A study on the knowledge, attitude and practice of Midwives on infection control in Maternity units in Lusaka Urban Clinics.

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Libetwa, Miriam Chilembwe
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Infection Control is a major problem in UTH, Lusaka. It was important to see if a similar problem occurred in urban maternity units.TITLE OF STUDY: A study on the knowledge, attitude, and practice of midwives on Infection Control in Maternity Units in Lusaka Clinics.OBJECTIVES: To determine the extent to which midwives working in labour ward understand, accept and practice according to infection control guidelines in their working environment. HYPOTHESIS:1. Poor infection control practice is due to inadequate materials/equipment. 2.Adequate knowledge of infection control guideline enhances attitude and practice among midwives.STUDY DESIGN: A descriptive study design using a structured interview schedule with fixed questions and answers was used to collect data from practicing midwives. A check-list was also used to observe routines of midwifery care. Content analysis of the midwives curriculum for both Registered and Enrolled midwives was done. Focus group discussion with Maternity Unit in-Charges was also done. SETTING: Six maternity units in Lusaka Urban District, namely Chilenje, Kanyama, Chawama, George, Chelston and Chipata Health Centres, were included. SAMPLE SIZE: 42 midwives were observed as they carried out the midwifery routines of care. The same midwives were interviewed. RESULTS:Generally the midwives, both Enrolled and Registered, did not practice the Universal Infection Control. The midwives who qualified after 31 December 1987, practiced hand-washing more often than those who qualified before 31 December 1987. The contributing factors to non-practice of the Universal Infection Control stemmed from the lack of supplies,especially the gloves, plastic aprons,disinfectants and the use of the autoclave and principles thereof. The institutions did not have any guidelines on Infection Control, and as a result, midwives provided the care as long as no one was visibly in danger. None of the respondents had ever attended any workshop on Infection Control and they perceived themselves at risk of contracting HIV/Hepatitis because of the non-practice of the Universal Infection Control. The data showed that midwives were performing artificial rupture of membranes on all the patients who were admitted with intact membranes. Episiotomy seemed to be performed on all primigravidae women who were aged between 10 and 20 years old. CONCLUSION:In view of the poor practice of Infection Control by midwives in the six maternity units, there is need for the government, particularly Ministry of Health, with the relevant authorities to institute an Infection Control Policy, which will provide guidance for practice. There is the need for the District Health Management Board to colla¬borate with the General Nursing Council and the Quality Assurance Programme team in implementing and monitoring the practice. The practice can only be of quality if the necessary resources were available and if Midwives observed the basic practice in infection control.
Infection control , Maternity , Midwives working in Maternity wards