Hand hygiene knowledge and practices among health care workers in Uganda: Evidence from Mukono and Kagadi districts

@misc{twinomugisha2026hand,
  title = {{Hand hygiene knowledge and practices among health care workers in Uganda: Evidence from Mukono and Kagadi districts}},
  author = {F. TWINOMUGISHA and R. K. Mugambe and J. B. Isunju and E. Buregyeya and D. Musoke and S. Murungi and H. Kajumbula and H. Yakubu and R. Kimwanga and S. Simiyu and R. Suraja and E. Mliva and E. C. Mulwanda and M. Manga and C. L. Moe},
  howpublished = {medRxiv},
  year = {2026},
  month = oct,
  doi = {10.64898/2026.10.06.26364922},
  url = {https://www.medrxiv.org/content/10.64898/2026.10.06.26364922v1},
  note = {CC BY},
}

TY  - UNPB
TI  - Hand hygiene knowledge and practices among health care workers in Uganda: Evidence from Mukono and Kagadi districts
AU  - F. TWINOMUGISHA
AU  - R. K. Mugambe
AU  - J. B. Isunju
AU  - E. Buregyeya
AU  - D. Musoke
AU  - S. Murungi
AU  - H. Kajumbula
AU  - H. Yakubu
AU  - R. Kimwanga
AU  - S. Simiyu
AU  - R. Suraja
AU  - E. Mliva
AU  - E. C. Mulwanda
AU  - M. Manga
AU  - C. L. Moe
PY  - 2026
DA  - 2026/10/06
PB  - medRxiv
DO  - 10.64898/2026.10.06.26364922
UR  - https://www.medrxiv.org/content/10.64898/2026.10.06.26364922v1
AB  - BackgroundHand hygiene (HH) is one of the most effective measures to prevent healthcare-associated infections (HAIs) and limit the transmission of antimicrobial-resistant pathogens in healthcare facilities (HCFs). Effective HH programs depend not only on the availability of essential resources but also on healthcare workers (HCWs) knowledge, attitudes, and adherence to recommended HH practices. Despite the critical role of these factors in improving infection prevention and control (IPC), evidence on HH knowledge and practices among HCWs remains limited. In Uganda, such evidence from lower-level district health facilities is particularly scarce. This study assessed HH knowledge and practices, along with associated factors, among HCWs at selected health facilities in the Mukono and Kagadi districts of Uganda.  MethodsA cross-sectional study was conducted among 586 HCWs at selected health facilities in the Mukono and Kagadi districts from May to June 2025. Data were collected using a structured questionnaire administered via KoboCollect, covering participants socio-demographic and professional characteristics, HH knowledge, self-reported HH practices, and facility-related factors. Descriptive statistics summarized the data, and modified Poisson regression with generalized estimating equations (GEE), accounting for clustering of HCWs within facilities, was used to estimate prevalence ratios for factors associated with HH knowledge and practices.  ResultsOverall, 82.1% of HCWs had adequate HH knowledge, and 43.0% had good HH practice. Nearly all respondents correctly identified the recommended handwashing duration (98.8%), the minimum effective alcohol concentration for alcohol-based hand rub (ABHR) (98.8%), proper HH as the most effective method for preventing HAIs (97.6%), and 89.9% correctly listed all five WHO Moments for HH. HCWs in Mukono were more likely to have adequate HH knowledge than those in Kagadi (aPR = 1.36; 95% CI: 1.15-1.60). HCWs with 6-10 years of experience had higher knowledge of HH than those with less than two years of experience (aPR=1.16, 95% CI: 1.02-1.33). Good HH practice was significantly more common among clinical officers (aPR=1.36, 95% CI: 1.06-1.75) and other cadres (aPR=1.65, 95% CI: 1.14-2.39) than nurses and nursing assistants.  ConclusionHCWs demonstrated high HH knowledge but suboptimal HH practice, suggesting a gap between knowledge and self-reported practice. Interventions should move beyond knowledge dissemination to strengthen compliance through multimodal, cadre-specific strategies, particularly for nurses and nursing assistants.
ER  -