AUTHOR=Galli Anaïs , Winkler Mirko S. , Hattendorf Jan , Friedrich Max N. D. , Bagayogo Issa , Ballo Aboubacar , Bänziger Carola , Dembélé Hassane , Keita Mamadou Sory , Peter Maryna , Tall Alimata Ousséni , Utzinger Jürg , Owen Branwen Nia 

TITLE=Baseline Characteristics of a Cluster Randomized Controlled Trial Targeting Hand Hygiene in Primary Healthcare in Burkina Faso and Mali

JOURNAL=International Journal of Public Health

VOLUME=Volume 70 - 2025

YEAR=2025

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2025.1608406

DOI=10.3389/ijph.2025.1608406

ISSN=1661-8564

ABSTRACT=Objectives: This study presents baseline characteristics of a cluster randomized controlled trial (cRCT) on hand hygiene in primary health care in Burkina Faso and Mali, addressing data gaps on hand hygiene practices in these settings.Methods: We implemented a two-arm cRCT in 48 primary health care facilities. Baseline data were collected (January–June 2023), followed by covariate-constrained randomization. We conducted covert hand hygiene observations, hand-rinse sampling for Escherichia coli detection, and a survey on behavioral factors among health care workers. The primary outcome is observed handwashing rate.Results: Baseline data included 309 health care workers. Trial arms were balanced in hand hygiene adherence, behavioral factors and E. coli contamination. Hand hygiene adherence was low (12%). E. coli contamination was high in Burkina Faso (76%) and Mali (23%). Participants had a high intention to wash their hands (93%) but only a quarter could name all moments for hand hygiene.Conclusions: Poor hand hygiene and E. coli contamination in our setting may heighten nosocomial infection risks. Interventions should address knowledge and build on high intentions to perform hand hygiene.