Assessment of Hand Hygiene Knowledge, Attitude, and Practice Among Health Sciences Students in Herat, Afghanistan: A Cross-Sectional Study

Abstract

Background: Hand hygiene (HH) is a fundamental practice in preventing hospital-acquired infections (HAIs), yet compliance among healthcare workers, including students, remains suboptimal. This study assesses the knowledge, attitude, and practice (KAP) related to HH among final-year health sciences students in Herat, Afghanistan. Methods: A convenience-based cross-sectional study was conducted in October to December 2023 at public and private health sciences institutions in Herat, using a structured questionnaire to assess KAP on HH. A sample of 427 participated. Data analysis in SPSS 27 included descriptive statistics, chi-square tests, and logistic regression. Results: The overall accuracy of responses was 84.61% (IQR: 76.92, 84.61), reflecting a strong level of awareness. Attitudes toward HH were also largely positive, with a correct rate of 81.25% (IQR: 75.00, 85.41). Additionally, self-reported adherence to proper HH practices was notably high at 92.85% (IQR: 85.71, 98.21). Students assigned to the emergency ward (23.6%) demonstrated significantly higher knowledge compared to those in other wards (p = 0.016). Logistic regression further confirmed that work setting played a crucial role, with students in the internal ward exhibiting significantly higher knowledge levels than their peers (95% CI: 1.001–4.448) (p = 0.050). The study objectives were met, revealing that final-year students possessed strong knowledge, positive attitudes, and high adherence to HH practices. However, the work environment was a key determinant of knowledge variation across wards. Conclusion: Despite high awareness and adherence, misconceptions and barriers to compliance exist. Strengthening educational interventions, institutional policies, and real-time monitoring is crucial to ensuring sustained HH practices among future healthcare professionals.