Project – Knowledge and Practice of Infection Prevention and Control Among Midwives at General Hospital, Ikot Ekpene, Akwa Ibom State, Nigeria

CHAPTER ONE

INTRODUCTION

Background of the Study

Infection prevention and control (IPC) is a critical component of healthcare delivery that protects both patients and healthcare workers from healthcare-associated infections (HAIs). It involves a set of evidence-based practices, including hand hygiene, use of personal protective equipment, safe injection practices, environmental cleaning, and proper waste management (World Health Organization [WHO], 2022). In maternity and delivery settings, IPC is particularly important because midwives are frontline healthcare providers who manage labor, delivery, and immediate postpartum care, which involves frequent exposure to blood, body fluids, and potentially infectious materials (Akinyemi et al., 2017).

Globally, healthcare-associated infections remain a major public health concern, accounting for significant morbidity, mortality, and healthcare costs, particularly in low- and middle-income countries (Allegranzi et al., 2011). In Nigeria, the prevalence of HAIs in hospitals ranges from 10% to 30%, with maternal and neonatal units being among the most affected areas (Okechukwu & Eze, 2020). Studies have shown that inadequate knowledge and poor practice of IPC among healthcare workers, including midwives, contribute significantly to the spread of infections such as sepsis, hepatitis B, HIV, and COVID-19 within healthcare facilities (Oluwole et al., 2019).

Midwives play a pivotal role in ensuring safe maternal and neonatal care. Their knowledge and adherence to IPC guidelines are essential for reducing HAIs, improving patient outcomes, and protecting their own health (WHO, 2022). Despite national policies and training programs on IPC, evidence suggests that compliance among healthcare workers remains suboptimal due to factors such as inadequate training, lack of resources, high patient load, and insufficient monitoring (Akinyemi et al., 2017; Okechukwu & Eze, 2020).

At General Hospital, Ikot Ekpene, Akwa Ibom State, midwives are key providers of maternal and newborn care, yet little empirical data exists on their knowledge and practice of IPC. Understanding the current status of IPC knowledge and practice among these midwives is essential for designing interventions that can enhance adherence to safety protocols, reduce infection risks, and improve maternal and neonatal outcomes (Oluwole et al., 2019). This study aims to fill this knowledge gap and provide evidence for targeted training, policy improvements, and resource allocation in the hospital.

Statement of the Problem

Healthcare-associated infections remain a significant threat to patient safety worldwide, particularly in maternity units where midwives provide hands-on care to women during labor and the immediate postpartum period (Allegranzi et al., 2011). In Nigeria, studies have reported that many healthcare workers, including midwives, have inadequate knowledge of IPC guidelines and fail to implement recommended practices consistently (Okechukwu & Eze, 2020).

At General Hospital, Ikot Ekpene, anecdotal reports indicate that while some midwives have attended training on IPC, adherence to protocols is inconsistent. Factors such as high patient-to-staff ratios, limited availability of personal protective equipment, and poor institutional monitoring may contribute to lapses in practice (Akinyemi et al., 2017). These gaps pose risks not only to mothers and newborns but also to healthcare workers themselves.

Despite the critical role of midwives in preventing infections in maternal and neonatal care, there is limited empirical evidence from General Hospital, Ikot Ekpene regarding the level of knowledge and actual practice of IPC among midwives. Without such data, hospital administrators and policymakers lack the information needed to implement effective interventions to improve compliance, reduce HAIs, and enhance patient safety. This study, therefore, seeks to assess the knowledge and practice of infection prevention and control among midwives at the facility.

Research Questions

1. What is the level of knowledge of infection prevention and control among midwives at General Hospital, Ikot Ekpene?

2. To what extent do midwives at General Hospital, Ikot Ekpene practice recommended IPC measures?

3. What factors influence the practice of IPC among midwives at General Hospital, Ikot Ekpene?

4. What are the barriers to effective IPC implementation among midwives at the facility?

Objectives of the Study

General Objective:
To assess the knowledge and practice of infection prevention and control among midwives at General Hospital, Ikot Ekpene, Akwa Ibom State, Nigeria.

Specific Objectives:

1. To determine the level of knowledge of IPC among midwives at General Hospital, Ikot Ekpene.

2. To assess the level of compliance with recommended IPC practices among midwives at the facility.

3. To identify factors influencing IPC practice among midwives.

4. To identify barriers to effective IPC implementation in the hospital.

Hypothesis

Null Hypothesis (H₀):
There is no significant relationship between the level of knowledge of infection prevention and control and the practice of recommended IPC measures among midwives at General Hospital, Ikot Ekpene.

Significance of the Study

This study is significant for several reasons. First, it will provide empirical data on the knowledge and practice of IPC among midwives in a secondary healthcare facility in Akwa Ibom State, informing hospital administrators and policymakers about current strengths and gaps. Second, the findings can guide the design and implementation of targeted training programs to improve midwives’ adherence to IPC protocols, reducing HAIs in the hospital. Third, the study will contribute to the broader literature on maternal and neonatal safety in Nigeria and may serve as a reference for similar facilities in other parts of the country. Finally, improving IPC practices has the potential to enhance maternal and neonatal outcomes while protecting healthcare workers from occupational infections.

Scope of the Study

The study will focus on midwives working at General Hospital, Ikot Ekpene, Akwa Ibom State. It will assess their knowledge and self-reported practices of infection prevention and control, as well as factors influencing IPC adherence. The study will not include other categories of healthcare workers or midwives from other health facilities outside the study area.

Definition of Terms

1. Infection Prevention and Control (IPC): A set of evidence-based practices and procedures designed to prevent the spread of infections within healthcare settings, including hand hygiene, use of personal protective equipment, safe injection practices, environmental cleaning, and waste management (WHO, 2022).

2. Knowledge of IPC: The awareness and understanding of infection prevention principles, guidelines, and procedures that healthcare workers, particularly midwives, possess, which influence their ability to prevent healthcare-associated infections (Oluwole et al., 2019).

3. Practice of IPC: The actual application or implementation of recommended infection prevention and control measures by healthcare workers during patient care activities (Okechukwu & Eze, 2020).

4. Midwives: Healthcare professionals trained in the management of normal pregnancy, childbirth, and postpartum care, who are responsible for providing maternal and newborn healthcare services (WHO, 2022).

5. Healthcare-Associated Infections (HAIs): Infections acquired by patients or healthcare workers within a healthcare setting, which were not present or incubating at the time of admission (Allegranzi et al., 2011).

6. General Hospital, Ikot Ekpene: A secondary healthcare facility located in Ikot Ekpene, Akwa Ibom State, Nigeria, providing maternal, neonatal, and other general healthcare services.

7. Compliance: The degree to which midwives adhere to recommended infection prevention and control protocols during healthcare delivery (Akinyemi et al., 2017).

8. Barriers: Factors that hinder or prevent midwives from fully implementing IPC measures, which may include lack of resources, inadequate training, high patient load, or institutional constraints (Okechukwu & Eze, 2020).

Project – Knowledge and Practice of Infection Prevention and Control Among Midwives at General Hospital, Ikot Ekpene, Akwa Ibom State, Nigeria