Coronavirus Disease-19 Outbreak: Barriers to Hand Hygiene Practices Among Healthcare Professionals in Sub-Saharan Africa

BACKGROUND: Hand hygiene practice entails hand washing, which is simple, cost-effective, and one of the first lines of defense in ceasing the spread of the current pandemic. This narrative review of published studies is conducted to highlight factors impacting hand hygiene practice and identify evidence-based strategies for improvement in sub-Saharan Africa. METHODS: The literature search strategy covered printed and online sources, including manual library search (PubMed), Embase, Medline, and Cochrane Library. For papers written in English and published in the last ten years. A systematic analysis of available data was subsequently performed based on the review questions. RESULTS: An estimated 134 articles were found online, and thirty-two articles utilized in the final analysis. Overall, hand hygiene betides with low compliance rates in developing countries. The calculated compliance rate was 20.49%. The challenges identified were the poverty of awareness and scientific knowledge concerning hand hygiene, infrastructural deficit including lack of access to clean and potable water, soap, hand rub gel, misconceptions regarding hand hygiene practice, etc. CONCLUSION: Healthcare-associated infections draw increasing attention from all and sundry due to the growing recognition that most of these are preventable. Free evidence-based practice suggests that strict adherence to hand hygiene reduces the risk of cross-transmission of infections and especially in the COVID-19 pandemic era. The challenges identified in this review are consistent with the findings of studies conducted elsewhere. With “Clean Care is Safer Care” as a prime list of the World Health Organization’s global initiative on patient safety programs; therefore, it is high time for developing countries to formulate the much-needed policies for implementing basic infection prevention practices in our healthcare settings.

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Evaluating Antipoverty Transfer Programmes in Latin America and Sub-Saharan Africa. Better Policies? Better Politics?

Journal of Globalization and Development ◽

10.1515/jgd-2014-0006 ◽

2015 ◽

Vol 6 (1) ◽

Cited By ~ 10

Author(s):

Armando Barrientos ◽

Juan Miguel Villa

Keyword(s):

Developing Countries ◽

Latin America ◽

Development Policy ◽

Sub Saharan Africa ◽

Evidence Based ◽

Political Factors ◽

Evaluation Practice ◽

Complementary Role ◽

Sub Saharan

AbstractTwo broad explanations can be offered for the incidence of impact evaluations in antipoverty transfer programmes in developing countries. The first, and arguably dominant, explanation suggests this is a consequence of a shift towards evidence-based development policy. A second explanation emphasises the complementary role of policy competition and political factors in motivating evaluations. The paper assesses the relevance of the latter in Latin America and sub-Saharan Africa through (i) a comparison of evaluation practice and (ii) the analysis of a new database of flagship antipoverty transfer programmes.

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When Should the Emphasis on Schistosomiasis Control Move to Elimination?

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed3030085 ◽

2018 ◽

Vol 3 (3) ◽

pp. 85 ◽

Cited By ~ 12

Author(s):

W. Secor ◽

Daniel Colley

Keyword(s):

South America ◽

Operational Research ◽

Sub Saharan Africa ◽

World Health ◽

Evidence Based ◽

Clean Water ◽

Schistosomiasis Control ◽

The World ◽

The Caribbean ◽

Sub Saharan

The stated goal of the World Health Organization’s program on schistosomiasis is paraphrased as follows: to control morbidity and eliminate transmission where feasible. Switching from a goal of controlling morbidity to interrupting transmission may well be currently feasible in some countries in the Caribbean, some areas in South America, northern Africa, and selected endemic areas in sub-Saharan Africa where there have been improvements in sanitation and access to clean water. However, in most of sub-Saharan Africa, where programmatic interventions still consist solely of annual mass drug administration, such a switch in strategies remains premature. There is a continued need for operational research on how best to reduce transmission to a point where interruption of transmission may be achievable. The level of infection at which it is feasible to transition from control to elimination must also be defined. In parallel, there is also a need to develop and evaluate approaches for achieving and validating elimination. There are currently neither evidence-based methods nor tools for breaking transmission or verifying that it has been accomplished. The basis for these statements stems from numerous studies that will be reviewed and summarized in this article; many, but not all of which were undertaken as part of SCORE, the Schistosomiasis Consortium for Operational Research and Evaluation.

