Tantum Lucy K, Mahamane Ezechiel, Bauza Valerie, Mahamadou Kairou Oudou Bilo, Sanoussi Elisha Y, Salzberg Aaron, Anderson Darcy M
The Water Institute at UNC, Gillings School of Global Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
World Vision Niger, Niamey, Niger.
Environ Health Insights. 2024 Aug 14;18:11786302241271554. doi: 10.1177/11786302241271554. eCollection 2024.
Infrastructure for water, sanitation, hygiene, cleaning, and waste management is essential for supporting safe environmental conditions in healthcare facilities. Routine maintenance is important for preventing infrastructure breakdowns, but few studies have examined healthcare facility maintenance practices. This study documented environmental maintenance tasks in healthcare facilities in Niger, described bottlenecks to maintenance, and assessed strategies for coping with breakdowns. At 34 rural healthcare facilities in Niger, we conducted quantitative surveys to assess frequency of maintenance tasks and held qualitative interviews with healthcare facility staff to understand bottlenecks to maintenance. On at least a monthly basis, 4% of healthcare facilities inspected their water source and pump for the purpose of detecting and replacing worn parts, 15% inspected water taps and basins, and 29% inspected incinerators. Healthcare facility staff described barriers to accessing government funds for maintenance. Instead, they paid out of their own salaries or raised funds through appeals to community members or revenue generation initiatives. Other bottlenecks included ill-defined management responsibilities and difficulty of finding skilled technicians for maintenance. Findings highlight opportunities to support healthcare facilities in budgeting, advocacy, and training skilled technicians. Initiatives to install infrastructure at healthcare facilities will be more sustainable if they are accompanied by postconstruction planning, training, and funding for maintenance.
供水、环境卫生、个人卫生、清洁及废物管理基础设施对于维持医疗机构的安全环境条件至关重要。日常维护对于防止基础设施故障很重要，但很少有研究考察过医疗机构的维护做法。本研究记录了尼日尔医疗机构的环境维护任务，描述了维护工作的瓶颈，并评估了应对故障的策略。在尼日尔的34家农村医疗机构，我们进行了定量调查以评估维护任务的频率，并与医疗机构工作人员进行了定性访谈以了解维护工作的瓶颈。至少每月一次，4%的医疗机构检查其水源和水泵以检测和更换磨损部件，15%检查水龙头和水池，29%检查焚化炉。医疗机构工作人员描述了获取政府维护资金的障碍。相反，他们用自己的工资支付或通过向社区成员呼吁或创收活动筹集资金。其他瓶颈包括管理职责不明确以及难以找到熟练的技术人员进行维护。研究结果凸显了在预算编制、宣传和培训熟练技术人员方面支持医疗机构的机会。如果在建设后进行规划、培训并提供维护资金，那么在医疗机构安装基础设施的举措将更具可持续性。
