Improving Hygiene in Guardian Waiting Shelters and Communities in Malawi: an intervention development and feasibility study

In Malawi, Guardian Waiting Shelters (GWS) serve as homes for the guardians while they take care of their patients at the hospital or as homes for pregnant waiting mothers and their guardians, and in other scenarios, a combination of pregnant waiting mothers and their guardians and other guardians from the general wards. However, most GWS are overcrowded, have limited environmental services, have unsanitary conditions and have limited infection prevention and control. Such conditions may create a significant risk for communicable disease transmission between caregivers using GWS as well as subsequent transmission to communities when individuals return home. WASHTED, in collaboration with the University of Strathclyde and the London School of Hygiene and Tropical Medicine (LSHTM) is conducting a research study to improve hygiene in Guardian Waiting Shelters and Communities in Malawi. The aim of the study is to develop and test a targeted facility-based intervention designed to improve hygiene behaviours at both GWS and in the home environment after facility discharge. The research will be conducted from November 2022 to July 2023 (with the possibility of extension) and will target GWSs in all District Hospitals of Southern District of Malawi. The research will be in three phases: Phase 1: Process documentation & rapid assessment of Southern District Hospitals (6 months) Objectives: To assess the intervention development and delivery strategy of the current GWS intervention implemented at QECH To rapidly assess the capacity and conditions of hygiene facilities at GWS at all District Hospitals in Malawi’s Southern Region. Phase 2: Formative research and intervention development (to be conducted for a period of 8 months) Objective: To further explore the institutional, social, environmental, and psychological determinants of targeted hygiene behaviours both at the GWS and in community settings in 4 GWS. Phase 3: Feasibility Study (8 months) Objective: To assess the feasibility of the modified GWS intervention in formal feasibility study The study received funding from the Reckitt Global Hygiene Institute (RGHI). Total funding: $300,000 outputs: GWS Policy brief
Mangochi Hospital’s guardian waiting shelter