乌干达坎帕拉大都市区医疗设施供水、环境卫生和个人卫生服务供应情况评估。
Assessment of water, sanitation and hygiene service availability in healthcare facilities in the greater Kampala metropolitan area, Uganda.
机构信息
Programs Department, WaterAid Uganda, P.O. Box 11759, Kampala, Uganda.
Department of Disease Control and Environmental Health, School of Public Health, Kampala, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
出版信息
BMC Public Health. 2020 Nov 23;20(1):1767. doi: 10.1186/s12889-020-09895-9.
BACKGROUND
Improved Water, Sanitation and Hygiene (WASH) in Healthcare facilities (HCFs) is of significant public health importance. It is associated with a reduction in the transmission of healthcare acquired infections (HAIs), increased trust and uptake of healthcare services, cost saving from infections averted, increased efficiency and improved staff morale. Despite these benefits, there is limited evidence on availability of WASH services in HCFs in the Greater Kampala Metropolitan Area (GKMA). This study assessed the availability and status of WASH services within HCFs in the GKMA in order to inform policy and WASH programming.
METHODS
A cross-sectional study was conducted in 60 HCFs. Availability of WASH services in the study HCFs was assessed using a validated WASH Conditions (WASHCon) tool comprising of structured interviews, HCF observations and microbial water quality analysis. Data were analysed using Stata 14 software and R software.
RESULTS
Overall, 84.5% (49/58) and 12.1% (7/58) of HCFs had limited and basic WASH service respectively. About 48.3% (28/58) had limited water service, 84.5% (49/58) had limited sanitation service, 50.0% (29/58) had limited environmental cleanliness service, 56.9% (33/58) had limited hand hygiene service, and 51.7% (30/58) had limited waste management service. About 94.4% of public HCFs had limited WASH service compared to only 68.2% of private not for profit facilities. More health centre IIIs, 92.5% and health centre IVs (85.7%) had limited WASH service compared to hospitals (54.5%).
CONCLUSIONS
Our findings indicate that provision of water, sanitation, hand hygiene, environmental cleanliness, and health care waste management services within HCFs is largely hindered by structural and performance limitations. In spite of these limitations, it is evident that environmental cleanliness and treatment of infectious waste can be attained with better oversight and dedicated personnel. Attaining universal WASH coverage in HCFs will require deliberate and strategic investments across the different domains.
背景
改善医疗保健设施（HCF）中的水、环境卫生和个人卫生（WASH）对公共卫生具有重要意义。它与减少医疗保健获得性感染（HAIs）的传播、增加对医疗保健服务的信任和接受度、避免感染造成的成本节约、提高效率和改善员工士气有关。尽管有这些好处，但在大坎帕拉大都市区（GKMA）的 HCF 中，关于 WASH 服务的可用性有限。本研究评估了 GKMA 内 HCF 中的 WASH 服务的可用性和状况，以便为政策和 WASH 规划提供信息。
方法
在 60 个 HCF 中进行了横断面研究。使用经过验证的 WASH 条件（WASHCon）工具评估研究 HCF 中的 WASH 服务的可用性，该工具包括结构化访谈、HCF 观察和微生物水质分析。使用 Stata 14 软件和 R 软件分析数据。
结果
总体而言，84.5%（49/58）和 12.1%（7/58）的 HCF 分别有有限和基本的 WASH 服务。约 48.3%（28/58）的 HCF 供水有限，84.5%（49/58）的 HCF 卫生服务有限，50.0%（29/58）的 HCF 环境卫生服务有限，56.9%（33/58）的 HCF 手部卫生服务有限，51.7%（30/58）的 HCF 废物管理服务有限。与仅 68.2%的私立非营利性设施相比，约 94.4%的公共 HCF 有有限的 WASH 服务。更多的卫生中心 III（92.5%）和卫生中心 IV（85.7%）的 WASH 服务有限，而医院（54.5%）的 WASH 服务有限。
结论
我们的研究结果表明，HCF 中供水、卫生、手部卫生、环境卫生和医疗保健废物管理服务的提供受到结构和绩效限制的严重阻碍。尽管存在这些限制，但显然可以通过更好的监督和专门人员来实现环境卫生和传染性废物的处理。要在 HCF 中实现普遍的 WASH 覆盖，需要在不同领域进行深思熟虑和战略性的投资。
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