We’ve previously reported on the participatory training package developed for health facility cleaners on basic environmental hygiene and infection prevention and control (IPC). The package was piloted in the Gambia where we also provided the facilities involved with cleaning procedure guidelines where previously they did not exist. However, the guidelines were text-based and therefore poorly understood by cleaning staff with low levels of literacy.
In response to this we worked with a local graphic artist, Kieren McDonald, to illustrate the guidelines and provide an accessible reference manual for staff with poor literacy skills. Field testing of the illustrated guidelines’ suitability was an essential next step in their development.
During her trip to the Gambia last month, Dr Beverly Donaldson, Post-Doctoral Research Midwife and long-standing colleague to Soapbox, introduced the manual to staff at one health centre and one hospital there. The key stakeholders – cleaners, nurses and midwives and colleagues in the Ministry of Health – subjected the guidelines to very practical scrutiny and fed their opinions back to Beverly. The manual was assessed on whether the illustrations were meaningful, conveyed an accurate message of best practice cleaning techniques, and if they were considered to be a useful tool for the facilities.
The feedback received by Beverly was positive on all counts with some interesting differences between stakeholder groups. Staff who had been involved in the pilot of the participatory training package and had received formal IPC training found the illustrated guidelines straightforward to interpret. Those who had no formal training saw prior training either in the use of the guidelines or in wider IPC as a necessary prerequisite. The cleaning staff also requested the guidelines in a poster format to be displayed in appropriate areas, considering that this visual aid would prompt good practice and act as a daily reminder.
Following the pilot, the next stage is to incorporate the feedback received into the guidelines and develop the next version. The ultimate aim is to develop universally applicable guidelines while addressing the challenge of ensuring they are adaptable to local variations in practice and equipment, while maintaining best practice.