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Evaluating the foundations that help avert antimicrobial resistance: Performance of essential water sanitation and hygiene functions in hospitals and requirements for action in Kenya


Autoři: Michuki Maina aff001;  Olga Tosas-Auguet aff003;  Jacob McKnight aff003;  Mathias Zosi aff001;  Grace Kimemia aff001;  Paul Mwaniki aff001;  Constance Schultsz aff002;  Mike English aff001
Působiště autorů: Health Services Research Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya aff001;  Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands aff002;  Nuffield Department of Medicine, University of Oxford—Oxford, United Kingdom aff003;  Amsterdam Institute for Global Health and Development- Amsterdam, The Netherlands aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0222922

Souhrn

Background

Water Sanitation and Hygiene (WASH) in healthcare facilities is critical in the provision of safe and quality care. Poor WASH increases hospital-associated infections and contributes to the rise of antimicrobial resistance (AMR). It is therefore essential for governments and hospital managers to know the state of WASH in these facilities to set priorities and allocate resources.

Methods

Using a recently developed survey tool and scoring approach, we assessed WASH across four domains in 14 public hospitals in Kenya (65 indicators) with specific assessments of individual wards (34 indicators). Aggregate scores were generated for whole facilities and individual wards and used to illustrate performance variation and link findings to specific levels of health system accountability. To help interpret and contextualise these scores, we used data from key informant interviews with hospital managers and health workers.

Results

Aggregate hospital performance ranged between 47 and 71% with five of the 14 hospitals scoring below 60%. A total of 116 wards were assessed within these facilities. Linked to specific domains, ward scores varied within and across hospitals and ranged between 20% and 80%. At ward level, some critical indicators, which affect AMR like proper waste segregation and hand hygiene compliance activities had pooled aggregate scores of 45 and 35% respectively. From 31 interviews conducted, the main themes that explained this heterogenous performance across facilities and wards included differences in the built environment, resource availability, leadership and the degree to which local managers used innovative approaches to cope with shortages.

Conclusion

Significant differences and challenges exist in the state of WASH within and across hospitals. Whereas the senior hospital management can make some improvements, input and support from the national and regional governments are essential to improve WASH as a basic foundation for averting nosocomial infections and the spread of AMR as part of safe, quality hospital care in Kenya.

Klíčová slova:

Antimicrobial resistance – Health care facilities – Hygiene – Kenya – Nosocomial infections – Nurses – Pediatrics – Sanitation


Zdroje

1. Hans Jørn Kolmos. Health Care Associated Infections: Sources and Routes of Transmission. In: Infection Control–Updates Croatia2012 [cited 2017 2nd November ]. Available from: http://cdn.intechopen.com/pdfs-wm/28876.pdf.

2. Weber N, Patrick M, Hayter A, Martinsen AL, Gelting R. A conceptual evaluation framework for the water and sanitation for health facility improvement tool (WASH FIT). Journal of Water, Sanitation and Hygiene for Development. 2019. doi: 10.2166/washdev.2019.090

3. World Health Organisation. Safe management of waste from health care activities 2014 [cited 2018 18th December ]. Available from: http://www.who.int/water_sanitation_health/publications/wastemanag/en/.

4. World Health Organization & United Nations Childrens Fund (UNICEF) WASH in health care facilities: global baseline report 2019. Geneva: 2019.

5. World Health Organization, UNICEF. Water and Sanitation for Health Facility Improvement Tool (WASH FIT): a practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Geneva: 2017 9241511699.

6. Adams J, Bartram J, Chartier Y. Essential environmental health standards in health care: World Health Organization; 2008.

7. World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level: World Health Organization; 2016.

8. Maina M, McKnight J, Tosas-Auguet O, Zosi M, Kimemia G, Mwaniki P, et al. Extending the use of the World Health Organisations’ Water Sanitation and Hygiene assessment tool for surveys in hospitals–from WASH-Fit to WASH-FAST. 2019:Forthcoming.

9. English M, Ayieko P, Nyamai R, Were F, Githanga D, Irimu G. What do we think we are doing? How might a clinical information network be promoting implementation of recommended paediatric care practices in Kenyan hospitals? Health Research Policy and Systems. 2017;15(1):4. doi: 10.1186/s12961-017-0172-1 28153020

10. Weber Nicole, Martinsen Andrea L, Sani Amidou, Assigbley Elom Kokou Eric, Azzouz Chedly, Hayter Arabella, et al. Strengthening Healthcare Facilities Through Water, Sanitation, and Hygiene (WASH) Improvements: A Pilot Evaluation of “WASH FIT” in Togo. Health Security. 2018;16(S1):S-54–S-65. doi: 10.1089/hs.2018.0042 30480501

11. R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: 2017.

12. QSR International Pty Ltd. NVivo qualitative data analysis Software;. 12 ed2018.

13. United Nations General Assembly. Transforming our world: the 2030 Agenda for Sustainable Development. New York: United Nations. 2015;(1).

14. World Health Organization. Water, sanitation and hygiene in health care facilities: practical steps to achieve universal access to quality care. Geneva: 2019.

15. World Health Organisation. Global strategy, burden of disease, and evidence and action priorities, Workshop Report. United Kingdom: 2016.

16. Ichoho JW. Implementation of outsourcing strategy at the Nairobi Hospital, Kenya. [Unpublished MBA Project]. In press 2013.

17. Amirabadi Zadeh H, Maleki MR, Salehi M, Watankhah S. An Exploration of the Role of Hospital Committees to Enhance Productivity. Global journal of health science. 2016;8(3):199–209. Epub 2015/10/27. doi: 10.5539/gjhs.v8n3p199 26493440; PubMed Central PMCID: PMC4804034.

18. Ministry of Health Kenya. National and county health budget analysis FY 2016/17. 2017.

19. Barasa E, Rogo K, Mwaura N, Chuma J. Kenya National Hospital Insurance Fund Reforms: Implications and Lessons for Universal Health Coverage. Health Systems & Reform. 2018;4(4):346–61. doi: 10.1080/23288604.2018.1513267 30398396


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