Open the Tap for Maternal and Newborn Care

Background: Reliable provision of safe water at healthcare facility level is essential to achieve quality care and minimize the risk of healthcare associated infections. To this end, various standards stipulate that availability of water should be guaranteed in healthcare facilities. However, the adherence to and consequences of non-adherence to these standards in the healthcare sector are rarely evaluated. Objectives: We set out to assess the association between water rationing and early neonatal infections in the Bolgatanga Regional Hospital, which is faced with water rationing three days per week. Setting: Data from the maternity and neonatal care unit of the Bolgatanga Regional hospital were used. Design and participants: A retrospective cohort study using routine hospital data was conducted. Associations were assessed between the source of water (piped or stored/trucked during rationing) in the hospital in the first 48 hours after delivery and the development of early neonatal infection; risk ratios (RR) and their associated 95% confidence intervals (95% CI) were calculated. Results: It was found that the risk of early neonatal infection during periods of stored/trucked water (6.9/1000 live births) was twice that during tap water (3.4/1000 livebirths); (RR 2.0, 95% CI 1.3-3.2, p=0.002). Furthermore, only 30% of the new-borns had uninterrupted access to tap water in the first two days after birth. Conclusion: During water rationing, the significantly higher risks of early neonatal infections should be considered prospectively and alternatives secured to protect such vulnerable groups. More research is recommended to build a specific association between the alternative sources of water during rationing and the risk of neonatal infections in order to identify the best option during such difficult times.