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Determinants and Effects of Adolescent Substance Use in Africa: A Systematic Review Protocol

10.21203/rs.3.rs-37924/v1 ◽

2020 ◽

Author(s):

Sandra Jumbe ◽

Tony Mwenda-Kamninga ◽

Isaac Mwalwimba ◽

Ukwuori-Gisela Kalu

Keyword(s):

Systematic Review ◽

Substance Use ◽

Associated Factors ◽

Sub Saharan Africa ◽

World Health ◽

Adolescent Substance Use ◽

Health Concern ◽

Cochrane Library ◽

Adolescent Substance ◽

Sub Saharan

Abstract Background: Substance use among adolescents continues to be a growing major public health concern in Africa. Recent studies infer an overall estimated prevalence of 42% among adolescents in sub-Saharan Africa. Unfortunately, this phenomenon is not adequately documented across many settings in the continent despite known negative health and social consequences on affected individuals and their communities. Little is known about the social context of substance use in Africa among this population. Our aim is to conduct a systematic review to explore determinants and associated factors that influence adolescent substance use and the effects of substance use in sub-Saharan Africa.Methods: The Cochrane Library, PubMed, EMBASE, African Journals Online, Google Scholar, Scopus, Global Health, PsychINFO, Web of Science, and the World Health Organization (WHO) regional databases will be searched for population-based observational studies reporting on the prevalence of substance use of adolescents (age 10 - 19 years) across Africa. Search dates will be from January 2000 to December 2019. Data will be extracted from eligible publications, using a data extraction tool developed for this study. A random effects meta-analysis will be conducted to pool determinants and effects (at 95% confidence interval) of estimated substance abuse among adolescents. Alternative visual and statistical approaches will be adopted instead of traditional meta-analytic approaches where necessary.Discussion: This systematic review will describe the range of determinants and associated factors that have been found to significantly influence substance use in this population group over the last two decades. Additionally, the review will also describe the possible effects of substance use among adolescents. Documenting this evidence is important as it can potentially be used to inform comprehensive interventions and treatment programmes that are targeted at adolescents and their parents in these settings.Systematic review registration: registered on PROSPERO; registration number tbc.

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Health financing for universal health coverage in Sub-Saharan Africa: a systematic review

Global Health Research and Policy ◽

10.1186/s41256-021-00190-7 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Susan C. Ifeagwu ◽

Justin C. Yang ◽

Rosalind Parkes-Ratanshi ◽

Carol Brayne

Keyword(s):

Systematic Review ◽

Health Services ◽

Universal Health Coverage ◽

Health Financing ◽

Sub Saharan Africa ◽

World Health ◽

Cochrane Library ◽

Health Coverage ◽

Sub Saharan ◽

Universal Health

Abstract Background Universal health coverage (UHC) embedded within the United Nations Sustainable Development Goals, is defined by the World Health Organization as all individuals having access to required health services, of sufficient quality, without suffering financial hardship. Effective strategies for financing healthcare are critical in achieving this goal yet remain a challenge in Sub-Saharan Africa (SSA). This systematic review aims to determine reported health financing mechanisms in SSA within the published literature and summarize potential learnings. Methods A systematic review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. On 19 to 30 July 2019, MEDLINE, EMBASE, Web of Science, Global Health Database, the Cochrane Library, Scopus and JSTOR were searched for literature published from 2005. Studies describing health financing approaches for UHC in SSA were included. Evidence was synthesised in form of a table and thematic analysis. Results Of all records, 39 papers were selected for inclusion. Among the included studies, most studies were conducted in Kenya (n = 7), followed by SSA as a whole (n = 6) and Nigeria (n = 5). More than two thirds of the selected studies reported the importance of equitable national health insurance schemes for UHC. The results indicate that a majority of health care revenue in SSA is from direct out-of-pocket payments. Another common financing mechanism was donor funding, which was reported by most of the studies. The average quality score of all studies was 81.6%, indicating a high appraisal score. The interrater reliability Cohen’s kappa score, κ=0.43 (p = 0.002), which showed a moderate level of agreement. Conclusions Appropriate health financing strategies that safeguard financial risk protection underpin sustainable health services and the attainment of UHC. It is evident from the review that innovative health financing strategies in SSA are needed. Some limitations of this review include potentially skewed interpretations due to publication bias and a higher frequency of publications included from two countries in SSA. Establishing evidence-based and multi-sectoral strategies tailored to country contexts remains imperative.

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Unintended Pregnancies Among HIV Positive Women In Sub Saharan Africa: A Scoping Review Protocol

10.21203/rs.3.rs-970739/v1 ◽

2021 ◽

Author(s):

Oguntade Racheal Tomilola ◽

Ojewole Elizabeth Bolanle ◽

Ogunrombi Modupe Olufunmi

Keyword(s):

