Methods: The project was funded by the German ESTHER initiative and carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in the Arsi zone of Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and right after the intervention, which consisted of a four day workshop and the provision of hand hygiene products. A second follow up was conducted 3 months after external funding of the activities ran out. Hand hygiene compliance is expressed as the proportion of predefined opportunities met by hand hygiene actions. Furthermore, healthcare workers’ knowledge about hand hygiene was assessed before and after the intervention.
Data was analyzed using SPSS version 20 and a χ2 statistic test was used to compare rates of baseline and post-intervention hand hygiene adherence. Knowledge questionnaire scores were calculated as the sum of correct answers. Results were indicated as medians and were assessed by Wilcoxon rank-sum test.
Results: We observed a total of 2904, 2923 and 2244 hand hygiene opportunities at baseline, first and second follow-up, respectively. There was significant enhancement in hand hygiene compliance from 1.4% at baseline to 11.4% in the first follow-up (p<0.001). The higher level of hand hygiene compliance persisted in the second follow-up (13.2%), which shows that hospital authorities were capable to sustain compliance after termination of international funding. The median knowledge score increased from 13 (IQR 11-15) at baseline to 17 (IQR 15-18) after the training (p<0.001).
Conclusion: The implementation of WHO multimodal hand hygiene improvement strategy was feasible in Ethiopia as a resource-constrained setting. Furthermore the improved level of hand hygiene was sustainable after termination of external funding and handover of responsibility to hospital authorities.
T. Beyene, None
F. Pfäfflin, None
N. Schmidt, None
T. Feldt, None
D. Häussinger, None