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Cycle 8 (2019 Deadline)

Improving hand hygiene practice among healthcare workers through mhealth and environmental cues in Kampala Metropolitan Area

PI: Richard Kibirango Mugambe (, Makerere University School of Public Health
U.S. Partner: Christine Moe, Emory University
Project Dates: To be determined

Project Overview:
Water, sanitation, and hygiene (WASH) in healthcare facilities (HCF) are critical in the provision of quality health care. It has been argued that good WASH infrastructure and practices in HCF should reduce health-care acquired infections (HAI), increase trust and uptake of healthcare services, and increase efficiency and improve staff morale. This research team headed by PI Dr. Richard Kibirango Mugambe has designed their PEER project to address two key questions: (1) why healthcare workers (HCWs) don’t adhere to hand hygiene guidelines in Uganda, and (2) what are the simple, effective, and inexpensive interventions to enhance hand-hygiene practices among HCWs in Uganda. Specifically, the project aim is to determine the impact of mobile phone WASH text messages and environmental cues on hand hygiene practices among healthcare workers in the Greater Kampala Metropolitan Area (GKMA). Researchers will determine the barriers and opportunities for enhancing healthcare workers’ hand hygiene practices in HCFs in the GKMA and determine the impact of WASH mobile text information and reminders (MTIR) and environmental cues on hand hygiene practices among health workers. The expected outcomes include an improved ratio of completed hand hygiene events/hand hygiene opportunities (number of times hand hygiene is observed to be done at critical times out of the total number of observed hand hygiene opportunities) and increased knowledge on hand hygiene practices, which will be explored using questions related to hand hygiene benefits and procedure. U.S. partner Dr. Christine Moe will provide critical assistance in the project by training faculty from the Makerere University School of Public Health and staff from the Ministry of Health on using the specified hand hygiene interventions, monitoring outcomes, and conducting laboratory procedures for determining microbial contamination on the hands of HCWs. The partnership will also enable Dr. Mugambe and Dr. Moe to build on their ongoing research on WASH-related factors associated with sepsis in neonates reporting at selected HCFs in Kampala.

The planned project activities are a response to critical WASH gaps in Uganda and will support efforts towards achieving Sustainable Development Goal (SDG) 6. This research specifically contributes towards achieving target 6.1, which seeks to achieve universal and equitable access to safe and affordable drinking water for all by 2030, as well as target 6.2, which seeks to ensure access to adequate and equitable sanitation and hygiene for all and ending open defecation by the year 2030. The study also fits into the USAID Water and Development Country Plan for Uganda, in particular by helping to drive a systematic and evidence-based social and behavior change program in households and in institutions (including schools and HCFs); support HCF hygiene audits and action planning in supported districts; and supporting the establishment and strengthening of community, district, and regional institutions to develop the necessary capabilities to enable sustainable WASH outcomes in home, school, and HCF settings.

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