KNOWLEDGE AND PRACTICES OF INFECTION PREVENTION AMONG TEACHERS IN EARLY CHILDHOOD EDUCATION CENTRES IN THE SUHUM MUNICIPALITY

ABSTRACT
Teachers in early childhood education centres are the epitome of care concerning infection prevention for young children in educational programmes. A comparative descriptive quantitative survey was used to assess the knowledge level, practice and resources availability for infection prevention in early childhood education centres in the Suhum Municipality. One hundred and sixty (160) teachers from 52 randomly selected early childhood centres; cretches, nurseries, day cares and kindergartens were \recruited for the study. The findings of the study revealed that both public and private school teachers in early childhood education centres have a good knowledge about infection prevention measures and control. Knowledge level on infection prevention is comparable between the two categories of teachers. However, this did not translate into practice. It was observed that most of the learning centres visited were overcrowded (exceeded GES recommended 28 children per a teacher ratio). There were also inadequate and inappropriate sanitary facilities in the studied early childhood education centres. Notwithstanding lack of resources, private schools had more resource than the public schools (p=0.001). It is recommended caregivers in childhood education centres receive adequate training on infection prevention before and during employment. The Ministry of Education and Ghana Health Service must ensure there are adequate sanitary facilities before approval is given for the running of the programme and regular monitoring to ensure their sustainability.


CHAPTER ONE
INTRODUCTION
Background to the Study
Infection prevention at early childhood education centres refers to policies and procedures employed to reduce the transmission of microorganisms among children and the staff in the schools. Such measures include following national immunization guidelines in immunising both children and teachers. Other key areas of concern include the implementation of general hygienic measures such as appropriate hand washing procedures, environmental sanitation, management of bodily fluids and respiratory etiquette. Infection prevention at childhood learning centres remains a global public health issue. This is evident in the kinds of policies and guidelines developed and adapted from international organizations such as United Nations International Children Emergency Fund (UNICEF), American Academy of Paediatrics (AAP), World Health Organisation (WHO) and Centers for Disease Control (CDC).

On the other hand, local policies and standards concerning infection prevention that are set for childcare operators and teachers in early childhood education centres remain inadequate to safeguard the health and welfare of children who attend these education centres. It could be argued that are neither teachers health care professionals nor do they have intensive training in standard infection control precautions. However, since childhood, learning centres are public institutions with vulnerable children, basic knowledge and practices on infection prevention applied by these teachers would reduce disease  transmission  among  children  as  well  as  the  teachers  to  a  degree.

Health protection surveillance (2012) is of the view that teachers in early education centres should be managed from an occupational health viewpoint, in the same manner as healthcare staff. Once they are exposed to infectious bodily fluids such as blood, vomitus, faeces, urine and nasal secretion, they are committed to provide a safe and healthy working environment for the entire staff. The American Academy of Paediatrics (2012) also states, that teachers are operating under a policy of nondisclosure of infection with blood-borne pathogens among children. As previously recommended by the AAP, HIV-infected children should be admitted without restriction to childcare centres and schools and that they should be allowed to participate in all activities to the extent that their health and other recommendations for management of contagious diseases permit. Therefore, all persons responsible for the care of children need to understand appropriate infection prevention and control practices to protect immuno compromised children, as well as caregivers and lay mates, from acquiring transmissible infections.

Statement of the Problem
Several infections have been linked to early childhood education centres. According to Nesti and Goldbaum (2007), establishments of early childhood centres are known to be environments with special epidemiological characteristics for disease transmission since such centres have populations with characteristic profiles and with specific risks for the transmission of infectious diseases. Sonoda et al. (2007), using stool laboratory investigations, found enterohemorragic Escherichia coli (EHEC) in 229 nursery school children, 49 nursery school staff and 78 family members of the patients after a follow up was made on a 7-year girl who had an infected diarrhoea stool with EHEC. Subsequent follow-ups indicated her 4-year old sister who attended a nursery school was also infected together with five children who presented diarrhoea at the same nursery school. Similarly, Raffaelli et al. (2007) investigated an outbreak of E.coli 0157: H 7 in diarrhoea stool in an urban childcare centre of which 11 out of 45 participants tested positive and two out of the 11 had progressed to haemolytic uremic syndrome. In the same way, Younus et al. (2010), in their case-control study, also suggested that a Salmonella infection, which is one of the causes of gastrointestinal diseases in children under the age of five, was associated with attendance at a day care centre. Otitis media has also been found to be one of the common infections in early childhood education centres. Bluestone and Klein (2007) defines Otitis Media as inflammation of the middle ear without reference to pathology may have adverse effects on a child with reduced performance at reading comprehension and or compromised cognitive ability which can further result in compromised educational performance due to inability to hear in class (partial loss or temporal loss in hearing).

In Ghana, though early childhood education centres have not been in existence for long, there has been an increase in the establishment of the centres as a result of mandatory requirement of educational reform in Ghana (2007) to set up early childhood education centre in every public school. There is also an increasing private childhood education centres because of the changing maternal role in society. As enumerated earlier, the establishment of early childhood education centres comes with its associated infections, which could be compounded by the prevailing sanitation problems in Ghana with diarrhoea diseases as a consequence, In addition, there is paucity of literature on infection prevention practices in early childhood education centres in Ghana. There is therefore the need to assess the situation in the childhood learning centres concerning the knowledge level, practice of caregivers, availability of resources and barriers to infection practices in the early childhood educations centres and make recommendations for the betterment of the programme. The Suhum Municipality is known to be one of the districts with the highest number of early childhood education centres approximately 115 (Suhum Municipal Education Office, 2015) both in public and private lives in the country and could be a good model for the problem of the study.

Purpose of the Study
The study aimed at assessing the knowledge level and infection prevention practices among teachers within early childhood education centres in the Suhum Municipality.

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Item Type: Ghanaian Postgraduate Material  |  Attribute: 137 pages  |  Chapters: 1-5
Format: MS Word  |  Price: GH50  |  Delivery: Within 30Mins.
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