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Soapboxer Giorgia Gon recently returned from a to Zanzibar, where huge advancements are being made in hygiene practices within maternity wards.

On the 12th of April I was lucky enough to attend the inception meeting for the HANDS study in Zanzibar looking at drivers of hand hygiene compliance among birth attendants in maternity units. Here I had the opportunity to meet many of the stakeholders who were so enthusiastically involved with Soapbox’s previous work in Zanzibar; the needs assessment of WASH and IPC in maternity units, and find out what happened after the needs assessment dissemination workshop.

Dr Dahoma, the Director of Preventive Services in Zanzibar, together with Dr Kabole, WaterAid Tanzania, summarized the results of this earlier needs assessment project. Two actions were agreed that concluded the needs assessment project in November 2014 – fixing and/or replacing the sinks in maternity units where none were functioning, and training orderlies who are involved in several aspects of environmental hygiene but receive no formal training. During my visit I saw how the Ministry of Health for Zanzibar (MoH), in collaboration with WaterAid, the Pemba Health Laboratory, and other partners, met these aims head-on and then went much further. All nine of the maternity units with no functional sink now have large ‘trough’ sinks with multiple taps; I had the chance to see the maternity unit in Chake Chake hospital and water was flowing from every sink. However the most impressive achievement for me was the eagerness and speed with which the MoH developed a cleaners training package and trained over 30 orderlies on environmental hygiene. With a low literate population, the decision to make the training 90% practical has proven to be a great success.

In just over a year the Zanzibar MoH has proudly pushed the agenda for improving IPC in maternity units and in healthcare facilities as a whole, creating a safer and cleaner environment for births across the country. Soapbox was one of the organisations that helped catalyse this change, and I feel honoured to have been part of the journey.