ArticleGlobal health action2019
An invisible workforce: the neglected role of cleaners in patient safety on maternity units.
Article in Global health action, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review.Antimicrobial resistance and infection control · 2025Pooled it
- Musculoskeletal disorders among older hospital cleaners: a systematic review of prevalence and risk factors.Frontiers in public health · 2025Pooled it
- Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review.Antimicrobial resistance and infection control · 2021Pooled it
- A clinical trial evaluation of handwashing products and educational resources to improve hand hygiene in paediatric patients and school children.Frontiers in public health · 2024Trial
- Experiencing geriatric rehabilitation through the older adult's eyes: a mixed methods evaluation study of a virtual reality intervention among healthcare professionals.Age and ageing · 2026Article
- Enhancing hand hygiene compliance in healthcare environmental services staff: a systematic approach to indicator development.Antimicrobial resistance and infection control · 2025Article
- Evaluation of the feasibility, appropriateness, and acceptability of an environmental cleaning program improvement toolkit at a tertiary care hospital in Nigeria.Antimicrobial resistance and infection control · 2025Article
- Prevalence and risk factors of work-related musculoskeletal disorders among older hospital cleaners in Wenzhou, China.Frontiers in public health · 2025Article
- Environmental cleaning barriers and mitigation measures identified through two initiatives in four countries, 2018-2023: a commentary.Antimicrobial resistance and infection control · 2024Article
- Infection prevention and control: knowledge, practices and associated factors among cleaners at a National Referral Hospital in Uganda.Infection prevention in practice · 2024Article
- Infection prevention and control and related practices in African neonatal units: The Pan-African neonatal care assessment study (PANCAS).International journal of hygiene and environmental health · 2024Article
- Assessing the impact of a cleaning programme on environmental hygiene in labour and neonatal wards: an exploratory study in The Gambia.Antimicrobial resistance and infection control · 2024Article
- Analysis of water, sanitation, and hygiene facilities using the WASH-FIT approach and its relation to patient satisfaction and maternal mortality at hospitals in Indonesia.Frontiers in public health · 2024Article
- Hand hygiene compliance and associated factors among healthcare workers in selected tertiary-care hospitals in Bangladesh.The Journal of hospital infection · 2023Article
- Multimodal environmental cleaning strategies to prevent healthcare-associated infections.Antimicrobial resistance and infection control · 2023Article
- Article
- Infection Prevention and Control Practices and Associated Factors Among Healthcare Cleaners in Gondar City: An Analysis of a Cross-Sectional Survey in Ethiopia.Risk management and healthcare policy · 2023Article
- Hepatitis B Vaccination Coverage among Bangladeshi Healthcare Workers: Findings from Tertiary Care Hospitals.Vaccines · 2022Article
- "More than just cleaning": A qualitative descriptive study of hospital cleaning staff as patient caregivers.International journal of nursing studies advances · 2022Article
- Evidence of Antimicrobial Resistance from Maternity Units and Labor Rooms: A Water, Sanitation, and Hygiene (WASH) Study from Gujarat, India.Healthcare (Basel, Switzerland) · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 5 countries.
Funding
Abstract
Hospital cleaning has been shown to impact on rates of healthcare-associated infections (HCAIs) and good environmental hygiene is critical to quality care, yet those tasked with the role of ensuring a safe and clean environment often go unrecognised as members of the healthcare workforce. Sepsis is a leading cause of maternal and newborn death, a significant proportion of these cases are estimated to be due to HCAIs. Deliveries in health institutions have now reached 75% globally, and in low and middle income countries the corresponding increased pressure on facilities has impacted both quality of care provided and quality of the birth environment in terms of infection prevention and control (IPC) and HCAIs. The paper discusses the neglected role of health facility cleaners, providing evidence from the literature and from needs assessments conducted by The Soapbox Collaborative and partners in Bangladesh, India, The Gambia and Zanzibar. While not the primary focus of the assessments, common themes emerged consistently pointing to institutional neglect of cleaning and cleaners. The paper argues that low status within facilities, wider societal marginalisation, lack of training, and poor pay and working conditions contribute to the lack of prioritisation placed on health facility environmental hygiene. With increased international attention focused towards health facility water, sanitation and hygiene and a growing focus on IPC, now is the time to address the neglect of this frontline healthcare workforce. We propose that provision of and improved training can enable the recognition of the valuable role cleaning staff play, as well as equipping these staff with the tools required to perform their job to the highest standard. In addition to training, wider systems changes are necessary to establish improvements in environmental hygiene and the role of cleaning staff, including addressing resource availability, supportive supervision, and an increased emphasis on preventative healthcare.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.