Introduction : Hand Hygiene (HH) in hospital settings is an effective measure to protect patients from the spread of healthcare-associated infections (HAIs). However, its compliance is still low. We aimed to determine the factors associated with low compliance with HH by providers in Lualaba Province. Methods : A cross-sectional study was conducted with 384 providers from five healthcare facilities (HCFs) from November 23 to December 10, 2023. A self-administered questionnaire and an HH observation grid were used to collect data. Chi-square tests and logistic regression measured the association between the variables of interest at an alpha significance level of 0.05. Results : A total of 5266 opportunities for compliance with HM were identified, and the overall compliance rate for HH was estimated at 37.9%. Some factors were associated with low compliance with HH: absence of administrative measures, OR = 1.966 (95% CI 1.064 - 3.631), p = 0.031; excessive workload, OR = 1.782 (95% CI 1.102 - 2.880), p = 0.018; absence of an infection prevention and control (IPC) committee, OR = 2.528 (95% CI 1.656 - 3.860), p < 0.001; lack of on-the-job training, OR = 2.348 (95% CI 1.337 - 4.125), p = 0.003; and lack of knowledge of HH OR = 4.749 (95% CI 2.398 - 9.407), p < 0.001. Conclusion : Few healthcare providers observe HH in Lualaba healthcare facilities. There is a need to implement administrative measures, train staff, and revitalize infection prevention and control (IPC) committees to address the challenges of low hand hygiene compliance.
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