Improving Hygiene in Guardian Waiting Shelters and Communities in Malawi: an Intervention Development and Feasibility Study
Principal Investigator: Robert Dreibelbis, RGHI Innovation Grant Award Holder.
Guardian Waiting Shelters (GWS) are temporary residential homes at healthcare facilities that provide dormitory type accommodations for caregivers (parents, relatives, carers) whose relatives have been admitted to hospitals.
GWS have limited environmental services, variable infection prevention and control protocols, and are overcrowded, creating significant risk for communicable disease transmission. These risks were particularly pronounced within the context of COVID-19, which resulted in high rates of hospitalisation, increasing the use of GWS while COVID-19 transmission dynamics created high risk of transmission among GWS residents and increased the risk of transmission to the home and community. In the first wave of the COVID-19 pandemic, the GWS at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi was identified as one of these high-risk, yet unsupported areas. Between April and September 2020 (1st peak of COVID-19), the WASHTED Centre (University of Malawi – The Polytechnic) and University of Strathclyde worked hand in hand with the Ministry of Health and Chira Fund to develop a bespoke programme for the GWS. This programme included a daily hygiene education programme focussed on transmission reduction through hand washing, mask wearing, physical distancing, and maintaining behaviours whilst at the GWS and when returning home.
This research builds on this, informing the adaptation, implementation, and evaluation of these novel interventions to promote hygienic behaviours. Furthermore, this will inform future programme and policy level interventions at the national and district level.
This research addresses two key areas:
- How to maintain adequate infection prevention and control standards within GWS.
- How to utilise the GWS intervention to improve hygiene behaviours after returning from the healthcare facilities to the home environment – a particularly critical window for preventing and reducing the risk of infectious disease.
