Predictors of pre-and post-care handwashing among community healthcare providers: a cross-sectional survey in Bangladeshi community clinics

Abstract

Lack of proper handwashing by healthcare providers is the major vector for the spread of nosocomial pathogens in healthcare settings. A cross-sectional study was conducted among 128 community healthcare providers (CHCPs) in the Kurigram district of Bangladesh to investigate predictors of handwashing before and after clinical care encounters. Data were collected between November and December 2019 via a paper-and-pen based survey using a semi-structured questionnaire. CHCP’s pre-care handwashing with soap/antiseptic hand cleaner was predicted by a higher level of education (Unadjusted/Crude odds ratio (COR) = 7.16, 95% CI 2.39–21.40, p = 0.000 and COR = 9.58, 95% Confidence Interval (CI) 3.28–27.92, p = 0.000, bachelors and masters, respectively), lengthier service (COR = 6.90, 95% CI 1.40–34.17, p = 0.015 and COR = 7.8, 95% CI 1.49–40.98, p = 0.015, 5–8 and >8 years, respectively), and presence of handwashing facility (COR = 4.48, 95% CI 1.34–14.95, p = 0.015). However, post-care handwashing was also associated with a higher level of education (COR = 13.36, 95% CI 1.54–115.63, p = 0.019, masters) and availability of soap (COR = 17.73, 95% CI 5.03–59.73, p = 0.000), as well as by male sex (COR = 3.14, 95% CI 1.01–9.79, p = 0.049). Implementation of an effective training program on hand hygiene combined with improved access to handwashing stations and adequate supply of soap or antiseptic hand cleaner is required to improve both pre-and post-care clinical encoun-ter handwashing practices among CHCPs.