Assessment of Environmental Cleaning Practices and the Impacts on Infection Prevention and Control in Selected Hospitals in Tanzania — Oak Academic Publishing
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Assessment of Environmental Cleaning Practices and the Impacts on Infection Prevention and Control in Selected Hospitals in Tanzania
Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
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Department of Chemical and Mining Eng., University of Dar es Salaam, Dar es Salaam, Tanzania
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World Health Organization (WHO), Tanzania, Dar es Salaam, Tanzania
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Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
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Department of Environmental Studies, The Open University of Tanzania, Dar es Salaam, Tanzani
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National Institute of Medical Research, Dar es Salaam, Tanzania
,
National Council for Technical Education, Dar es Salaam, Tanzania
,
Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
,
World Health Organization (WHO), Tanzania, Dar es Salaam, Tanzania
,
World Health Organization (WHO), Tanzania, Dar es Salaam, Tanzania
1 Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
2 Department of Chemical and Mining Eng., University of Dar es Salaam, Dar es Salaam, Tanzania
3 World Health Organization (WHO), Tanzania, Dar es Salaam, Tanzania
4 Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
5 Department of Environmental Studies, The Open University of Tanzania, Dar es Salaam, Tanzani
6 National Institute of Medical Research, Dar es Salaam, Tanzania
7 National Council for Technical Education, Dar es Salaam, Tanzania
8 Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
9 World Health Organization (WHO), Tanzania, Dar es Salaam, Tanzania
10 World Health Organization (WHO), Tanzania, Dar es Salaam, Tanzania
To achieve Sustainable Development Goal (SDG) in healthcare facilities (HCFs,) the provision of water, sanitation, healthcare waste management, hand hygiene and environmental cleanliness services is crucial. Good WASH services in HCFs settings have the potential to reduce healthcare acquired infections (HAIs), increase trust and uptake of healthcare services, increase efficiency and improve staff morale. To address this, a National Assessment was carried out to ascertain environmental cleanliness condition of the healthcare facilities at all levels. The assessment of healthcare waste management in the facilities was conducted in all the 26 regions of Tanzania Mainland including districts and lower healthcare facilities. A standardized checklist and tools were used to assess and monitor various aspects related to healthcare waste management using open source software for data collection (ODK). Data were analyzed using SPSS computer software. It was observed that most of permanent staff (88%) in the Healthcare facilities had knowledge on hand hygiene, but the gap was observed to the waste handlers (12%) who were not equipped with the hand hygiene knowledge. About 89% of the hand washing stations were available at mortuary units, followed by 75% at main entrance and the lowest was 3% at waste zone areas of the healthcare facilities. Hand washing materials like soap were mainly found at theaters (64%) followed by mortuary (60%) and last at waste zones. The assessment concludes that handling of healthcare wastes is not practiced to the expectations, and there is a need to strengthen the situation. The findings provide evidence for those engaged in improving HCF conditions to develop evidence-based policies and efficient programs, enhance service delivery systems, and make better use of available resources.
KeywordsEnvironmental CleaningInfection PreventionSanitationHand Hygiene and Water Supplies
WHO (2020) Water, Sanitation, Hygiene, and Waste Management for the COVID-19 Virus, Interim Guidance. World Health Organization, Geneva. https://apps.who.int/iris/handle/10665/331846
Velleman, Y., Mason, E., Graham, W., Benova, L., Chopra, M., Campbell, O.M.R., et al. (2014) From Joint Thinking to Joint Action: A Call to Action on Improving Water, Sanitation, and Hygiene for Maternal and Newborn Health. PLOS Medicine, 11, e1001771. https://doi.org/10.1371/journal.pmed.1001771
