<p>Infection Prevention and Control Preparedness Level and Associated Determinants in 56 Acute Healthcare Facilities in Ghana</p>

Abstract

Background: Infection prevention and control (IPC) is a globally relevant aspect of all health systems impacting the health and safety of both patients and healthcare workers. However, best practices remain a challenge in healthcare delivery especially in resource limited situations. The primary objective of this study was to assess the infection prevention and control (IPC) preparedness levels of acute healthcare facilities in Ghana and to determine the factors associated with the overall IPC preparedness levels in acute healthcare facilities. Methods: A cross-sectional study adapting the IPC assessment framework (IPCAF) developed by the World Health Organization (WHO) was conducted. Five of the core components of the WHO IPCAF were used to assess the IPC level of 56 acute healthcare facilities in Ghana. Results: Of the 56 facilities surveyed, only 19 had an IPC program with clearly defined objectives. Overall, 8 (14.3%) facilities scored an IPC preparedness level of "Advance", 18 (32.1%) facilities received an "Intermediate" IPC preparedness score, 23 (41.1%) facilities received an IPC preparedness level of "basic" and 7 (12.5%) facilities scored an IPC preparedness level of "inadequate". IPC materials like detergents, running water and PPEs were not significantly supplied. Government owned facilities performed better in terms of IPC preparedness as compared to privately owned facilities. A PLUM-ordinal regression analysis revealed that an IPC program with clearly defined objectives (OR= 76; 95% CI; 7.23, 808.19), dedicated IPC budget (OR= 13; 95% CI; 3.8-44.3) and regular mandatory training (OR= 50.9; 95% CI; 6.1-425) were associated with increased IPC preparedness. Conclusion: Generally, the IPC preparedness levels in a majority of the facilities were low and required significant improvements in several areas. Facilities must make periodic reviews and adjust their objectives based on facility priorities.

Infection Prevention and Control at Lira University Hospital, Uganda: More Needs to Be Done

“…Previous studies conducted in Ghana and Uganda have reported similar findings. The study from Ghana using five of the WHO IPCAF core components found that 41.1% of the health facilities had a ‘basic’ level of compliance similar to what we found [ 17 ]. However, unlike LUH, 37.5% of these facilities in Ghana had senior level leaders participating in IPC activities and a dedicated budget was allocated [ 17 ].…”

“…The study from Ghana using five of the WHO IPCAF core components found that 41.1% of the health facilities had a ‘basic’ level of compliance similar to what we found [ 17 ]. However, unlike LUH, 37.5% of these facilities in Ghana had senior level leaders participating in IPC activities and a dedicated budget was allocated [ 17 ]. In a study on implementation of IPC in health facilities in the Arua district of Uganda [ 18 ], 93.8% of these did not have an IPC committee, 93.8% reported an irregular supply of disposables and other supplies (such as gloves, soap, disinfectants), most facilities had no structures to monitor HCAI, and 72.6% never had in-service IPC training.…”

“…Data were collected using the self-administered WHO IPCAF tool ( supplementary Table S1 ). The tool has eight core components: (i) IPC programme, (ii) IPC guidelines, (iii) IPC education and training, (iv) HCAI surveillance, (v) multimodal strategies for implementation of IPC interventions, (vi) monitoring/audit of IPC practices and feedback, (vii) workload, staffing, and bed occupancy, and (viii) built environment, materials, and equipment for IPC at the facility level [ 17 ].…”

The first WHO global survey on infection prevention and control in health-care facilities

“…From Jan 16 Weighted multivariable regression analysis showed that a lower total IPCAF score was significantly associated with low-income (-229•8 points lower [95% CI -352•3 to -107•3]) and lower-middle-income (-80•1 points lower [-148•1 to -12•1]) country status than high-income country status. A higher total IPCAF score was significantly associated with health-care facilities reporting their care level as Other (98•7 points higher [95% CI 36•7 to 160•6]) and categorised as a tertiary care facility (73 points higher [23•3 to 122•8]) rather than a primary care facility.…”

Antimicrobial stewardship capacity and infection prevention and control assessment of three health facilities in the Ashanti Region of Ghana

“…A study that assessed IPC initiatives in Ghana assessed five out of eight possible IPC components of the standard tool in the facilities. 19 Thus, a more comprehensive assessment is needed to ensure all gaps in practice are identified and addressed for health and safety. This will provide guidance on the need for pragmatic interventions through AMS and IPC to address and/or contain the high burden of AMR.…”