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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