Social and cultural dimensions of hygiene in Cambodian health care facilities

Pascale Hancart Petitet (1, 2) , Céline Dumas (1) , Anne Laure Faurand- Tournaire (1) , Alice Desclaux (1, 3) , Sirenda Vong (2)

1 GReCSS - Groupe de Recherches Cultures Santé Sociétés
2 Institut Pasteur du Cambodge
3 TransVIHMI - Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes

Abstract Background: The frequency of bloodborne pathogen healthcare-healthcaressociated infections is thought to be high in developing Southeast Asian Countries. The underlying social-socialultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings. Methods: We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-semitructured and open-opennded interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors) and with patients who attended the study health facilities. Results: Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1) informal and formal social rapports in hospitals, (2) major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-lowanking staff. Conclusion: Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.

Mots clés: Hygiene; heath care settings; nocosomiale transmission; Cambodia

Domaines: Anthropologie sociale et ethnologie

Pascale Hancart Petitet, Céline Dumas, Anne Laure Faurand- Tournaire, Alice Desclaux, Sirenda Vong. Social and cultural dimensions of hygiene in Cambodian health care facilities. BMC Public Health, 2011, 11 (83), pp.1. ⟨10.1186/1471-2458-11-83⟩. ⟨hal-00583922⟩