Women’s Health and Action Research Centre, Km 11 Lagos-Benin Expressway, Igue-Iheya, Benin City, Edo State, Nigeria.
Int J Qual Health Care. 2012 Dec;24(6):634-40. doi: 10.1093/intqhc/mzs057. Epub 2012 Oct 18.
Puerperal sepsis accounts for 12% of maternal deaths in Nigeria. To date, little is known about the background hospital factors that predispose pregnant women to puerperal infection that leads to mortality. The objective of this study was to investigate the nature and pattern of existing policies and practices relating to infection control in maternity care centres in Edo state, South-South Nigeria.
Cross-sectional study consisting of in-depth interviews with service providers, observation of clinical practices and examination of medical records.
Public and private health-care facilities in eight local government areas (LGAs) selected from the three senatorial districts of Edo State, Nigeria.
Health providers from 63 primary, secondary and tertiary maternity care centres.
Sixty-three health-care facilities were sampled from eight LGAs from the three senatorial districts in Edo State. Three pre-tested tools were adapted to the local setting and used to interview key informants in the health facilities and to observe for practices and records relating to infection control.
Of the 63 health facilities, 68% (43) reported that they had infection control procedures in place, while only 25% (16) reported that they documented these as manuals or charts. Only 13% (8) of facilities had infection control committees; 11% (7) routinely carried out audits of maternal deaths, while 33% (21) reported that they had an ongoing programme for staff training on infection control. A high proportion of the health facilities reported that staff routinely wash their hands before and after sterile procedures, but only half of the facilities were observed to have 24-h running water and only two-thirds had soap and antiseptic solutions in delivery and operating theatre areas. Although more than 90% (57) of the health facilities reported that they use sterile gloves routinely, unused sterile gloves were found in only 60% (38) of these facilities, and recycled gloves in 11.1% (7).
The results of this study suggest the need for improved record-keeping procedures, the development of appropriate policies and protocols for infection control and staff training on infection control in maternity care facilities in Edo State. A public health education and advocacy programme to create awareness on clean delivery places as an approach for reducing maternal morbidity and mortality and to build political will for implementing related activities is also urgently needed.
产后脓毒症占尼日利亚产妇死亡人数的 12%。迄今为止，人们对导致产妇感染和死亡的医院背景因素知之甚少。本研究的目的是调查与尼日利亚南南埃多州产妇保健中心感染控制相关的现有政策和实践的性质和模式。
横断面研究，包括对服务提供者进行深入访谈、观察临床实践和检查病历。
从尼日利亚埃多州三个参议员区的八个地方政府区（LGAs）选择的公立和私立保健设施。
来自 63 个初级、中级和三级产妇保健中心的卫生保健提供者。
从埃多州三个参议员区的八个 LGAs 中抽取了 63 个保健设施。对三个预先测试的工具进行了调整，以适应当地环境，并用于访谈卫生设施中的主要知情者，并观察与感染控制有关的做法和记录。
在 63 个卫生设施中，68%（43 个）报告有感染控制程序，而只有 25%（16 个）报告有这些程序的文件记录作为手册或图表。只有 13%（8 个）的设施有感染控制委员会；11%（7 个）定期对产妇死亡进行审计，而 33%（21 个）报告有持续的工作人员感染控制培训计划。相当多的卫生设施报告说，工作人员在进行无菌操作前后经常洗手，但只有一半的设施观察到有 24 小时自来水，只有三分之二的设施在分娩和手术室区域有肥皂和抗菌溶液。尽管超过 90%（57 个）的卫生设施报告说他们经常使用无菌手套，但只有 60%（38 个）的设施发现无菌手套未使用，11.1%（7 个）的设施使用回收手套。
本研究结果表明，埃多州产妇保健设施需要改进记录保存程序，制定感染控制的适当政策和方案，并对工作人员进行感染控制培训。还迫切需要开展公共卫生教育和宣传活动，提高人们对清洁分娩场所的认识，作为降低产妇发病率和死亡率的一种方法，并为实施相关活动建立政治意愿。
