Clean water, hand hygiene, and infection risk: a facility-based study in Zambia
1
Copperbelt University, MULESA CONSULTANCY FIRM, Choma, District, Zambia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Title: Clean water, hand hygiene, and infection risk: a facility-based study in zambia Author: mulemwa-sharon simushi, mph candidate, zambia
INTRODUCTION:
poor access to clean water and weak hygiene practices increase infection risk in healthcare settings. in zambia, many lower-level facilities face water interruptions and inconsistent hygiene compliance. this study assessed how clean water availability and hand hygiene practices affect the frequency of infections at the facility level.
METHODS:
a cross-sectional study was conducted in 6 primary health care facilities in southern zambia. data collection tools were adapted from the world health organization hand hygiene and water-sanitation assessment guidance. facility water availability was observed for 8 weeks and recorded as reliable or unreliable. hand hygiene compliance among health workers was assessed through structured observations (n=180 opportunities). suspected healthcare-associated infections (hcais) were collected using facility registers and verified through clinician review.
RESULTS:
sixty-seven percent of facilities had unreliable water supply. overall hand hygiene compliance was 54%. compliance was higher in facilities with reliable water (72%) compared to those with unreliable water (47%). facilities with unreliable water recorded 2.3 times more suspected hcais than facilities with a stable water source. the most common infections were diarrhea-related illness, wound infections, and respiratory infections. lack of nearby handwashing points and water shortages were the main barriers reported by health workers.
CONCLUSIONS:
facilities with reliable clean water supply had better hand hygiene compliance and fewer infections. strengthening water systems and improving access to handwashing points can significantly reduce infection risk. investments in water reliability and hygiene compliance are critical to improving facility-level sanitation and infection prevention. Keywords: clean water, hand hygiene, sanitation, hospital hygiene, hcais, zambia
Title: Clean water, hand hygiene, and infection risk: a facility-based study in zambia Author: mulemwa-sharon simushi, mph candidate, zambia
INTRODUCTION:
poor access to clean water and weak hygiene practices increase infection risk in healthcare settings. in zambia, many lower-level facilities face water interruptions and inconsistent hygiene compliance. this study assessed how clean water availability and hand hygiene practices affect the frequency of infections at the facility level.
METHODS:
a cross-sectional study was conducted in 6 primary health care facilities in southern zambia. data collection tools were adapted from the world health organization hand hygiene and water-sanitation assessment guidance. facility water availability was observed for 8 weeks and recorded as reliable or unreliable. hand hygiene compliance among health workers was assessed through structured observations (n=180 opportunities). suspected healthcare-associated infections (hcais) were collected using facility registers and verified through clinician review.
RESULTS:
sixty-seven percent of facilities had unreliable water supply. overall hand hygiene compliance was 54%. compliance was higher in facilities with reliable water (72%) compared to those with unreliable water (47%). facilities with unreliable water recorded 2.3 times more suspected hcais than facilities with a stable water source. the most common infections were diarrhea-related illness, wound infections, and respiratory infections. lack of nearby handwashing points and water shortages were the main barriers reported by health workers.
CONCLUSIONS:
facilities with reliable clean water supply had better hand hygiene compliance and fewer infections. strengthening water systems and improving access to handwashing points can significantly reduce infection risk. investments in water reliability and hygiene compliance are critical to improving facility-level sanitation and infection prevention. Keywords: clean water, hand hygiene, sanitation, hospital hygiene, hcais, zambia
| eISSN: | 2654-1459 |
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