Comparative assessment of infection prevention and control practice among maternity unit health workers in public and private secondary health facilities in Kaduna state, Nigeria

Abstract

Introduction: Infection Prevention and Control (IPC) practice in health facilities is abysmally low in developing countries, resulting in significant preventable morbidity and mortality. Objective(s): This study assessed and compared health workers' practice of IPC strategies in public and private secondary health facilities in Kaduna State. Method(s): An analytic cross-sectional comparative study was employed. Multistage sampling technique was used to select 227 participants each comprising of doctors, midwives and nurses drawn from public and private health facilities. Data was collected using interviewer-administered questionnaire and observation checklist. Data was analysed using both bivariate and multivariate analysis. Statistical significance was determined at p value < 0.05. Result(s): The practice of infection prevention is poor. Overall, 48% of the HW used plain soap to wash their hands, and 35.1% of them used hand operated faucet to turn water on and off during hand washing. These practices were significantly poorer in public health facilities (40.1% and 30.0% respectively) compared to private health facilities (55.9% and 40.5% respectively) (p < 0.001 and P<0002 respectively). Overall, 42.3% of the health workers did not change their gowns in-between seeing patients, with the significantly higher rates in 73.1% of private compared to 42.3% of public health facility workers (p < 0.001). Additionally, 30.5% and 10.1% of health workers do not use face mask and eye goggle respectively when conducting procedures likely to generate splash of body fluids, however, there was no significant difference in these poor practices in public compared to private health facilities. The mean IPC practice was 51.6%+/-12.5, this was significantly lower among public (48.8%+/-12.5) compared to private (54.5%+/-11.9) health facility workers (p value <0.0001). Private HF workers were three times more likely to implement IPC interventions compared to public health facility workers. Conclusion(s): IPC practice especially among public health facility workers was poor.