ABSTRACT
Most of health care workers [HCWs] are aware of the importance of hand hygiene procedures, but still the adherence and compliance with this simple action remains low. Evaluation of compliance with hand hygiene was carried out in a Sudanese hospital setting. Adherence to hand hygiene was evaluated hospital wide through direct observation, collecting data on hand hygiene carried out whenever indicated opportunity of hand hygiene. The results were analyzed using mixing effects models. A total of 1930 opportunities were observed from different study area of the hospital. Overall compliance was [40.8%]. Adherence was highest in nurses [45%] followed by physicians [37.9%]. High statistical difference [p = 0.0001] was observed in hand hygiene opportunities after [68.1%] than before [31.9%] an activity. The situation in which the compliance was highest were those with intermediate risk of infection [49.7%], where in the high risk situation the hand hygiene carried out in [38.7%] of the occasions. Low adherence observed suggests that more and new interventions should be carried in order to focus in modification of HCWs habits and attitudes, working at several levels: individual and institutional