Facilitators and Barriers Experienced by Environmental Cleaning Staff in Health Care Facilities in Uganda Open Access
Keili, Kiyamia (Spring 2021)
Abstract
Background: Health care-associated infections (HCAIs) are a major contributor to morbidity and mortality globally, with a higher burden on developing countries. However, HCAIs can be prevented with proper infection prevention and control (IPC) interventions, including environmental cleaning of the health care facility (HCF). Environmental cleaners play a significant role in the maintenance of HCF cleanliness, but their experiences and the factors influencing their work practices are not well-documented, especially in low-resource HCFs. Therefore, this qualitative study seeks to understand the barriers and facilitators that influence cleaning practices of cleaners in HCFs in urban Uganda.
Methods: Key informant interviews were conducted in nine health centres, in the greater Kampala metropolitan area, with 12 heads of cleaning staff or their assistants. The interview data was analyzed using MAXQDA and themes were identified through multiple rounds of coding.
Results: Themes were categorized as barriers or facilitators and organized using the Person-Environment-Occupation Model (PEO) of Occupational Performance (Law et al, 1996). Barriers to proper cleaning practices included lack of appreciation, poor waste segregation practices by other staff, low availability of cleaning supplies, patients’ behaviors, cleaning frequency, and high workload. Facilitators included access to income, appreciation from other staff, sufficient water supply, provision of IPC trainings, adequate waste disposal infrastructure, health workers positive contributions, and sharing of cleaning responsibilities.
Discussion: These barriers and facilitators highlight the point that regardless of how motivated cleaners may be to perform their jobs, without the support of supervisors and health workers environmental cleaning may not be performed according to IPC standards and protocols.
Table of Contents
Chapter 1: Introduction…………………………………………………………………………1
Chapter 2: Manuscript…………………………………………………………………………..4
I. Introduction………………………………………………………………………7
II. Materials and Methods…………………………………………………………10
a. Study Setting…………………………………………………………………10
b. Study Design…………………………………………………………………10
c. Data Analysis…………………………………………………………….......11
III. Results…………………………………………………………………………...12
a. Barriers to Maintaining Environmental Cleanliness…………………………12
b. Facilitators to Maintaining Environmental Cleanliness………………….......17
IV. Discussion……………………………………………………………………….22
a. Limitations…………………………………………………………………...25
b. Recommendations……………………………………………………………26
V. Conclusion………………………………………………………………………27
VI. Manuscript References…………………………………………………………28
Chapter 3: Conclusion and Public Health Implications……………………………………...32
Thesis References……………………………………………………………….34
Appendix: Interview Guide…………………………………………………….39
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