title: Environmental factors and WASH practices in the perinatal period in Cambodia: implications for newborn health.
abstract: Infection contributes to a significant proportion of neonatal death and disability worldwide, with the major burden occurring in the first week of life. Environmental conditions and gaps in water, sanitation and hygiene (WASH) practices may contribute to the risk of infection, particularly in settings where health centers are expanding to meet the growing demand for skilled care at birth and homes do not have adequate access to water and sanitation. A qualitative approach was used to understand the environmental context for infection prevention and control (IPC) and WASH associated behaviors in health centers where women give birth, and in homes of newborns, in a rural Cambodian province. Structured observations and focus group discussions revealed important gaps in optimal practices, and both structural and social barriers to maintaining IPC during delivery and post-partum. Solutions are available to address the issues identified, and tackling these could result in marked environmental improvement for quality of care and neonatal outcomes. Water, sanitation and hygiene in home and health center environments are likely to be important contributors to health and should be addressed in strategies to improve neonatal survival.
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112, USA. abazzano@tulane.edu.
authors.forename: Alessandra N
authors.initials: AN
authors.lastname: Bazzano
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112, USA. oberhel@tulane.edu.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Oberhelman
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112, USA. kstorck@tulane.edu.
authors.forename: Kaitlin Storck
authors.initials: KS
authors.lastname: Potts
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112, USA. agordon8@tulane.edu.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Gordon
authors.affiliation: National Institute of Public Health, #2 Kim Y Sung Blvd, Tuol Kork, Phnom Penh P.O. Box 1300, Cambodia. chivorn@rhac.org.kh.
authors.forename: Chivorn
authors.initials: C
authors.lastname: Var
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002160:Cambodia; D017028:Caregivers / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006920:Hygiene; D000068104:Infant Health / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018743:Perinatal Care / Q000379:methods* / Q000706:statistics & numerical data; D012424:Rural Population; D012499:Sanitation / Q000379:methods; D055815:Young Adult