Determinants of Low Hand Hygiene Compliance in Healthcare Facilities in Lualaba Province, Democratic Republic of the Congo

Introduction: Hand Hygiene (HH) in hospital settings is an effective measure to protect patients from the spread of healthcare-associated infections (HAIs). However, its compliance is still low. We aimed to determine the factors associated with low compliance with HH by providers in Lualaba Province. Methods: A cross-sectional study was conducted with 384 providers from five healthcare facilities (HCFs) from November 23 to December 10, 2023. A self-administered questionnaire and an HH observation grid were used to collect data. Chi-square tests and logistic regression measured the association between the variables of interest at an alpha significance level of 0.05. Results: A total of 5266 opportunities for compliance with HM were identified, and the overall compliance rate for HH was estimated at 37.9%. Some factors were associated with low compliance with HH: absence of administrative measures, OR = 1.966 (95% CI 1.064 - 3.631), p = 0.031; excessive workload, OR = 1.782 (95% CI 1.102 - 2.880), p = 0.018; absence of an infection prevention and control (IPC) committee, OR = 2.528 (95% CI 1.656 - 3.860), p Conclusion: Few healthcare providers observe HH in Lualaba healthcare facilities. There is a need to implement administrative measures, train staff, and revitalize infection prevention and control (IPC) committees to address the challenges of low hand hygiene compliance.