A knowledge dissemination workshop on ‘WASH & CLEAN in the labour ward: A situation analysis in India and Bangladesh”was held on 25 March 2015 at BRAC Centre Auditorium.  The Bangladesh part of this study is a collaboration between BRAC and the University of Aberdeen, UK with funding support from the Soapbox Collaborative, UK. In the workshop, findings of the study on water, sanitation and hygiene (WASH) and infection prevention practices in maternity unit of hospital was shared withstakeholders working in the field of maternal health.

Dr. Md Shah Nawaz, Additional Director General of Health Services, Ministry of Health and Family Welfare, Government of Bangladesh was present as the chief guest.Professor DrMdShamiul Islam, the Line Director of Hospital Services Management, Directorate General of Health Service was the special guest. Among the key speakers were Dr. Wendy J Graham, Professor of Obstetric Epidemiology, University of Aberdeen, UK, MS Suzanne Cross, Senior Programme Officer, The Soapbox Collaborative, UK andDrTanveenIshaque, Senior Research Associate, Research and Evaluation Division, BRAC. The session was chaired by Dr. Ahmed MushtaqueRaza Chowdhury, Vice Chairperson, BRAC. Academicians, researchers, policy makers, clinicians, professionals, microbiologists and representatives from national and international organisations were present in the session.

Bangladesh findings were shared by DrTanveenIshaque and MrsAtiya Rahman.One of the key findings of the study is that visual cleanliness does not always indicate microbiological safety. The cleaner environment might have fewer germs, but not necessary they are completely safe. Inadequacies in training on infection, prevention and control for healthcare providers and an absence of training for cleaners were identified. The majority of healthcare providers expressed their need to get formal infection prevention training for their cleaners and other health care providers. Lack of organizational policies and protocols for infection prevention and control, absence of formal infection control committee and relevant checklists for monitoring and quality control contributed to suboptimal standards of infection, prevention and control practices in the participating facilities. Staff motivation specifically cleaners of the health facilities were shaped by high level of dissatisfaction due to heavy workload and poor salary which ultimately affecting the overall infection prevention practices of the facilities.  Most women who received care from the participating facilities did not have any idea about the fatal consequences or risks that they or their baby might face as a result of exposure to an unsafe hospital environment.

In his speech, Dr. Md Shah Nawaz talked about some of the important characteristics of Bangladesh health sector.  Per capita health expenditure is only $27 dollar/ year. The rate of institutional delivery is 29%. He talked about the wide variation in the service provision between urban and rural setting. Even within the urban setting, wide variation exists. For example, cost of cesareans delivery varies widelyranging from BDT 4000 taka to overBDT 100,000. He mentioned that our health sector has good data storage and management information system. There is more than 180,000 service centres available all over the country. He gratefully recognisedthe valuable contribution of some of the distinguished guest present in the session and also requested others to come forward.

In his speech, DrMdShamiul Islam mentioned about the remarkable growth in health sector. However, there is lots of scope of improvement in service quality. There is clear relationship between infection and maternal mortality. So infection prevention and control is very important. Visual cleanliness is not sufficient. He mentioned that there is lots of rules, regulation and protocols ara available, but they are not properly implemented. He sought everyone’s support in the health sector. He thanked the team of this valuable and timely research and also welcomed more researchers to conduct evidence based researches.

In the concluding remark Dr. Ahmed MushtaqueRaza Chowdhury said that we all have a role to play in ensuring WASH and Clean practice. It is not just about having a protocol, rather there needs to be a detailed and clear strategy. Finally he thanked the researcher team, government officials and audience to be part of this knowledge dissemination strategy.

The dissemination session was followed by a consultative policy discussion session. National & international experts on health sectorwere given some of the priority areas of maternal health. They identified key issues under each area, suggested next step, proposed timeline and identify priority stakeholders for the programme implementation