Background Infection Prevention and Control (IPC) is critical in controlling the COVID-19 pandemic and is one of the pillars of the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to the COVID-19 pandemic in Cox's Bazar, Bangladesh, to identify best practices, challenges, and recommendations for improvement of the current and future responses. Methods We conducted two meetings with 54 participants purposively selected from different organizations and agencies involved in the frontline implementation of IPC in Cox's Bazar district, Bangladesh. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meeting notes and transcripts were then analyzed manually using content analysis, and results were presented in text and quotes. Results Best practices included: assessments, a response plan, a working group, trainings, early case identification and isolation, hand hygiene in Health Facilities (HFs), monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centers (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of availability of uniforms for health workers, in particular cultural and gender appropriate uniforms and Personal Protective Equipment (PPE). Recommendations from the IAR were: (1) to promote the institutionalization of IPC, programs in HFs (2) establishment of IPC monitoring mechanisms in all HCFs, (3) strengthening IPC education and training in health care facilities, and (4) strengthen public health and social measures in communities. Conclusion Establishing IPC programmes that include monitoring and continuous training are critical in promoting consistent and adaptive IPC practices. Response to a pandemic crisis combined with concurrent emergencies, such as protracted displacement of populations with many diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization, and close supervision.

Introduction: Infection Prevention and Control (IPC) is key in the control of COVID-19 pandemic and one of the pillars considered in the WHO COVID-19 Strategic Preparedness and Response Plan 2020. We conducted an Intra-Action Review (IAR) of IPC response efforts to COVID-19 pandemic in Rohingya refugee camps in Cox’s Bazar, Bangladesh to identify best practices, challenges, and recommendations for improvement of the current and future responses.Methods: Two meetings were conducted with a total of 54 participants purposively selected from different organizations and agencies that had been involved in frontline implementation of IPC in Cox’s Bazar district. We used the IPC trigger questions from the WHO country COVID-19 IAR: trigger question database to guide the discussions. Meetings notes and transcripts were analysed manually using content analysis and results presented in text and quotes.Results: Best practices included: assessments, response plan, working group, trainings, early case identification and isolation, hand hygiene in HFs, monitoring and feedback, general masking in HFs, supportive supervision, design, infrastructure and environmental controls in Severe Acute Respiratory Infection Isolation and Treatment Centres (SARI ITCs) and HFs and waste management. Challenges included: frequent breakdown of incinerators, limited PPE supply, inconsistent adherence to IPC, lack of working uniforms and lack of culture- and gender adapted work uniforms and Personal Protective Equipment (PPE). Recommendations were: institutionalization of IPC, establishment of IPC monitoring mechanisms in all HCFs, strengthening IPC education and training and public health and social measures in communities. Conclusion: IPC monitoring and continuous training provides critical support in promoting consistent and adaptive IPC implementation. Response to pandemic crisis combined with concurrent emergencies, like a protracted displacement with many, diverse actors, can only be successful with highly coordinated planning, leadership, resource mobilization and close supervision.