WaterAid and partners are Changing Hygiene Around Maternal Priorities (CHAMP) Plus

(Type 2) Research

Research Focus: Changing Hygiene Around Maternal Priorities 

Location: Cambodia 

Partners: WaterAid Cambodia, London School of Hygiene and Tropical Medicine (LSHTM) and the National Institute of Public Health of the Ministry of Health (MoH), Cambodia (NIPH).

Key Research Questions:

Can a hygiene intervention delivered through existing health care facilities:

a)      Improve hygiene behaviours – specifically hand hygiene - that influence maternal and neonatal infection during labour, delivery, and post-natal care?

b)      Improve maternal satisfaction with healthcare services?

c)      Improve the hygiene of maternal and neonatal care practices in the home environment?

d)      Empower women to ensure quality, hygienic care in healthcare facilities and home?

“Changing Hygiene Around Maternal Priorities Plus is really important for improving maternal and child health and it also aligns with national policy on Infection Prevention and Control for healthcare facilities in Cambodia.”

- Director of Provincial Health Department, Kampong Cham Province


Research Description: 

Changing Hygiene Around Maternal Priorities (CHAMP) is a Water for Women-funded innovative hygiene behaviour research project and learning initiative, established in 2018. It aims to improve the hygiene behaviours of midwives, mothers, fathers, caregivers and visitors that influence maternal and neonatal infection during labour, delivery and post-natal care in healthcare facilities in Cambodia. A secondary objective is to improve the current understanding of how hygiene informs perceived quality of care and satisfaction with health services.


Findings from its 2021 evaluation indicate that the CHAMP intervention is associated with statistically significant improvements in hand hygiene practices among midwives during childbirth and caregivers during post-natal care. However, overall adherence to hand hygiene protocol in healthcare facilities remains sub-optimal.


The “CHAMP Plus” research project provides an opportunity to expand the reach and scope of the original research. This includes moving the intervention to larger healthcare facilities with higher volumes of births, such as referral hospitals, which enables the program to further improve hand hygiene protocol adherence and provide evidence on how hygiene informs patient preferences and patient satisfaction. CHAMP Plus also provides the opportunity to adapt to the COVID-19 context.  


The CHAMP Plus intervention is being tested in a rigorous before-and-after study. Evidence generated from the proposed expansion is being fed into ongoing policy processes in Cambodia to influence Cambodia’s Maternal Newborn Child Health National Strategy.


CHAMP Plus is intended to complement and strengthen existing policies and guidelines related to hygiene and infection prevention and control in healthcare facilities in Cambodia.


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Photo: WaterAid

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