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ORIGINAL ARTICLE
Year : 2019  |  Volume : 7  |  Issue : 1  |  Page : 25-30

Infection control practices at facilities providing monetary incentives for facility births: An assessment at selected labour and delivery rooms in two states of India


1 Department of Microbiology, Maulana Azad Medical College, New Delhi, India
2 Department of Sexual and Reproductive Health, Bhubaneswar, Odisha, India
3 Centre for Clinical Global Health Education, Johns Hopkins University, Baltimore, Maryland, USA
4 Department of Pediatrics, Children's National Medical Center, George Washington University, Children's Research Institute, Washington, DC, USA
5 Department of infectious Diseases, Mayo Clinic College of Medicine and Science, USA
6 Department of Pediatrics, Children's National Medical Center; Department Global Health and Epidemiology, George Washington University, Children's Research Institute, Washington, DC, USA

Correspondence Address:
Dr. Vikas Manchanda
Department of Microbiology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi - 110 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpsic.jpsic_5_19

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Introduction: We report findings from an assessment of infection prevention and control (IPC) practices using a standardised assessment tool at five facilities in high maternal mortality areas of India. Methods: This study was conducted in five public facilities in the two high-focus states ‒ Odisha and Rajasthan. Both the states registered a high uptake of the Janani Suraksha Yojana programme. We surveyed facilities using the infection control assessment tool. The overall quality of those practices assessed in each section was as follows: A – excellent practices in this area (75%–100% of the possible total score); B – good practices in this area (from 50% to 75% of the possible total score) and C – poor practices needing immediate attention (<50% of the possible total score). Results: The mean score for the hospital facility was 36% (27%–46%) in the C category. General ward facilities mean score was 83% (between 50% and 100%) in the A category. Biomedical waste management scored between 10% and 47% both in the C category. Adherence to policies regarding waste management scored 25%–50% in the C category. All the sites had dedicated labour rooms, and for all the modules, the mean score was <50% (22%–47%) in the C category. On general issues, staff education and labour and delivery service design, across the sites, the mean score was 30% (25%–50%) in the category C. Prophylactic antibiotics were used with a mean score of 67% (33% at one site 100% at four sites) for normal delivery and that was inappropriate. Post-partum care received mean score of 23% (20%–25%). The mean length of stay was 1–2 days following uncomplicated delivery and 5–7 days' post-C section delivery. Conclusions: Our study reveals that basic core components of IPC practices were not being fully implemented for safe delivery of babies. Antibiotics were being used inappropriately for normal delivery. A robust IPC programme and antimicrobial stewardship programme should be implemented in labour and delivery rooms.


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