Evidence map›Paper›PMID 33023531›Full record

Observational studyBMC pregnancy and childbirth2020

Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria.

Yolisa Nalule, Helen Buxton, Erin Flynn, Olutunde Oluyinka, Stephen Sara, Oliver Cumming, Robert Dreibelbis

Open access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.4field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 20 citations in OpenAlex.

  1. Trial
  2. Article
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  6. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 3 countries.

Yolisa NaluleDisease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
Helen BuxtonDisease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
Erin FlynnInfection and Immunity, South Australian Health and Medical Research Institute, Adelaide, 5000, Australia.
Olutunde OluyinkaMaternal and Child Survival Program (MCSP)/Save the Children Nigeria, Abuja, Nigeria.
Stephen SaraMaternal and Child Survival Program (MCSP)/Save the Children US, Washington, DC, 20036, USA.
Oliver CummingDisease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
Robert DreibelbisDisease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK. Robert.Dreibelbis@lshtm.ac.uk.
London School of Hygiene & Tropical Medicine · GBSave the Children · USSouth Australian Health and Medical Research Institute · AUUniversity of London · GB

Funding

United States Agency for International Development AID-OAA-A-14-00028
6 · The paper itself

Abstract

backgroundNewborns delivered in healthcare facilities in low- and middle-income countries are at an increased risk of healthcare associated infections. Facility-based studies have focused primarily on healthcare worker behaviour during labour & delivery with limited attention to hygiene practices in post-natal care areas and largely ignore the wide variety of actors involved in maternal and neonatal care.

methodsThis exploratory mixed-methods study took place in six healthcare facilities in Nigeria where 31 structured observations were completed during post-natal care, discharge, and the first 6 hours after return to the home. Frequency of hand hygiene opportunities and hand hygiene actions were assessed for types of patient care (maternal and newborn care) and the role individuals played in caregiving (healthcare workers, cleaners, non-maternal caregivers). Qualitative interviews with mothers were completed approximately 1 week after facility discharge.

resultsMaternal and newborn care were performed by a range of actors including healthcare workers, mothers, cleaners and non-maternal caregivers. Of 291 hand hygiene opportunities observed at health facilities, and 459 observed in home environments, adequate hand hygiene actions were observed during only 1% of all hand hygiene opportunities. Adequate hand hygiene prior to cord contact was observed in only 6% (1/17) of cord contact related hand hygiene opportunities at healthcare facilities and 7% (2/29) in households. Discharge advice was infrequent and not standardised and could not be remembered by the mother after a week. Mothers reported discomfort around telling non-maternal caregivers to practice adequate hand hygiene for their newborn.

conclusionsIn this setting, hand hygiene practices during post-natal care and the first 6 hours in the home environment were consistently inadequate. Effective strategies are needed to promote safe hand hygiene practices within the post-natal care ward and home in low resource, high-burden settings. Such strategies need to target not just mothers and healthcare workers but also other caregivers.

Indexed as

AdultCaregiversContinuity of Patient CareCross InfectionFathersFemaleGuideline AdherenceHand HygieneHealth FacilitiesHealth PersonnelHumansInfant, NewbornInfection ControlMaleMothersNigeriaHand hygieneHealthcare associated infectionsInfection prevention and controlMaternal infectionNeonatal infectionNewborn careNigeriaPost-natal

Identifiers

PMID33023531
PMCPMC7541299
OpenAlexW3092458267

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.