WHO (2020) Water, Sanitation, Hygiene, and Waste Management for SARS-CoV-2, the Virus that Causes COVID-19: Interim Guidance. https://www.who.int/publications/i/item/WHO-2019-nCoV-IPC-WASH-2020.4
Ige, F., Ohihoin, A., Amuda, B., Amoo, O., Onwuamah, C., Okwuraiwe, A., Shaibu, J., Odewale, E., James, A., Kayode, A., Adeshina, A. and Audu, R. (2021) The Effectiveness of Infection Control Practices among Health Care Workers Responding to the COVID-19 Pandemic in Nigeria. Advances in Infectious Diseases, 11, 232-239. https://doi.org/10.4236/aid.2021.112021
Saito, R., Virji, M.A., Henneberger, P.K., Humann, M.J., LeBouf, R.F., Stanton, M. L., Liang, X. and Stefaniak, A.B. (2015) Characterization of Cleaning and Disinfecting Tasks and Product Use among Hospital Occupations. American Journal of Industrial Medicine, 58, 101-111. https://doi.org/10.1002/ajim.22393
WHO (2008) Core Components of Infection Prevention and Control Programmes in Healthcare. Report of Second Meeting on Infection Prevention and Control in Healthcare, Geneva, Switzerland, 26-27. https://www.who.int/teams/integrated-health-services/infection-prevention-control/core-components
Nyampundu, K., Mwegoha, W.J.S. and Millanzi, W.C. (2020) Sustainable Solid Waste Management Measures in Tanzania: An Exploratory Descriptive Case Study among Vendors at Majengo Market in Dodoma City. BMC Public Health, 20, 1075-1083. https://doi.org/10.1186/s12889-020-08670-0
Cronk, R. and Bartram, J. (2018) Environmental Conditions in Health Care Facilities in Low- and Middle-Income Countries: Coverage and Inequalities. International Journal of Hygiene and Environmental Health, 221, 409-422. https://doi.org/10.1016/j.ijheh.2018.01.004
Nejad, S.B., Allegranzi, B., Syed, S.B., Ellis, B. and Pittet, D. (2011) Healthcare Associated Infection in Africa: A Systematic Review. Bulletin of the World Health Organization, 89, 757-765. https://doi.org/10.2471/BLT.11.088179
Elling, H., Behnke, N., Tseka, J.M., Kafanikhale, H., Mofolo, I., Hoffman, I., Reuland, F., McCord, R. and Cronk, R. (2022) Role of Cleaners in Establishing and Maintaining Essential Environmental Conditions in Healthcare Facilities in Malawi. Journal of Water, Sanitation and Hygiene for Development, 12, 302-317. https://doi.org/10.2166/washdev.2022.206
Tenna, A., Stenehjem, E., Margoles, L., Kacha, E., Blumberg, H. and Kempker, R. (2013) Infection Control Knowledge, Attitudes, and Practices among Healthcare Workers in Addis Ababa, Ethiopia. Infection Control & Hospital Epidemiology, 34, 1289-1286. https://doi.org/10.1086/673979
Huttinger, A., Dreibelbis, R., Kayigamba, F., Ngabo, F., Mfura, L., Merryweather, B., Cardon, A. and Moe, C. (2017) Water, Sanitation and Hygiene Infrastructure and Quality in Rural Healthcare Facilities in Rwanda. BMC Health Services Research, 17, Article No. 517. https://doi.org/10.1186/s12913-017-2460-4
Anderson, D.M., Cronk, R., Fejfar, D., Pak, E., Cawley, M. and Bartram, J. (2021) Safe Healthcare Facilities: A Systematic Review on the Costs of Establishing and Maintaining Environmental Health in Facilities in Low- and Middle-Income Countries. International Journal of Environmental Research and Public Health, 18, Article No. 817. https://doi.org/10.3390/ijerph18020817
WHO (2009) Guidelines on Hand Hygiene in Healthcare: First Global Patient Safety Challenge Clean Care Is Safer Care. https://pubmed.ncbi.nlm.nih.gov/23805438/
Wiedenmayer, K., Msamba, V.S., Chilunda, F., Kiologwe, J.C. and Seni, J. (2020) Impact of Hand Hygiene Intervention: A Comparative Study in Health Care Facilities in Dodoma Region, Tanzania using WHO Methodology. Antimicrobial Resistance and Infection Control, 9, 2-9. https://doi.org/10.1186/s13756-020-00743-4
Ola-Adisa, E.O., Mangden, Y.E., Sati, Y.C. and Adisa, J.O. (2015) Knowledge, Attitudes/Beliefs and Practices in Medical Waste Management—An Appraisal of Jos North LGA, Plateau State, Nigeria. International Journal of Research in Humanities and Social Studies, 2, 43-56. https://irepos.unijos.edu.ng/jspui/bitstream/123456789/1723/1/5-1.pdf
The United Republic of Tanzania (2017) The National Action Plan on Antimicrobial Resistance (2017-2022). Ministry of Health Community Development Gender Elderly and Children (MHCDGEC), Ministry of Agriculture, Livestock and Fisheries (MALF).
Batagarawa, R.L. (2011) Sustainability Appraisal of Waste Management in Nigeria: Development and Evaluation of an Index Based Tool. Department of Civil Engineering, University of Portsmouth, Portsmouth.
