Assessment of infection control practices in maternity units in Southern Nigeria.
OBJECTIVE
Puerperal sepsis accounts for 12% of maternal deaths in Nigeria. To date, little is known about the background hospital factors that predispose pregnant women to puerperal infection that leads to mortality. The objective of this study was to investigate the nature and pattern of existing policies and practices relating to infection control in maternity care centres in Edo state, South-South Nigeria.


METHODS
Cross-sectional study consisting of in-depth interviews with service providers, observation of clinical practices and examination of medical records.


METHODS
Public and private health-care facilities in eight local government areas (LGAs) selected from the three senatorial districts of Edo State, Nigeria.


METHODS
Health providers from 63 primary, secondary and tertiary maternity care centres.


METHODS
Sixty-three health-care facilities were sampled from eight LGAs from the three senatorial districts in Edo State. Three pre-tested tools were adapted to the local setting and used to interview key informants in the health facilities and to observe for practices and records relating to infection control.


RESULTS
Of the 63 health facilities, 68% (43) reported that they had infection control procedures in place, while only 25% (16) reported that they documented these as manuals or charts. Only 13% (8) of facilities had infection control committees; 11% (7) routinely carried out audits of maternal deaths, while 33% (21) reported that they had an ongoing programme for staff training on infection control. A high proportion of the health facilities reported that staff routinely wash their hands before and after sterile procedures, but only half of the facilities were observed to have 24-h running water and only two-thirds had soap and antiseptic solutions in delivery and operating theatre areas. Although more than 90% (57) of the health facilities reported that they use sterile gloves routinely, unused sterile gloves were found in only 60% (38) of these facilities, and recycled gloves in 11.1% (7).


CONCLUSIONS
The results of this study suggest the need for improved record-keeping procedures, the development of appropriate policies and protocols for infection control and staff training on infection control in maternity care facilities in Edo State. A public health education and advocacy programme to create awareness on clean delivery places as an approach for reducing maternal morbidity and mortality and to build political will for implementing related activities is also urgently needed.
Women’s Health and Action Research Centre, Km 11 Lagos-Benin Expressway, Igue-Iheya, Benin City, Edo State, Nigeria. feokonofua@yahoo.co.uk
Okonofua
O
Friday
Okpokunu
O
Edoja
Aigbogun
A
Osasu
Nwandu
N
Chinenye
Mokwenye
M
Cyril
Kanguru
K
Lovney
Hussein
H
Julia
D002985:Clinical Protocols; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D017053:Infection Control / Q000458:organization & administration* / Q000706:statistics & numerical data; D007318:Inservice Training / Q000458:organization & administration; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D009549:Nigeria / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011645:Puerperal Infection / Q000517:prevention & control; D011996:Records