Health care workers’ level of adherence to infection prevention and control and its impact on puerperal and neonatal sepsis among delivering women and neonates in Central Tanzania: A protocol for prospective cohort study

Abstract

AbstractIntroductionDelivering women and neonates are at a great risk of acquiring infections due to lack of adherence to infection prevention and control (IPC) and low level of immunity and extended exposure to care procedures that can lead to infections. This prospective study aims to assess the level of adherence to IPC among health care workers and its impact on puerperal and neonatal sepsis in Dodoma region.Methods and AnalysisLevel of adherence to IPC is examined cross-sectionally among health care workers (HCWs’) in contact with delivering women and their neonates. Prospective cohort approach is used to assess level of exposure of 294 delivering women and their neonates to poor hygienic practices of HCW through observation checklist. Outcomes including incidence of puerperal and neonatal sepsis are evaluated clinically two days later before discharge. Laboratory culture and sensitivity confirmatory tests of blood samples are done on positive cases. Data analysis for level of adherence to IPC practices, incidence of puerperal and neonatal sepsis as well as relative risk among the exposed women and neonates will be performed.Ethics and DisseminationThe University of Dodoma Research Ethics Committee (UDOM-REC) approved this study (Ref No. MA.84/261/’A’/25). Findings of this study will be published in international peer reviewed journals, disseminated in international conferences, to the participating hospitals, the University of Dodoma and the Tanzanian Ministry of Health for informing practice and policy.Strengths and limitations of this studyBy capturing data from both health care workers and patients using mixed methods approach, the study can examine the impact of health care worker’s infection prevention, and control practice on patient’s outcomes at the same time.Compared to other studies, this study objectively tracks and quantify the risk of infection from all possible points of contact between a health care worker and a client.The study can enable early identification of puerperal or neonatal infection and initiate treatment before discharge Exposure to pre-admission infection long incubation period and manifest at the hospital post-delivery may be difficult to capture and may confound the results without culture and sensitivity.The post-delivery women and their neonates will be followed for two days only to abide to hospital discharge protocol; this will limit the data to early onset of sepsis only.