ADHERENCE TO HAND HYGIENE STANDARD AND ASSOCIATED FACTORS AMONG HEALTHCARE PROFESSIONALS IN AGRO PASTORAL WOREDAS’ PUBLIC HEALTH FACILITIES OF WEST HARARGHE ZONE, EASTERN ETHIOPIA

Abstract

Background: Effective hand hygiene is a cost-efficient strategy for preventing infections and delivering substantial health benefits. Healthcare facilities with poor hand hygiene become hotspots for microbial infections, leading to increased illness and potential fatalities among patients. This mixed-method study was attentive to examine rural lower-level health centers. Objective: The study sought to investigate adherence to hand hygiene standards and associated factors among healthcare professionals in public healthcare facilities within the agro-pastoral woredas of the West Hararghe Zone, Eastern Ethiopia, from August 25 to September 15, 2024. Methods: A cross-sectional mixed-method study design was employed, including all 156 healthcare professionals comprehensively. For the qualitative component, 12 participants were purposively selected until saturation was reached. Data were collected using self-administered questionnaires and semi-structured interviews. Quantitative data were processed with Epinfo-7.2 and analyzed in STATA 17. Logistic regression used to assess associations between explanatory variables and outcomes. Statistical significance was defined at p<0.05, with odds ratios indicating the direction and strength of associations. Qualitative data were analyzed thematically. Results: 141 healthcare professionals participated, yielding a response rate of 90.4%. The study revealed that overall adherence to hand hygiene standards was approximately 18% (95% CI: 12.2%, 24.9%). Key predictors of adherence included the presence of workplace reminders (3 times more adherence; AOR=3.0, 95% CI=1.09, 8.01), subjective norms (5.9 times; AOR=5.9, 95% CI=1.06, 33.85), perceived behavioral control (0.14 times; AOR: 0.14, 95% CI: 0.02, 0.95), and system changes (10.5 times; AOR=10.5, 95% CI: 2.2, 49). Knowledge of hand hygiene standard 2.9 times (AOR=2.9, 95% CI=1.06, 8.11), while leadership having a joint yearly hand hygiene target/plan led to a 7.8 times increase in adherence (AOR=7.8, 95% CI=2.15, 22.05). Conclusion: The study found that only one in five healthcare professionals adhered to hand hygiene standards, posing significant infection risks for both patients and healthcare professional. Qualitative interviews indicated that hand hygiene strategies were not effectively adopted. There appeared role-confusion perception effect from the demands of serving multiple departments while providing services in an overcrowded room at lower-level health centers, which overwhelmed healthcare professionals to have poor hand hygiene adherence. Hence, it emphasized focused interventions to tackle systemic obstacles and behavioral factors.