Short Communication Predictors of pre-and post-care handwashing among community healthcare providers: a cross-sectional survey in Bangladeshi community clinics Kamrul Hsan a,b, *, Mahfuza Mubarak c , Tareq Rahman b,d , Abu Bakkar Siddique b,c , Mohammad Azizur Rahman e , David Gozal f , Md. Marjad Mir Kameli g , Nurullah Awal h and Md. Mahfuz Hossain c a Department of Public Health, Hamdard University Bangladesh, Hamdard City of Science, Education & Culture, Gazaria, Munshiganj 1510, Bangladesh b International Centre for Research, Innovation, Training and Development, Dhaka, Bangladesh c Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh d Department of Statistics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh e Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh f Department of Child Health, and the Child Health Research Institute, University of Missouri School of Medicine, Columbia, MO 65201, USA g Evidence and Learning Department, Save the Children, Cox’s Bazar Area Office, Cox’s Bazar, Bangladesh h WaterAid Bangladesh, Banani, Dhaka 1213, Bangladesh *Corresponding author. E-mail: kamrul.phi.ju@gmail.com KH, 0000-0002-1879-2785 ABSTRACT Lack of proper handwashing by healthcare providers is the major vector for the spread of nosocomial pathogens in healthcare settings. A cross-sectional study was conducted among 128 community healthcare providers (CHCPs) in the Kurigram district of Bangladesh to inves- tigate predictors of handwashing before and after clinical care encounters. Data were collected between November and December 2019 via a paper-and-pen based survey using a semi-structured questionnaire. CHCP’s pre-care handwashing with soap/antiseptic hand cleaner was predicted by a higher level of education (Unadjusted/Crude odds ratio (COR) ¼ 7.16, 95% CI 2.39–21.40, p ¼ 0.000 and COR ¼ 9.58, 95% Confidence Interval (CI) 3.28–27.92, p ¼ 0.000, bachelors and masters, respectively), lengthier service (COR ¼ 6.90, 95% CI 1.40–34.17, p ¼ 0.015 and COR ¼ 7.8, 95% CI 1.49–40.98, p ¼ 0.015, 5–8 and .8 years, respectively), and presence of handwashing facility (COR ¼ 4.48, 95% CI 1.34–14.95, p ¼ 0.015). However, post-care handwashing was also associated with a higher level of education (COR ¼ 13.36, 95% CI 1.54–115.63, p ¼ 0.019, masters) and availability of soap (COR ¼ 17.73, 95% CI 5.03–59.73, p ¼ 0.000), as well as by male sex (COR ¼ 3.14, 95% CI 1.01–9.79, p ¼ 0.049). Implementation of an effective training program on hand hygiene combined with improved access to handwashing stations and adequate supply of soap or antiseptic hand cleaner is required to improve both pre-and post-care clinical encoun- ter handwashing practices among CHCPs. Key words: hand hygiene, healthcare, soap, water HIGHLIGHTS • Frequency of handwashing with soap/antiseptic cleaner among community healthcare providers was significantly lower before compared to after patient care encounters. • Healthcare providers’ pre-care handwashing was associated with education, length of service, and handwashing facility and post-care handwashing was associated with sex, level of education, and availability of soap. INTRODUCTION Poor hand hygiene practices are pervasively common among healthcare providers working in primary healthcare facilities worldwide. Lack of proper hand hygiene is one of the major vehicles for transmission and spread of healthcare-associated infections (HAIs) and can affect both the care seekers as well as the healthcare providers, resulting in many millions of people being at risk worldwide (Rahman et al. 2022). In developing countries, the risk of HAIs is 2–20-fold higher than in developed countries (Shahida et al. 2016). In hospital settings, healthcare workers’ hands represent the principal route of transmission of nosocomial pathogens, which are typically transmitted by healthcare workers who fail to implement This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY-NC-ND 4.0), which permits copying and redistribution for non-commercial purposes with no derivatives, provided the original work is properly cited (http://creativecommons.org/licenses/by-nc-nd/4.0/). © 2023 The Authors Journal of Water, Sanitation and Hygiene for Development Vol 13 No 7, 487 doi: 10.2166/washdev.2023.192 Downloaded from http://iwaponline.com/washdev/article-pdf/13/7/487/1263590/washdev0130487.pdf by guest on 31 July 2023