Lowe, H., Woodd, S., Lange, I.L., Janjanin, S., Barnet, J. and Graham, W. (2021) Challenges and Opportunities for Infection Prevention and Control in Hospitals in Conflict-Affected Settings: A Qualitative Study. Conflict and Health, 15, Article No. 94. https://doi.org/10.1186/s13031-021-00428-8
Ogonsila, F.T. and Shaheen, M. (2020) Challenges Regarding the Control of Environmental Source of Contamination in Healthcare Settings in Low- and Middle-Income Countries. Antimicrobial Resistance and Infection Control, 9, Article No. 81. https://doi.org/10.1186/s13756-020-00747-0
Abdella, N., Tefera, M., Eredie, A., Landers, T., Malefia, Y. and Alene, K. (2014) Hand Hygiene Compliance and Associated Factors among Health Care Providers in Gondar University Hospital, Gondar, North West Ethiopia. BMC Public Health, 14, 190-203. https://doi.org/10.1186/1471-2458-14-96
Gizaw, G., Alemu, Z. and Kibret, K. (2015) Assessment of Knowledge and Practice of Health Workers towards Tuberculosis Infection Control and Associated Factors in Public Health Facilities of Addis Ababa, Ethiopia: A Cross-Sectional Study. Archives of Public Health, 73, Article No. 15. https://doi.org/10.1186/s13690-015-0062-3
Shrestha, A., Bhattarai, D., Thapa, B., Basel, P. and Wagle, R. (2017) Healthcare Workers’ Knowledge, Attitudes and Practices on Tuberculosis Infection Control, Nepal. BMC Infectious Diseases, 17, Article No. 724. https://doi.org/10.1186/s12879-017-2828-4
Tantum, L.K., Gilstad, J.R., Bolay, F.K., Horng, L.M., Simpson, A.D., Letizia, A.G., Styczynski, A.R., Luby, S.P. and Ronan, F.A. (2021) Opportunities for Sustainable Hand Hygiene Interventions in Rural Liberian Hospitals. International Journal of Environmental Research and Public Health, 18, Article No. 8588. https://doi.org/10.3390/ijerph18168588
Kayiwa, D., Mugambe, R.K., Mselle, J.S., Isunju, J.B., Ssempebwa, J.C., Wafula, S.T., et al. (2020) Assessment of Water, Sanitation and Hygiene Service Availability in Healthcare Facilities in the Greater Kampala Metropolitan Area, Uganda. BMC Public Health, 20, Article No. 1767. https://doi.org/10.1186/s12889-020-09895-9
Ataiyero, Y., Dyson, J. and Graham, M. (2022) An Observational Study of Hand Hygiene Compliance of Surgical Healthcare Workers in a Nigerian Teaching Hospital. Journal of Infection Preventions, 23, 59-66. https://doi.org/10.1177/17571774211066774
Dancer, S.J. (2009) The Role of Environmental Cleaning in the Control of Hospital Acquired Infection. Journal of Hospital Infection, 73, 378-385. https://doi.org/10.1016/j.jhin.2009.03.030
Opollo, M.S., Otim, T.S., Kizito, W., Thekkur, P., Kumar, A.M., Kitutu, F.E., Kisame, R. and Zolfo, M. (2021) Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done. Tropical Medicine and Infectious Disease, 6, Article No. 69. https://doi.org/10.3390/tropicalmed6020069
Wasswa, P., Nalwadda, C.K., Buregyeya, E., Gitta, S.N., Anguzu, P. and Nuwaha, F. (2015) Implementation of Infection Control in Health Facilities in Arua District, Uganda: Cross Sectional Study. BMC Infectious Diseases, 15, Article No. 268. https://doi.org/10.1186/s12879-015-0999-4
Assadian, O., Harbarth, S., Vos, M., Knobloch, J.K., Asensio, A. and Widmer, A.F. (2021) Practical Recommendations for Routine Cleaning and Disinfection Procedures in Healthcare Institutions: A Narrative Review. Journal of Hospital Infection, 113, 104-114. https://doi.org/10.1016/j.jhin.2021.03.010
Dancer, S.J. (2017) Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination. Clinical Microbiology Reviews, 27, 665-690. https://doi.org/10.1128/CMR.00020-14
Peters, A., Otter, J., Moldovan, A., Parneix, P., Voss, A. and Pittet, D. (2018) Keeping Hospitals Clean and Safe without Breaking the Bank; Summary of the Healthcare Cleaning Forum. Antimicrobial Resistance & Infection Control, 7, 132-141. https://doi.org/10.1186/s13756-018-0420-3
WHO (2010) Technical Options for Excreta Disposal in Emergencies. Technical notes on Drinking Water, Sanitation and Hygiene in Emergencies. World Health Organization, Geneva.
Mitze, T., Kosfeld, R., Rode, J. and Wälde, K. (2020) Face Masks Considerably Reduce COVID-19 Cases in Germany. Proceedings of the National Academy of Sciences, 117, 32293-32301. https://doi.org/10.1073/pnas.2015954117
Dharmadhikari, A.S., Mphahlele, M., Stoltz, A., Venter, K., Mathebula, R., Masotla, T. and Nardell, E.A. (2012) Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis: Impact on Infectivity of Air on a Hospital Ward. American Journal of Respiratory and Critical Care Medicine, 185, 1104-1109. https://doi.org/10.1164/rccm.201107-1190OC https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19-masks
Mejjad, N., Cherif, E.K., Rodero, A., Krawczyk, D.A., Kharraz J., Moumen A., Laqbaqbi, M., Anna, D. and Fekri, A. (2021) Disposal Behavior of Used Masks during the COVID-19 Pandemic in the Moroccan Community: Potential Environmental Impact. International Journal of Environmental Research and Public Health, 18, Article No. 4382. https://doi.org/10.3390/ijerph18084382