SynthesisBMC health services research2020
Birth attendants' hand hygiene compliance in healthcare facilities in low and middle-income countries: a systematic review.
Synthesis in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Hand hygiene compliance among healthcare workers at a tertiary maternity hospital in Sierra Leone: a cross-sectional study.Antimicrobial resistance and infection control · 2026Article
- Safe and respectful? Birth attendants' hand hygiene compliance and its determinants using nationally representative data from Kenya, Malawi and Nepal.Antimicrobial resistance and infection control · 2025Article
- Article
- A controlled before-and-after study of a multi-modal intervention to improve hand hygiene during the peri-natal period in Cambodia.Scientific reports · 2022Article
- Hand Hygiene Social Norms Among Healthcare Workers During Early COVID-19: Results of a Global Survey.International journal of public health · 2022Article
- Going Electronic: Venturing Into Electronic Monitoring Systems to Increase Hand Hygiene Compliance in Philippine Healthcare.Frontiers in pharmacology · 2022Article
- Hand hygiene during facility-based childbirth in Cambodia: a theory-driven, mixed-methods observational study.BMC pregnancy and childbirth · 2021Observational
- Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia.International journal of environmental research and public health · 2021Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundWith an increasing number of women delivering in healthcare facilities in Low and Middle Income Countries (LMICs), healthcare workers' hand hygiene compliance on labour wards is pivotal to preventing infections. Currently there are no estimates of how often birth attendants comply with hand hygiene, or of the factors influencing compliance in healthcare facilities in LMICs.
methodsWe conducted a systematic review to investigate the a) level of compliance, b) determinants of compliance and c) interventions to improve hand hygiene during labour and delivery among birth attendants in healthcare facilities of LMICs. We also aimed to assess the quality of the included studies and to report the intra-cluster correlation for studies conducted in multiple facilities.
resultsWe obtained 797 results across four databases and reviewed 71 full texts. Of these, fifteen met our inclusion criteria. Overall, the quality of the included studies was particularly compromised by poorly described sampling methods and definitions. Hand hygiene compliance varied substantially across studies from 0 to 100%; however, the heterogeneity in definitions of hand hygiene did not allow us to combine or compare these meaningfully. The five studies with larger sample sizes and clearer definitions estimated compliance before aseptic procedures opportunities, to be low (range: 1-38%). Three studies described two multi-component interventions, both were shown to be feasible.
conclusionsHand hygiene compliance was low for studies with larger sample sizes and clear definitions. This poses a substantial challenge to infection prevention during birth in LMICs facilities. We also found that the quality of many studies was suboptimal. Future studies of hand hygiene compliance on the labour ward should be designed with better sampling frames, assess inter-observer agreement, use measures to improve the quality of data collection, and report their hand hygiene definitions clearly.
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