Assessment of Infection Prevention and Control Compliance in Labour Wards of Tertiary Hospitals in the South East Zone

Infection prevention and control (IPC) compliance in labour wards is a fundamental determinant of maternal infection rates, including puerperal sepsis and surgical site infection, yet systematic IPC assessments of South East Nigerian labour ward environments are uncommon in the published literature. This study assesses IPC compliance in labour wards of five tertiary hospitals in the South East geopolitical zone, covering Imo, Enugu, Abia, Anambra, and Ebonyi States. Using the WHO IPC assessment framework adapted for maternity settings, on-site assessments evaluated hand hygiene infrastructure, personal protective equipment availability, instrument sterilisation practices, environmental cleaning, and waste management. Direct observation of 50 intrapartum care events supplemented facility assessments. Overall IPC compliance scores ranged from 44 to 72 percent, with no facility achieving full compliance. Hand hygiene compliance at critical moments of care (before and after vaginal examination) was below 50 percent in all facilities. Sterile glove availability was inconsistent in two facilities. Instrument decontamination by high-level disinfection was correctly performed in 60 percent of observed events. Professional recommendations include WHO five moments hand hygiene training, labour ward IPC champion designation, monthly IPC audit cycles, and ring-fenced IPC budget allocation in the five assessed South East tertiary institutions. Keywords: infection prevention, labour ward, IPC compliance, South East Nigeria, maternal sepsis