E Tartari1, S Tomczyk2, D Pires3, B Zayed4, A P Coutinho Rehse5, P Kariyo6, V Stempliuk7, W Zingg3, D Pittet3, B Allegranzi8. 1. Infection Prevention and Control Programme, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland; Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 2. Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland. 3. Infection Prevention and Control Programme, Geneva University Hospitals, and Faculty of Medicine, Geneva, Switzerland. 4. WHO Antimicrobial Resistance and Infection Prevention and Control Unit, Regional Office for the Eastern Mediterranean, Cairo, Egypt. 5. Health Emergencies Programme, WHO Regional Office for Europe, Copenhagen, Denmark. 6. Equipe d'Appui Interpays pour l'Afrique Centrale, WHO Country Office, Libreville, Gabon. 7. Pan American Health Organization Office for Jamaica, Bermuda and the Cayman Islands, Kingston, Jamaica. 8. Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland. Electronic address: allegranzib@who.int.
Abstract
BACKGROUND: Strengthening infection prevention and control (IPC) is essential to combat healthcare-associated infections, antimicrobial resistance, and to prevent and respond to outbreaks. AIM: To assess national IPC programmes worldwide according to the World Health Organization (WHO) IPC core components. METHODS: Between June 1st, 2017 and November 30th, 2018, a multi-country, cross-sectional study was conducted, based on semi-structured interviews with national IPC focal points of countries that pledged to the WHO 'Clean Care is Safer Care' challenge. Results and differences between regions and national income levels were summarized using descriptive statistics. FINDINGS: Eighty-eight of 103 (85.4%) eligible countries participated; 22.7% were low-income, 19.3% lower-middle-income, 23.9% upper-middle-income, and 34.1% high-income economies. A national IPC programme existed in 62.5%, but only 26.1% had a dedicated budget. National guidelines were available in 67.0%, but only 36.4% and 21.6% of countries had an implementation strategy and evaluated compliance with guidelines, respectively. Undergraduate IPC curriculum and in-service and postgraduate IPC training were reported by 35.2%, 54.5%, and 42% of countries, respectively. Healthcare-associated infection surveillance was reported by 46.6% of countries, with significant differences ranging from 83.3% (high-income) to zero (low-income) (P < 0.001); monitoring and feedback of IPC indicators was reported by 65.9%. Only 12.5% of countries had all core components in place. CONCLUSION: Most countries have IPC programme and guidelines, but many less have invested adequate resources and translated them in implementation and monitoring, particularly in low-income countries. Leadership support at the national and global level is needed to achieve implementation of the core components in all countries.
BACKGROUND: Strengthening infection prevention and control (IPC) is essential to combat healthcare-associated infections, antimicrobial resistance, and to prevent and respond to outbreaks. AIM: To assess national IPC programmes worldwide according to the World Health Organization (WHO) IPC core components. METHODS: Between June 1st, 2017 and November 30th, 2018, a multi-country, cross-sectional study was conducted, based on semi-structured interviews with national IPC focal points of countries that pledged to the WHO 'Clean Care is Safer Care' challenge. Results and differences between regions and national income levels were summarized using descriptive statistics. FINDINGS: Eighty-eight of 103 (85.4%) eligible countries participated; 22.7% were low-income, 19.3% lower-middle-income, 23.9% upper-middle-income, and 34.1% high-income economies. A national IPC programme existed in 62.5%, but only 26.1% had a dedicated budget. National guidelines were available in 67.0%, but only 36.4% and 21.6% of countries had an implementation strategy and evaluated compliance with guidelines, respectively. Undergraduate IPC curriculum and in-service and postgraduate IPC training were reported by 35.2%, 54.5%, and 42% of countries, respectively. Healthcare-associated infection surveillance was reported by 46.6% of countries, with significant differences ranging from 83.3% (high-income) to zero (low-income) (P < 0.001); monitoring and feedback of IPC indicators was reported by 65.9%. Only 12.5% of countries had all core components in place. CONCLUSION: Most countries have IPC programme and guidelines, but many less have invested adequate resources and translated them in implementation and monitoring, particularly in low-income countries. Leadership support at the national and global level is needed to achieve implementation of the core components in all countries.
Keywords:
Antimicrobial resistance; Core components; Healthcare-associated infection; Implementation; Infection prevention and control; World Health Organization
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