Hand hygiene - washing of hand with soap and water, rubbing of hand with ethanol and sanitizer is one of the basic but critical procedures in infection prevention and control, IPC. Researchers have established that the hand is one of the fastest mediums that human ­-to - human infection transmission happens.

As the human hand has continual contact with the environment on daily basis, it is also used to scratch the itching part of the body and serve the mouth with food and drugs, making it crucial to always keep the hand clean. But in Ghana, hand hygiene practices among health care practitioners remain a challenge.

In a research by Alfred Edwin Dawson of the University of Ghana, Department of Biostatistics and Community Health, the most commonly identified barriers to hand hygiene by health workers is limited resources and lack of knowledge on times to perform hand washing or rubbing.

Published in research gate June 2018 on hand hygiene among health practitioners reveal that hand hygiene resources were deficient in all 15 service centers resulting to 9.2% to 57% and 9.6% to 54% of care -related hand hygiene compliance among Doctors and nurses.  Compliance was higher when risk is perceived to be higher -in the emergency and wound dressing/treatment rooms and labour wards. Except the neonatal intensive care unit (NICU) which always shows the highest level of compliance among health workers in Ghana.

Charles wills Kekeli, a medical practitioner at Greater Accra Regional Hospital in Accra, could relate to this phenomenon saying the unavailability of basic resources—water, soap, ethanol, sanitizers and gloves causes nonadherence. However, he admitted there are some level of negligence on the part of health practitioners whenever they perceive their level of exposure could not cause any harm. ‘’ Sometimes we do perform sessions without gloves or performing hand hygiene due to unavailability of basic resources. In some cases, too we feel like our exposure to the patient will not cause anything.’’ As part of Global Hand Washing Partnership, forming hand hygiene habits is being able to undertake the procedure in hand hygiene intrinsically without involving the decision-making parts of the brain.

Mary Eyram Ashinyo, Deputy Director of quality Assurance at the Ghana Health Service says health systems must ensure strict adherence to monitoring and evaluation practices to enhance Infection Prevention and Control. ‘’ We sense more risk now than ever among health practitioners.  Managers and directors at the various level of health systems in the country must ensure best practices in hand hygiene; she said.’’

However, faced with covid 19 pandemic, where key resources for hand hygiene for hospitals in Ghana is readily available there is a shift in the protocol to hand hygiene—practitioners are more conscious.  

0tchi, Elorm Hillary, a consultant at Africa Institute of Healthcare Quality, Safety and Accreditation in weighing the impact of covid 19 says, hand hygiene has optimally increased among practitioners and it must be sustained. He urged government to continually empower local production for these resources even after covid 19. ‘’one positive thing about the pandemic; it saw the internal push for local resources in the virus's fight; he said.’’