healthcare costs, morbidity and mortality. This study aimed to assess the magnitude and factors associated with hand hygiene compliance among health care providers working at the primary hospitals of Waghimira Zone, Northeast Ethiopia.

Methods: Facility-based cross-sectional study design supplemented with qualitative research method was employed at the primary hospitals of Waghimira Zone from March 02-15, 2020. Simple random sampling using lottery method was applied to select 253 study participants. The data were coded on pre-arranged coding sheet and entered into Epi-Data version 3.1 and exported to SPSS version 25 for analysis. Descriptive statistics were displayed using tables and figures. Binary logistic regression analysis was used to test associations between the independent and the outcome variable. Multivariable logistic regression analysis was fitted to identify the independent predictors of hand-hygiene compliance at p-value < 0.05 and AOR with 95% confidence interval. Six Key Informant Interviews were conducted with purposively selected chief executive and clinical officers. Thematic content analysis was made and the findings were written sequentially with explanatory method.

Results: One-fifth of the subjects (20.6%, 95% CI = 15.2, 24.9) had good hand hygiene compliance. Attended training on hand hygiene protocol (AOR = 3.18, 95% CI: 1.39, 7.28), accessible to adequate soap and water (AOR = 3.77, 95%CI: 1.52, 9.37), having alcohol for hand rub (AOR = 2.67, 95%CI: 1.18, 6.05) and having hand wash sink (AOR = 2.31, 95%CI: 1.03, 5.14) were significantly associated with hand hygiene compliance which also supported by the qualitative findings.

Conclusions: Hand hygiene compliance among health care providers was low in the study area. Attended training on hand hygiene, accessibility to adequate soap and water, alcohol-based hand rub, and having hand washing sink in working area were statistically significant. Hence, the primary hospitals should be equipped with adequate supply to all the basic hand hygiene facilities.

Keywords: Compliance; Ethiopia; Hand hygiene; Health care providers; Primary hospitals.

Fig. 1

Sampling technique and procedure in primary hospitals of Waghimira Zone, 2020

Fig. 2

Hand hygiene compliance of health care providers at primary hospitals of Waghimira Zone, North East Ethiopia, 2020 (n = 253)