Availability of hand hygiene infrastructure and point-of-care resources in Sierra Leone’s public hospitals: a nationwide multicentre cross-sectional study

By
Bobson Derrick Fofanah
Rugiatu Z. Kamara
Ibrahim Franklyn Kamara
Nanah Fofanah
Augustus Osborne
Ralph Williams
Emmanuel Marx Kanu
Fatmata B. Kargbo
Sia Morenike Tengbe
George Ameh
Binyam Hailu
Reham Ragab
Landry Kabego
Miranda Deeves
Frieder Schaumburg
Julie Storr
Martin P. Grobusch
Claire Kilpatrick
Sulaiman Lakoh
October 8, 2026

Infection

Overview

This nationwide multicentre cross-sectional study assessed hand hygiene infrastructure and point-of-care resources in eligible public hospitals in Sierra Leone. The supplied article text describes the study rationale, setting, eligibility, and data-collection period, but does not provide its results; therefore, the availability of specific resources cannot be summarized.

Background

Healthcare-associated infections and antimicrobial resistance contribute to preventable morbidity and mortality, with a greater reported HAI burden in low- and middle-income countries than in high-income countries. Hand hygiene is a core infection-prevention measure, and the WHO multimodal improvement strategy emphasizes point-of-care practice and a functional built environment alongside individual effort. Earlier Sierra Leone assessments cited in the article reported limited running-water availability in hospital units and infrastructure and funding deficiencies in public hospitals. The study was designed to address the limited evidence on hospital hand hygiene infrastructure and resources in the country.

Data Highlights

Study characteristic	Reported information
Design	Nationwide, multicentre cross-sectional survey using a validated WHO instrument
Setting	19 eligible public secondary- and tertiary-care hospitals in Sierra Leone
Ward scope	Operational inpatient and clinical wards, including acute, medical, surgical, high-dependency, intensive-care, emergency, outpatient, isolation, and resuscitation areas
Data-collection period	February–March 2025
Results	Not included in the supplied article text

Key Findings

The study evaluated ward-level hand hygiene infrastructure and point-of-care resource availability in Sierra Leone’s public hospitals.
Of 27 public hospitals described in the source, 19 were eligible because they had a functional infection prevention and control programme and a trained focal person.
All operational inpatient and clinical wards in participating hospitals were eligible, regardless of patient occupancy at the time of assessment.
The survey used a validated WHO instrument derived from the WHO multimodal hand hygiene improvement strategy.
The article introduction reports that an earlier investigation in two major referral hospitals found running water systems in 9.5% of hospital units.
The supplied text does not include the current study’s resource-availability results or outcome estimates.

Clinical Implications

The study’s stated focus is on whether hand hygiene infrastructure and point-of-care resources are available across hospital wards, factors the WHO multimodal strategy identifies as part of the enabling environment for hand hygiene. The supplied material does not report the study’s findings, so it does not support conclusions about current resource gaps or specific actions for participating hospitals.

Conclusion

This nationwide survey was designed to assess hand hygiene infrastructure and point-of-care resources across eligible public hospitals in Sierra Leone. Its results are not present in the supplied text, limiting interpretation of the extent of resource availability.