Evidence map›Paper›PMID 40457467›Full record

ArticleAntimicrobial resistance and infection control2025

Strengthening neonatal care through ward assistants: a Kenyan case study in enhancing infection prevention and control practices.

Michuki Maina, Nancy Odinga, Vincent Kagonya, Gloria Ngaiza, Sebastian Fuller, Onesmus Onyango, Caroline Waithira, Dorothy Oluoch, David Gathara, Peter Mwangi and 9 more

Abstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

19 authors.

Michuki MainaKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya. mmaina@kemri-wellcome.org.ORCID 0000-0001-6874-8929
Nancy OdingaKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Vincent KagonyaKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Gloria NgaizaNuffield Department of Medicine, The University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK.
Sebastian FullerNuffield Department of Medicine, The University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK.
Onesmus OnyangoKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Caroline WaithiraKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Dorothy OluochKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
David GatharaKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Peter MwangiDepartment of Health, Nyeri County, P.O. Box 1112-10100, Nyeri, Kenya.
Loise MwangiDepartment of Health, Embu County, P.O. Box 36-60100, Embu, Kenya.
Penina MusyokaDepartment of Health, Machakos County, P.O. BOX 1996, Machakos, 90100, Kenya.
Lucy KinyuaDepartment of Health, Nyeri County, P.O. Box 1112-10100, Nyeri, Kenya.
Lydia ThuraniraDepartment of Health, Kiambu County, P.O. Box 2344-00900, Kiambu, Kenya.
Virginia NjorogeDepartment of Health, Kiambu County, P.O. Box 2344-00900, Kiambu, Kenya.
Ngina MwangiDepartment of Health, Embu County, P.O. Box 36-60100, Embu, Kenya.
Zainab KioniDepartment of Health, Machakos County, P.O. BOX 1996, Machakos, 90100, Kenya.
Mike EnglishKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Edna MutuaKEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.

Funding

National Institute for Health and Care Research NIHR130812Wellcome TrustWellcome Trust 207522
6 · The paper itself

Abstract

backgroundInfection prevention and control (IPC) is a critical component of neonatal care, particularly in low- and middle-income countries (LMICs), where healthcare settings face unique challenges. Neonates, especially preterm and low birth weight infants, are at higher risk for infections, including healthcare-associated infections. In Kenya, neonatal units struggle with limited resources, understaffing, and shortages of essential supplies, significantly impeding effective IPC practices.

methodsThis study employed a mixed methods approach in four public neonatal units in Kenya to assess the impact of deploying ward assistants on IPC practices. Data collection included structured and unstructured observations, in-depth interviews, and focus group discussions with healthcare workers and caregivers. The intervention aimed to address gaps in routine cleanliness, waste management, and adherence to IPC protocols.

resultsThe introduction of ward assistants led to noticeable improvements in overall ward cleanliness and waste disposal, highlighting the potential for enhanced infection control. Mothers' hand hygiene practices improved, driven by targeted sensitization efforts. Despite these gains, significant challenges remained. Hand hygiene adherence among healthcare providers was inconsistent, and equipment cleaning and decontamination were frequently compromised by insufficient supplies and overwhelming patient demand. The findings underscored the critical role of resources and the need for consistent supervision and training to support sustainable IPC improvements.

conclusionDeploying ward assistants in neonatal units can positively influence IPC practices, particularly in addressing environmental cleanliness and waste management. However, these benefits alone are insufficient to address systemic barriers to IPC, including resource constraints and variability in adherence among staff. To sustain these gains, robust training, consistent supervision, and adequate resourcing are imperative. Future research should explore the long-term impact of such interventions and design context-specific strategies to overcome persistent barriers, ensuring safer neonatal care in resource-limited settings. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Cross InfectionInfection ControlFemaleFocus GroupsGuideline AdherenceHand HygieneHealth PersonnelHumansInfant, NewbornIntensive Care Units, NeonatalKenyaHealth workforceInfection preventionNeonatal careQuality of careWard assistants

Identifiers

PMID40457467
PMCPMC12131407

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.