Operationalising infection prevention for caesarean section in two Ghanaian hospitals: a qualitative study of healthcare provider perspectives

Background Surgical site infection (SSI) after caesarean section remains a preventable source of maternal morbidity, prolonged recovery, antibiotic exposure and avoidable health-system cost, particularly in low- and middle-income countries. Although global guidelines emphasises perioperative infection prevention, less is known about how these recommendations are translated into everyday caesarean-section practice in Ghanaian hospitals. This study explored healthcare providers’ perspectives on infection-prevention practices for caesarean section in two Ghanaian hospitals. Methods An exploratory qualitative study was conducted at KNUST Hospital in Kumasi and Tain District Hospital in Nsawkaw, Ghana. Eighteen healthcare professionals directly involved in caesarean-section care were purposively selected, with nine participants from each facility. In-depth interviews were conducted using a semi-structured guide. Interviews were audio-recorded, transcribed verbatim, anonymised and analysed thematically with support from Atlas.ti. The analysis was informed by SRQR and COREQ principles, with attention to credibility, dependability and confirmability. Results Five overarching themes described infection-prevention practice across the perioperative continuum: preoperative preparation, contamination prevention, intraoperative measures, antibiotic administration, and patient education with postoperative wound care. Both hospitals reported similar theatre-based practices, including barrier precautions, hand hygiene, surgical skin preparation, antiseptic use, avoidance of contaminated instruments, reduction in surgical duration and antibiotic use. The major difference concerned post-discharge wound care. Tain District Hospital relied more on community nurses for wound dressing support after discharge, whereas KNUST Hospital placed greater emphasis on guided self-care at home. Conclusion In the two hospitals, caesarean-section infection prevention was described as a practical bundle of behaviours embedded across the perioperative pathway. While core theatre practices were largely similar, differences in continuity of wound care after discharge suggest an important implementation area for strengthening post-caesarean SSI prevention in Ghana and similar settings.