Scoping Review ◽

Grey Literature ◽

Well Being ◽

Sub Saharan Africa ◽

World Health ◽

Cochrane Library ◽

Hiv Positive ◽

Unintended Pregnancies ◽

Hiv Positive Women ◽

Sub Saharan

Abstract Background: Unintended pregnancies pose a severe threat to the well-being of HIV-positive women and their unborn children. Factors contributing to the high incidence of unintended pregnancies include contraceptive failure, low uptake of contraceptives, and misuse of contraceptives. Despite various contraceptive options, an increased incidence of unintended pregnancies is rampant among HIV-positive women in the region of sub-Saharan Africa. This study seeks to present evidence of unintended pregnancies among women living with HIV in sub-Saharan Africa, including those using contraceptives.Method: This study entails a scoping review to survey and interrogate the literature to provide evidence for the incidence of unintended pregnancies among HIV-positive women in sub-Saharan Africa. A proposed framework by Arksey and O'Malley will guide this scoping review. Peer-reviewed articles which address the research questions will constitute the main search. Electronic databases such as EBSCOhost, Cochrane Library, World of Science, World Health Organization (WHO) library databases, Science Direct, Google Scholar PubMed, and grey literature search will be involved. References list from studies included will also be searched. The investigation of articles will be done employing keywords from the studies included. The inclusion and exclusion criteria will guide two separate reviewers with the screening of abstracts and full papers. To summarize the findings from this review, thematic content analysis will be done using NVivo version 11.Discussion: We expect that this review will add to the current body of knowledge on the incidence of unintended pregnancies among HIV-positive women, identify gaps for further future research, and show evidence that may contribute to strengthening the health system's regulations, guidelines, and policies that may help prevent unintended pregnancies among HIV positive women. Registration DOI: 10.17605/OSF.IO/EY3R5

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Improving Hand Hygiene Practices in a Rural Hospital in Sub-Saharan Africa

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.71 ◽

2016 ◽

Vol 37 (7) ◽

pp. 834-839 ◽

Cited By ~ 12

Author(s):

Ian C. Holmen ◽

Celestin Seneza ◽

Berthine Nyiranzayisaba ◽

Vincent Nyiringabo ◽

Mugisha Bienfait ◽

...

Keyword(s):

Hand Hygiene ◽

Low Income ◽

Rural Hospital ◽

Sub Saharan Africa ◽

World Health ◽

Post Intervention ◽

Improve Hand Hygiene ◽

Quasi Experimental ◽

Sub Saharan

OBJECTIVETo improve hand hygiene (HH) compliance among physicians and nurses in a rural hospital in sub-Saharan Africa (SSA) using the World Health Organization’s (WHO’s) Guidelines on Hand Hygiene in Health Care.DESIGNThis study was a quasi-experimental design divided into 4 phases: (1) preparation of materials and acquisition of the hospital administration’s support, (2) baseline evaluation, (3) intervention, and (4) follow-up evaluation.SETTINGA 160-bed, non-referral hospital in Gitwe, RwandaPARTICIPANTSA total of 12 physicians and 54 nurses participated in this study.METHODSThe intervention consisted of introducing locally produced alcohol-based hand rub (ABHR); educating healthcare workers (HCWs) on proper HH practice; providing pocket-sized ABHR bottles for HCWs; placing HH reminders in the workplace; and surveying HCWs at surrounding health centers regarding HH compliance barriers. Hand hygiene infrastructure, compliance, and knowledge were assessed among physicians and nurses using baseline observations and a follow-up evaluation survey.RESULTSOverall, HH compliance improved from 34.1% at baseline to 68.9% post intervention (P<.001), and HH knowledge was significantly enhanced (P<.001). The 3 departments included in this study had only 1 sink for 29 patient rooms, and 100% of HH opportunities used ABHR. Hand hygiene compliance was significantly higher among physicians than nurses both before and after the intervention. All measures of HH compliance improved except for “after body fluid exposure,” which was 51.7% before intervention and 52.8% after intervention (P>.05).CONCLUSIONHand hygiene campaigns using WHO methods in SSA have been implemented exclusively in large, referral hospitals. This study shows that an HH program using the WHO tools successfully improved HH in a low-income, rural hospital in SSA.Infect Control Hosp Epidemiol2016;37:834–839

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Effect of postpartum depression on exclusive breast-feeding practices in sub-Saharan Africa countries: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03535-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Demelash Woldeyohannes ◽

Yohannes Tekalegn ◽

Biniyam Sahiledengle ◽

Dejene Ermias ◽

Tekele Ejajo ◽

...

Keyword(s):

Postpartum Depression ◽

Breast Feeding ◽

Meta Analysis ◽

Feeding Practices ◽

Sub Saharan Africa ◽

World Health ◽

Cochrane Library ◽

Inclusion Criteria ◽

Exclusive Breast Feeding ◽

Sub Saharan

Abstract Background Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries. Methods PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Result A total of 1482 published articles and gray literatures were retrieved from different databases. Additional articles were identified from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30,021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). Conclusion In Sub Saharan Africa, the prevalence of postpartum depression was lower than the report of World Health Organization for developing Country in 2020. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.

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Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040607 ◽

2019 ◽

Vol 16 (4) ◽

pp. 607 ◽

Cited By ~ 6

Author(s):

Cam Le ◽

Erik Lehman ◽

Thanh Nguyen ◽

Timothy Craig

Keyword(s):

Quality Assurance ◽

Hand Hygiene ◽

Healthcare Workers ◽

Medical Center ◽

Compliance Rate ◽

World Health ◽

Limiting Factors ◽

Cultural Attitudes ◽

Knowledge And Attitude ◽

Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

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