Infection control in delivery care units, Gujarat state, India: a needs assessment

R Mehta, D Mavalankar, K V Ramani, S Sharma, J Hussein

Research output: Contribution to journalArticle

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Abstract

Background: Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India.
Methods: Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009.
Results: Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%.
Conclusions: This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems, protocols and procedures, and for training and research. Simply incentivizing the behaviour of women to use health facilities for childbirth via government schemes may not guarantee safe delivery.
Original languageEnglish
Article number37
Number of pages8
JournalBMC Pregnancy and Childbirth
Volume11
DOIs
Publication statusPublished - 20 May 2011

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Needs Assessment
Infection Control
Health Facilities
India
Parturition
Hand
Infection
Surgical Gloves
Government Programs
Equipment and Supplies
Gynecological Examination
Practice Guidelines
Information Systems
Motivation
Sepsis
Referral and Consultation
Public Health
Alcohols
Observation
Anti-Bacterial Agents

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Infection control in delivery care units, Gujarat state, India : a needs assessment. / Mehta, R; Mavalankar, D; Ramani, K V; Sharma, S; Hussein, J.

In: BMC Pregnancy and Childbirth, Vol. 11, 37, 20.05.2011.

Research output: Contribution to journalArticle

Mehta, R ; Mavalankar, D ; Ramani, K V ; Sharma, S ; Hussein, J. / Infection control in delivery care units, Gujarat state, India : a needs assessment. In: BMC Pregnancy and Childbirth. 2011 ; Vol. 11.
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abstract = "Background: Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India. Methods: Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009. Results: Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5{\%} of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70{\%} of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with {"}hands-free{"} taps. Only 15{\%} of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25{\%} of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3{\%} to 5{\%}. Conclusions: This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems, protocols and procedures, and for training and research. Simply incentivizing the behaviour of women to use health facilities for childbirth via government schemes may not guarantee safe delivery.",
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N2 - Background: Increasingly, women in India attend health facilities for childbirth, partly due to incentives paid under government programs. Increased use of health facilities can alleviate the risks of infections contracted in unhygienic home deliveries, but poor infection control practices in labour and delivery units also cause puerperal sepsis and other infections of childbirth. A needs assessment was conducted to provide information on procedures and practices related to infection control in labour and delivery units in Gujarat state, India. Methods: Twenty health care facilities, including private and public primary health centres and referral hospitals, were sampled from two districts in Gujarat state, India. Three pre-tested tools for interviewing and for observation were used. Data collection was based on existing infection control guidelines for clean practices, clean equipment, clean environment and availability of diagnostics and treatment. The study was carried out from April to May 2009. Results: Seventy percent of respondents said that standard infection control procedures were followed, but a written procedure was only available in 5% of facilities. Alcohol rubs were not used for hand cleaning and surgical gloves were reused in over 70% of facilities, especially for vaginal examinations in the labour room. Most types of equipment and supplies were available but a third of facilities did not have wash basins with "hands-free" taps. Only 15% of facilities reported that wiping of surfaces was done immediately after each delivery in labour rooms. Blood culture services were available in 25% of facilities and antibiotics are widely given to women after normal delivery. A few facilities had data on infections and reported rates of 3% to 5%. Conclusions: This study of current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems, protocols and procedures, and for training and research. Simply incentivizing the behaviour of women to use health facilities for childbirth via government schemes may not guarantee safe delivery.

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