KNOWLEDGE, ATTITUDE, PRACTICE AND ASSOCIATED FACTORS OF HEALTHCARE-ASSOCIATED INFECTIONS AMONG HEALTH CARE WORKERS IN PUBLIC AND PRIVATE HOSPITALS IN BORAMA, AWDAL, SOMALILAND

Abstract

Background: Due to limited resources and inadequate infection prevention measures, healthcare associated infections (HAIs) remain a major global public health issue, with low- and middle-income countries bearing a disproportionate share of the burden. Despite this growing concern, there is limited information available on the knowledge, attitudes, and practices (KAP) of healthcare workers in Somaliland regarding HAIs. Objective: This study aimed to assess the knowledge, attitudes, and practices (KAP) related to healthcare-associated infections among healthcare providers in public and private hospitals in Borama from May 15 to August 15, 2025. Methods: From May 15 to June 15, 2025, an institution-based cross-sectional study was carried out. Using simple random sample and proportionate allocation, 163 healthcare workers were chosen from twelve hospitals. A pre-tested, structured, self-administered questionnaire was used to gather data. Using SPSS version 20, descriptive statistics and binary logistic regression analyses were carried out; a p-value of less than 0.05 was deemed statistically significant. Result: The study found that HCWs had remarkably high levels of knowledge (96.3%) and favorable attitudes (96.3%) about HAI prevention. Additionally, good infection prevention strategies were reported by 85.9% of individuals. KAP scores were not substantially correlated with demographic traits including age, sex, education, or occupation, according to chi-square and regression models (p > 0.05). Rather, there was a significant correlation (p < 0.05) between improved practice results and institutional characteristics such as the availability of personal protective equipment (PPE), access to infection prevention (IP) manuals, IP training, and perceived organizational support. Conclusion and Recommendation: Excellent knowledge and favorable attitudes toward HAI prevention are displayed by HCWs in Borama, which translates into comparatively high self-reported practice levels. The results highlight the fact that institutional, systemic support is more important for effective infection prevention than individual HCW traits. Health authorities and hospital management should make sure that IPC resources are consistently available, institutionalize ongoing training and supportive supervision, and incorporate these evidence-based findings into national IPC policy frameworks in order to maintain and enhance these results.