Motivators and barriers to handwashing among healthcare workers in Koboko District, Uganda.

Abstract

Background: Handwashing by healthcare workers is as an effective measure to reduce the incidences of healthcare-associated infection in healthcare facilities. Compliance is still low in developing countries like Uganda. Identifying barriers and motivators to handwashing among healthcare workers can help in planning effective strategies for improvements. Main objective: This study assessed the motivators and barriers to handwashing among healthcare workers in Koboko district, Uganda. Methods: This facility-based descriptive cross-sectional study employed both quantitative and qualitative methods of data collection. The quantitative data were gathered from 117 randomly selected healthcare workers in all 16 government healthcare facilities in Koboko district using an Interviewer-administered questionnaire, while qualitative data were obtained from key informants who were members of the District Health Team of Koboko district and In-charges of Health Centre IIs, IIIs, and IV through Key-Informant Interviews. The collected quantitative data were cleaned, analyzed using Stata version 14, and presented in frequency tables and graphs with corresponding proportions. The qualitative data were recorded, transcribed verbatim in English, analyzed using thematic content analysis and deductive coding approach used to present themes and sub-themes. Results: The study included 117 health workers, with the majority being male 51.3% (60/117). Almost all participants worked in general medicine 98.3% (115/117) and had spent three or more years of work experience 70.9% (83/117). Nurses constituted one-third of the sample 33.3% (39/117). Barriers to handwashing included perceived behavioral control factors such as a scarcity of water for handwashing 76.9% (90/117) while a lack of staff supervision 78.6% (92/117) was a key subjective norm barrier. Conversely, most motivators for handwashing were behavioral beliefs or personal attitude motivators such as the fear of transmitting infections to patients 99.2% (116/117), and a key perceived behavioral control motivator as the presence of handwashing signage in working areas 74.4% (87/117) while Subjective norm motivator was significantly peer influence 80.3% (94/117). Conclusion: These findings provide an important insight regarding the barriers and motivators of handwashing behavior among health workers, emphasizing the importance of addressing behavioral controls and promoting positive attitudes and social norms for effective hand hygiene practices in health facilities.