Assessment of Caesarean Section and Healthcare Staff Behavior as Determinants of Neonatal Infections: A Mixed-Methods Study in a Neonatal Unit, Brother Rahmani Hospital, Algeria

Yassine BA and Ghofrane F

Published on: 2025-06-25

Abstract

Background: Neonatal infections are a leading cause of morbidity and mortality in neonatal intensive care units (NICUs), particularly in low- and middle-income countries. Caesarean section (C-section) and healthcare staff behavior have been proposed as potential risk factors for nosocomial infections in neonates. This study aimed to evaluate the association between childbirth mode and healthcare personnel practices with the occurrence of neonatal infections in the NICU of Brother Rahmani Hospital, Algeria.

Materials and Methods: A mixed-methods study was conducted, combining a retrospective case-control analysis of 70 neonates (35 cases, 35 controls) and a descriptive observational component involving healthcare staff. The quantitative analysis examined the relationship between mode of delivery and nosocomial infection, while the qualitative component assessed staff knowledge and adherence to infection prevention protocols through a structured questionnaire. Data were analyzed using EPI Info™ 7.2.7 with appropriate statistical tests, including Chi-square, Fisher’s exact test, and logistic regression.

Results: No statistically significant association was found between caesarean delivery and nosocomial infection (OR = 1.6154, p = 0.2269). The Mantel-Haenszel test ruled out major confounding. However, staff questionnaire responses revealed inconsistencies in infection control practices: only 42.9% wore full medical attire, and 38.1% failed to adhere to incubator cleaning protocols. Misunderstandings about sterilization standards and zoning concepts were also identified.

Discussion: While caesarean delivery was not a significant independent risk factor, behavioral and procedural lapses among healthcare personnel may contribute more critically to infection risks. Findings align with other regional studies that highlight the importance of staff compliance and training in infection control.

Conclusion: Caesarean section alone may not significantly increase the risk of neonatal infection, but staff behavior and protocol adherence are crucial determinants. Targeted training, standardized procedures, and improved surveillance are essential to reduce infection rates in NICU settings.