INTRODUCTION:
Poor hygiene practices in healthcare facilities contribute to healthcare-associated infections and undermine patient safety. Behavioural interventions targeting staff and facility culture are critical for sustainable infection prevention. The Kutuba campaign was implemented to improve hygiene behaviours in Monze District healthcare facilities through participatory and motivational approaches.

METHODS:
A quasi-experimental design was used from September 2023 to January 2024 across 24 healthcare facilities, involving 58 healthcare workers. Twelve facilities participated in the Kutuba campaign (intervention) and twelve served as controls. Data collection included structured questionnaires and direct observation of handwashing, hand drying, surface cleaning, waste management, and food hygiene. Statistical analysis was performed using chi-square tests and odds ratios with 95 percent confidence intervals to assess behavioural differences between intervention and control sites.

RESULTS:
Healthcare workers exposed to the Kutuba campaign were 6.27 times more likely to practice proper handwashing (95 percent CI: 1.56–25.25) and 3.71 times more likely to dry hands correctly (95 percent CI: 1.15–11.89). Facilities implementing Kutuba were significantly more likely to maintain functional incinerators and placenta pits (p<0.001). Surface cleaning frequency and food hygiene practices showed moderate, non-significant improvement.

CONCLUSIONS:
The Kutuba campaign effectively improved hygiene behaviours and waste management practices in primary healthcare facilities. Its behaviour-centred design demonstrates a scalable model for integrating WASH into infection prevention and control strategies within health systems, contributing to resilient, safe, and people-centred primary healthcare.