Jedidiah S Snyder, Erika Canda, Jordan Honeycutt, Lilly A O'Brien, Hannah K Rogers, Oliver Cumming, Joanna Esteves Mills, Bruce Gordon, Marlene K Wolfe, Bethany A Caruso, Matthew C Freeman
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引用次数: 0
Abstract
Introduction: This systematic review aimed to identify and evaluate the implementation of government measures that support equitable and sustained hand hygiene practices in community settings.
Methods: We systematically searched 12 databases, including PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, PAIS Index, WHO IRIS, UN Digital Library and World Bank eLibrary for peer-reviewed and grey literature published through late March 2023. Additional sources were identified through expert consultations and manual reference list checks of related reviews. Studies employing quantitative, qualitative or mixed-methods designs were eligible. Study quality was assessed using the Mixed Method Appraisal Tool. Government measures were categorised according to the Sanitation and Water for All Building Blocks framework: sector policy strategy; institutional arrangements; sector financing; planning, monitoring, review; and capacity development. Hand hygiene outcomes were classified as access, behaviour change or enabling environment and impact as positive, null or not evaluated.
Results: Thirty-one studies (24 journal articles and 7 grey literature) from 19 countries-mostly middle income (71%)-were included. Most focused on household (58%), schools (19%) or both (13%). A total of 75 government measures were identified, with sector policy strategy and capacity development being the most common (each 31%), followed by institutional arrangements (17%), planning, monitoring, review (13%) and sector financing (8%). Positive impacts were linked to 45 measures across all five Building Blocks in 17 studies.
Conclusion: This systematic review highlights diverse government measures supporting hand hygiene in community settings, with sector policy strategy and capacity development being the most frequently reported. While many government measures showed positive impacts, gaps remain in financing, implementation and sustainability beyond households and schools. Strengthening governance, increasing investment and expanding research on cost-effectiveness and implementation barriers are essential to improve hygiene initiatives and ensure equitable access.
本系统综述旨在确定和评估政府措施的实施情况，这些措施支持社区环境中公平和持续的手卫生习惯。方法：系统检索PubMed、Web of Science、EMBASE、CINAHL、Global Health、Cochrane Library、Global Index Medicus、Scopus、PAIS Index、WHO IRIS、UN Digital Library和World Bank Library等12个数据库，检索截至2023年3月下旬发表的同行评议文献和灰色文献。通过专家协商和手工核对有关审查的参考资料清单，确定了其他来源。采用定量、定性或混合方法设计的研究是合格的。采用混合方法评价工具评价研究质量。政府措施根据“人人享有卫生设施和用水”框架进行分类：部门政策战略；制度安排;部门融资;计划、监测、评审；能力发展。手卫生结果分为可及性、行为改变或有利环境，影响分为正面、无效或未评估。结果：纳入了来自19个国家的31项研究（24篇期刊文章和7篇灰色文献），主要是中等收入国家（71%）。大多数人关注家庭（58%）、学校（19%）或两者兼而有之（13%）。共确定了75项政府措施，其中最常见的是部门政策战略和能力发展（各占31%），其次是制度安排（17%）、规划、监测、审查（13%）和部门融资（8%）。在17项研究中，所有五个构建模块的45项措施都与积极影响有关。结论：本系统综述强调了政府在社区环境中支持手部卫生的各种措施，其中最常报告的是部门政策战略和能力发展。虽然许多政府措施显示出积极影响，但在家庭和学校以外的资金、实施和可持续性方面仍存在差距。加强治理、增加投资和扩大对成本效益和实施障碍的研究对于改善卫生行动和确保公平获取至关重要。普洛斯彼罗注册号：CRD42023429145。
期刊介绍：
BMJ Global Health is an online Open Access journal from BMJ that focuses on publishing high-quality peer-reviewed content pertinent to individuals engaged in global health, including policy makers, funders, researchers, clinicians, and frontline healthcare workers. The journal encompasses all facets of global health, with a special emphasis on submissions addressing underfunded areas such as non-communicable diseases (NCDs). It welcomes research across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialized studies. The journal also encourages opinionated discussions on controversial topics.
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