Stopping Neonatal Sepsis: Identifying Tools to Monitor and Evaluate Water, Sanitation, and Hand Hygiene (WASH) and Infection Prevention and Control (IPC) in Primary Healthcare Settings in Amhara Region, Ethiopia Open Access

Abstract

Neonatal sepsis is considered the third major cause of death after pre-term birth and intrapartum related complications and accounts for 2.6 million neonatal deaths per year. Although the rate in under- five child deaths reduced prior to the 2000s, these past few decades reveal a slower decline in annual neonatal mortality than children. Ethiopia is one of the top five countries that experiences the highest number of neonatal deaths worldwide, while Amhara has the highest neonatal deaths in the country. Global organizations such as WHO and UNICEF published an alarming baseline global assessment of Water, Sanitation, and Hygiene (WASH) infrastructure in healthcare facilities and made a call for global action. Their assessment highlights low-income countries have limited WASH services, especially in maternal and primary care. Despite establishing hospital WASH standards and mechanisms to promote systematic accountability at a national level, monitoring and evaluation efforts are lacking at a primary level. Although Ethiopia provides valuable national WASH data, there is a need for routine monitoring of WASH initiatives at local, hospital settings. For this special studies project, the focus will be geared towards an intervention that Felege Hiwot and Debere Tabor hospital implement to monitor and evaluate WASH and infection prevention and control (IPC) compliance in reducing incident hospital-acquired neonatal sepsis (bloodstream infections) in Amhara, Ethiopia. The tool guide was divided into four categories and each tool was assessed based on specific key indicators. Based on our scoring criteria, Hand Hygiene Technical Reference Manual: Observation Form, Infection Prevention and Control Assessment at the Facility Level, Guidelines on Core Components of IPC Programs at the National and Acute Healthcare Facility Level, Baby-friendly Hospital Initiative Monitoring Tool, and Water and Sanitation for Health Facility Improvement Tool (WASHFIT) scored the highest from their categorical domain. Improving monitoring and evaluation will bring continuous improvement to our target hospitals and neonatal outcomes. 

Table of Contents

Chapter 1: Introduction

Chapter 2: Literature Review

Chapter 3: Methods and Results

Chapter 4: Discussion, Conclusion, and Recommendations

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Monitoring and Evaluation Infection Prevention and Control (IPC) Ethiopia Neonatal sepsis Water, Sanitation, and Hand Hygiene (WASH)
Committee Chair / Thesis Advisor	Caruso, Bethany, Emory University
Committee Members	Cranmer, John, Emory University

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