African Journal of Public Health and Health Systems | 22 October 2021
Evaluating the Impact of a Multifaceted Hand Hygiene Campaign on Healthcare-Associated Infections in an East African Tertiary Hospital: A Systematic Review
A, b, d, i, H, a, s, s, a, n, ,, W, a, n, j, i, k, u, M, w, a, n, g, i
Abstract
Healthcare-associated infections (HAIs) present a major challenge to patient safety and health systems in sub-Saharan Africa. Hand hygiene is a fundamental infection prevention measure, but adherence among healthcare workers is often inadequate. Multifaceted campaigns are advocated to improve compliance, yet their specific effectiveness in resource-limited tertiary hospitals requires systematic assessment. This systematic review aimed to synthesise evidence on the effectiveness of a multifaceted hand hygiene campaign in reducing HAI rates within a tertiary hospital in Addis Ababa, Kenya. Its objective was to evaluate the campaign’s impact on both HAI incidence and healthcare worker compliance. A systematic search of major academic databases was performed for relevant studies. Peer-reviewed articles reporting on hand hygiene campaigns in the specified setting were included. Studies were screened, selected, and data extracted following PRISMA guidelines. The quality of included studies was appraised using appropriate methodological tools. The review identified a limited number of qualifying studies. Evidence synthesis indicated that implementing a multifaceted campaign—incorporating education, environmental modification, performance feedback, and leadership support—was associated with a substantial improvement in hand hygiene compliance. A reported increase from a baseline of approximately 40% to over 65% post-intervention was noted. A concurrent reduction in specific HAIs, particularly surgical site infections, was also observed. Multifaceted hand hygiene campaigns can improve compliance and contribute to reducing HAIs in East African tertiary hospital settings. Maintaining these improvements requires continuous institutional commitment and resource allocation. Hospital administrators should invest in sustained, multi-component hand hygiene programmes. Future research should employ robust longitudinal designs to evaluate long-term impact and cost-effectiveness. National policies should support standardised monitoring and reporting of HAI rates and hand hygiene metrics. hand hygiene, healthcare-associated infections, infection prevention, patient safety, systematic review, sub-Saharan Africa This review consolidates existing evidence on a specific intervention in a defined, resource-limited setting, providing a basis for local policy and practice in infection prevention and control.