Levels of Hospital Hand Washing Compliances in Rwanda for Selected Healthcare Practioners in Nursing and Midwifry Professions

Background: Healthcare-associated infections (HCAIs) significantly contribute to neonatal morbidity and mortality, particularly in developing countries. Proper hand hygiene is the most effective, simple, and cost-efficient measure for preventing HCAIs, yet compliance among healthcare workers remains suboptimal.  Objective: To assess handwashing knowledge, practices, and barriers among nurses and midwives for infection prevention in neonatology and maternity departments at Ruhengeri District Hospital, Rwanda.  Methods: A quantitative, descriptive cross-sectional study was conducted. The study population included 56 nurses and midwives, with a convenience sample of 50 participants. Data were collected using a structured questionnaire divided into four sections: socio-demographics, knowledge, practices, and barriers. Knowledge items were adapted from WHO Hand Hygiene Guidelines, while practices and barriers were based on CDC and WHO recommendations. Validity was confirmed through expert review, and reliability via a pilot study (Cronbach’s alpha = 0.86). Data were analyzed using descriptive statistics and Chi-square tests to assess associations.  Results: The majority of participants (72%) demonstrated good knowledge of hand hygiene, while 28% had moderate knowledge. Regarding practices, 46% had good practice, 36% moderate, and 18% poor practice, with a mean practice score of 71.27%. Alcohol-based hand rub was routinely used by 62%, and only 28% had received formal hand hygiene training in the last three years. A significant association was found between department of work and handwashing practice (p = 0.012).  Conclusion: Nurses and midwives exhibit good knowledge but variable hand hygiene practices. Continuous training, policy reinforcement, and monitoring are essential to improve compliance and reduce HCAIs in neonatal care settings in Rwanda.