Maina Michuki, Odinga Nancy, Kagonya Vincent, Ngaiza Gloria, Fuller Sebastian, Onyango Onesmus, Waithira Caroline, Oluoch Dorothy, Gathara David, Mwangi Peter, Mwangi Loise, Musyoka Penina, Kinyua Lucy, Thuranira Lydia, Njoroge Virginia, Mwangi Ngina, Kioni Zainab, English Mike, Mutua Edna
KEMRI-Wellcome Trust Research Programme, Health Services Research Group, PO Box 43640-00100, Nairobi, Kenya.
Nuffield Department of Medicine, The University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK.
Antimicrob Resist Infect Control. 2025 Jun 2;14(1):61. doi: 10.1186/s13756-025-01575-w.
Infection prevention and control (IPC) is a critical component of neonatal care, particularly in low- and middle-income countries (LMICs), where healthcare settings face unique challenges. Neonates, especially preterm and low birth weight infants, are at higher risk for infections, including healthcare-associated infections. In Kenya, neonatal units struggle with limited resources, understaffing, and shortages of essential supplies, significantly impeding effective IPC practices.
This study employed a mixed methods approach in four public neonatal units in Kenya to assess the impact of deploying ward assistants on IPC practices. Data collection included structured and unstructured observations, in-depth interviews, and focus group discussions with healthcare workers and caregivers. The intervention aimed to address gaps in routine cleanliness, waste management, and adherence to IPC protocols.
The introduction of ward assistants led to noticeable improvements in overall ward cleanliness and waste disposal, highlighting the potential for enhanced infection control. Mothers' hand hygiene practices improved, driven by targeted sensitization efforts. Despite these gains, significant challenges remained. Hand hygiene adherence among healthcare providers was inconsistent, and equipment cleaning and decontamination were frequently compromised by insufficient supplies and overwhelming patient demand. The findings underscored the critical role of resources and the need for consistent supervision and training to support sustainable IPC improvements.
Deploying ward assistants in neonatal units can positively influence IPC practices, particularly in addressing environmental cleanliness and waste management. However, these benefits alone are insufficient to address systemic barriers to IPC, including resource constraints and variability in adherence among staff. To sustain these gains, robust training, consistent supervision, and adequate resourcing are imperative. Future research should explore the long-term impact of such interventions and design context-specific strategies to overcome persistent barriers, ensuring safer neonatal care in resource-limited settings.
Not applicable.
感染预防与控制（IPC）是新生儿护理的关键组成部分，在低收入和中等收入国家（LMICs）尤其如此，这些国家的医疗机构面临着独特的挑战。新生儿，尤其是早产儿和低体重儿，感染风险更高，包括医疗相关感染。在肯尼亚，新生儿病房资源有限、人员不足且基本用品短缺，严重阻碍了有效的IPC措施的实施。
本研究在肯尼亚的四个公共新生儿病房采用混合方法，评估部署病房助理对IPC措施的影响。数据收集包括对医护人员和护理人员的结构化和非结构化观察、深入访谈以及焦点小组讨论。干预旨在解决常规清洁、废物管理和遵守IPC协议方面的差距。
病房助理的引入使病房整体清洁度和废物处理有了显著改善，凸显了加强感染控制的潜力。通过有针对性的宣传努力，母亲的手卫生习惯得到了改善。尽管取得了这些成果，但仍存在重大挑战。医护人员的手卫生依从性不一致，设备清洁和消毒经常因用品不足和患者需求过大而受到影响。研究结果强调了资源的关键作用以及持续监督和培训以支持可持续的IPC改进的必要性。
在新生儿病房部署病房助理可以对IPC措施产生积极影响，特别是在解决环境清洁和废物管理方面。然而，仅这些好处不足以解决IPC的系统性障碍，包括资源限制和工作人员依从性的差异。为了维持这些成果，强有力的培训、持续监督和充足的资源至关重要。未来的研究应探索此类干预措施的长期影响，并设计针对具体情况的策略来克服持续存在的障碍，确保在资源有限的环境中提供更安全的新生儿护理。
不适用。
