Assessment of access to hygiene in health care facilities in Kisangani, Democratic Republic of Congo

Background: Access to hygiene services in healthcare facilities is a key component of healthcare quality and infection prevention. In Kisangani, Democratic Republic of the Congo, evidence on Water, Sanitation and Hygiene (WASH) services in healthcare facilities remains limited. This study assessed access to hygiene services in healthcare facilities in Kisangani.
Methods: A cross- sectional analytical study was conducted in 93 healthcare facilities, including 88 health centers and 5 general referral hospitals. A total of 206 respondents participated in the survey. The main variables assessed were the availability of handwashing stations with water and soap, the use of personal protective equipment (PPE), the availability of functional sterilization equipment, and the presence of water points with handwashing facilities in toilets. Data were analyzed using Pearson's Chi-square test with a significance level of 5%.
Results: Functional handwashing stations were available in 64.08% of facilities, whereas only 19.9% had water and soap available in service areas. Personal protective equipment was available in all facilities (100%), while only 50.97% had functional sterilization Equipment. Functional hygiene committees existed in 13.59% of facilities, and none had menstrual hygiene management facilities. Overall, 50.97% of healthcare facilities demonstrated good hygiene access, while 49.03% showed poor hygiene access. Multivariate analysis revealed that being a public healthcare facility (AOR = 0.30; 95% CI: 0.15–0.68; p = 0.003) and having separate toilets for staff and patients (AOR = 7.4; 95% CI: 2.92–18.52; p < 0.0001) were significantly associated with better hygiene access.
Conclusion: Significant gaps remain in hygiene access across healthcare facilities in Kisangani, particularly regarding the availability of water and soap, sterilization equipment, and hygiene governance mechanisms. Strengthening WASH infrastructure, staff training, and hygiene management systems is essential to improve healthcare quality and reduce healthcare-associated infections.