BACKGROUND In 2014, 16 women died following female sterilization operations in Bilaspur, a district in central India. In addition to those 16 deaths, 70 women were hospitalized for critical conditions (Sharma, Lancet 384,2014). Although the government of India's guidelines for female sterilization mandate infection prevention practices, little is known about the extent of infection prevention preparedness and practice during sterilization procedures that are part of the country's primary health care services. This study assesses facility readiness for infection prevention and adherence to infection prevention practices during female sterilization procedures in rural northern India. METHOD The data for this study were collected in 2016-2017 as part of a family planning quality of care survey in selected public health facilities in Bihar (n = 100), and public (n = 120) and private health facilities (n = 97) in Uttar Pradesh. Descriptive analysis examined the extent of facility readiness for infection prevention (availability of handwashing facilities, new or sterilized gloves, antiseptic lotion, and equipment for sterilization). Correlation and multivariate statistical methods were used to examine the role of facility readiness and provider behaviors on infection prevention practices during female sterilization. RESULT Across the three health sectors, 62% of facilities featured all four infection prevention components. Sterilized equipment was lacking in all three health sectors. In facilities with all four components, provider adherence to infection prevention practices occurred in only 68% of female sterilization procedures. In Bihar, 76% of public health facilities evinced all four components of infection prevention, and in those facilities provider's adherence to infection prevention practices was almost universal. In Uttar Pradesh, where only 55% of public health facilities had all four components, provider adherence to infection prevention practices occurred in only 43% of female sterilization procedures. CONCLUSION The findings suggest that facility preparedness for infection prevention does play an important role in provider adherence to infection prevention practices. This phenomenon is not universal, however. Not all doctors from facilities prepared for infection prevention adhere to the practices, highlighting the need to change provider attitudes. Unprepared facilities need to procure required equipment and supplies to ensure the universal practice of infection prevention.

中文翻译：

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印度北部初级保健机构内女性绝育服务的感染预防准备和实践。

背景技术2014年，印度中部地区比拉斯普尔（Bilaspur）进行了女性绝育手术，导致16名妇女死亡。除了那16例死亡之外，还有70名因危重病住院的妇女（Sharma，Lancet 384,2014）。尽管印度政府的女性绝育指南要求采取预防感染的措施，但对于作为印度主要医疗服务一部分的绝育过程中预防感染的准备程度和实践知之甚少。这项研究评估了印度北部农村地区女性绝育过程中感染预防的设施准备情况以及对感染预防措施的遵守情况。方法本研究的数据是2016-2017年收集的，是比哈尔邦（n = 100），公共场所（n = 120）和私人场所（n = 97）的部分公共卫生设施的计划生育护理质量调查的一部分）在北方邦。描述性分析检查了设施预防感染的准备程度（洗手设施，新手套或已消毒手套的可用性，消毒液和消毒设备的可用性）。相关性和多元统计方法被用来检验女性绝育过程中设施准备状况和提供者行为在感染预防实践中的作用。结果在三个卫生部门中，有62％的设施具有所有四个感染预防组成部分。所有三个卫生部门都缺乏消毒设备。在具有所有四个组成部分的设施中，提供者遵守感染预防措施的情况仅发生在68％的女性绝育手术中。在比哈尔邦，有76％的公共卫生设施都体现了感染预防的所有四个组成部分，在这些设施中，提供者对感染预防实践的遵守几乎是普遍的。在北方邦，只有55％的公共卫生机构具有所有这四个要素，在女性绝育手术中，只有43％的医疗服务提供者遵守了感染预防措施。结论研究结果表明，预防感染的设施准备确实在提供者遵守感染预防措施方面起着重要作用。但是，这种现象并不普遍。并非所有为预防感染而准备的设施中的医生都遵守该惯例，强调需要改变提供者的态度。未经准备的设施需要采购所需的设备和用品，以确保普遍采取预防感染的措施。