Feasibility and acceptability of a novel intervention to improve hand hygiene behavior in rural Liberian health facilities

Author:

Tantum Lucy K.1ORCID,Gilstad John R.2ORCID,Horng Lily M.3ORCID,Tandanpolie Amos F.3ORCID,Styczynski Ashley R.3ORCID,Letizia Andrew G.4ORCID,Luby Stephen P.3ORCID,Arthur Ronan F.3ORCID

Affiliation:

1. a Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 135 Dauer Dr., Chapel Hill, NC 27599, USA

2. b School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, MD 20814, USA

3. c School of Medicine, Stanford University, 291 Campus Dr., Stanford, CA 94305, USA

4. d U.S. Naval Medical Research Unit-Two, Singapore, Singapore

Abstract

Abstract Hand hygiene is central to the prevention of healthcare-associated infection. In low-income settings, barriers to health worker hand hygiene may include inconsistent availability of hand hygiene supplies at the point of care. However, there is a lack of knowledge of interventions to improve and sustain health worker hand hygiene in these settings. This pilot study evaluates acceptability and feasibility of a personally-worn hand hygiene holster device for improving point-of-care access to alcohol-based handrub (ABHR). Holsters were distributed to clinical staff at a hospital in Liberia in July–September 2021. Data collection included 2,066 structured observations of hand hygiene behavior, six spot checks of supply availability, and focus group discussions with 13 clinical staff. The Integrated Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH) provided a framework for study design and qualitative analysis. Acceptability of the intervention was high, with users reporting that holsters were comfortable, easy to use, and aligned with their professional identities. Feasibility depended on consistent ABHR availability, which may diminish sustainability of this intervention. The hand hygiene holster is a promising tool for improving health worker hand hygiene behavior, but solutions to ABHR supply chain and distribution constraints are necessary to support sustainability of this intervention.

Funder

Henry M. Jackson Foundation

Publisher

IWA Publishing

Subject

Public Health, Environmental and Occupational Health,Pollution,Waste Management and Disposal,Water Science and Technology,Development

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