Washing hands with soap and water in preparation for
delivery significantly reduced the risk of
death for infants within the first month of life, according
to a study in Nepal conducted by
researchers at the Johns
Hopkins Bloomberg School of Public Health.
The study found a 19 percent lower risk of death among
newborns born at home in rural Nepal
when birth attendants washed their hands before delivery.
The study also found a 44 percent
reduction in risk of death if mothers washed their hands
prior to handling their newborn infant. The
findings are published in the July edition of the journal
Archives of Pediatric and Adolescent
"Several studies have shown that a mother's hand
washing can reduce the risk of diarrheal
disease in preschool-age children, but this is really the
first to examine the benefits of hand washing
on overall mortality during the first month of life, when
many deaths occur," said James Tielsch, the
study's senior author and professor in the Bloomberg
School's Department of
The study enrolled 23,662 newborns who had been
included in a larger evaluation of the effect
of skin and umbilical cord cleaning on newborn mortality.
More than 90 percent of the births took
place at home or on the way to a medical facility.
Researchers observed the newborns during the first
28 days of life through a series of 11 home visits. The
mothers of the infants were questioned about
their own hand-washing practices and the birth attendant's
According to the study, 52.9 percent of birth
attendants reported washing hands with soap and
water prior to delivery, while 14.8 percent of mothers
reported washing hands prior to handling their
infants. Newborns whose birth attendant washed his or her
hands prior to assisting with delivery had
a 19 percent lower risk of death compared to newborns whose
attendant did not. Newborns whose
mother washed her hands before handling their infants had a
44 percent lower risk of death
compared to those whose did not. The overall mortality rate
was 32.1 deaths per 1,000 births.
"More than 30,000 newborns die each year in Nepal. Our
findings suggest that a substantial
portion of these deaths could be prevented with routine
hand-washing practices," Tielsch said.
Funding for the research was provided by grants from
the National Institutes of Health, Bill &
Melinda Gates Foundation and U.S Agency for International
The study was written by Victor Rhee, Luke C. Mullany,
Subrana K. Khatry, Joanne Katz, Steven
C. LeClerq, Gary L. Darmstadt and Tielsch.