FACTORS INFLUENCING HAND WASHING PRACTICES AMONG HEALTH WORKERS AT PUBLIC AND PRIVATE HEALTH FACILITIES IN IBADAN, OYO STATE

Abstract

Nosocomial Infection is among the leading public health problems in many public and private hospitals resulting in soaring cost expenditure in managing its effect. Hand washing practice is however considered to be an important infection control measure and a crucial preventive way to curtail such problem in the health care settings. Poor hand washing practices by health workers contributed to the morbidity, mortality including the costs of hospitalized patients in Nigeria. The objectives of this study was to determine the prevalence and factors influencing hand washing practices among health workers at public and private Health facilities in Ibadan, Oyo state. A hospital based cross sectional survey was carried out among health workers from two local government areas in lbadan, Oyo state. Two local governments were selected by simple random sampling while 5 public and 5 private health facilities were also selected in each Local government area by simple random sampling. A semi structured, self administered questionnaire in addition with an observation checklist was used to obtain information on knowledge, practices and factors influencing the practices of hand washing from health workers who were interviewed. Four hundred and twelve questionnaires were returned, giving a response rate of (98.1 %). Mean age of was 34.0(SD= 10.6)years. About 73.1 % of the respondents were females and higher proportion of participants (70.4%) had between less than 1 and 10years of work experience. Higher proportion of respondents (78.6%) do practiced hand washing out of which (44.4%) were in public and (34.2%) were in private health facilities respectively (p<0.027) but majority (69.2%) did not practice effective hand washing according to WHO guideline. Of those (30.8%) who practiced it effectively were respondents (19.1 %) in public health facilities compared to (11.7%) in private (p<0.02). More than half (56.3%) had poor knowledge on technique of effective hand washing of which 30.8% were in public health facilities while 25.5% were in private. On observation of respondent's hand washing practice, it was discovered that a low proportion (16.7%) of the participants performed hand washing before procedure while majority (83.3%) performed hand washing after procedure out of 18 (100%) health workers that were observed. The fear of contacting hospital infections are about 5 times more likely not to have influenced the effective hand washing practices of respondents whose hand washing have never been motivated by this factor unlike those whose hand washing have always been motivated due to fear of contacting hospital infections.(OR=4.789, C.I=1.10-20.8) while skipping of hand washing due to workload, lack of regular water supply and feeling unwilling in asking others to wash hands were the major factors influencing effective hand washing practices. Health workers in public and private health facilities had inadequate knowledge and negative attitude towards hand washing practices. Educational programs such as workshop/ seminars that can improve hand washing practice in hospitals are recommended.