Opportunities to Overcome Implementation Challenges of Infection Prevention and Control in Low-Middle Income Countries

Abstract

Purpose of review Healthcare-associated infections (HAIs) and rising antimicrobial resistance (AMR) have posed a major challenge in patient care across the globe, more so in lower-middle-income countries (LMICs). Studies have shown that implementation of an effective infection prevention and control (IPC) program reduces incidence of HAI to a large extent. However, implementation of such a program in low-resource setting has many challenges. Research have shown that gaps exist due to absence of political will, trained manpower, and alternate healthcare priorities. Recent findings With progress in science of healthcare epidemiology and digital communication, opportunities to establish an effective IPC program at minimal cost is possible. In this review, we explore ways the existing challenges can be mitigated in LMICs. In recent times, the UN general assembly along with World Health Organization (2015) and member countries took a resolution to come up with an action plan to tackle the rising threat of AMR by strengthening IPC programs at national level.Summary We reviewed the progress made by the developing countries in their efforts to implement the program.

Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study

“…Cleaners have often been neglected in IPC programmes—data from 56 health facilities across Zanzibar, The Gambia, Bangladesh and India found that less than half provided any form of IPC training for cleaners and that the cleaning workforce had low status and poor work conditions [ 39 ]. In our study, the need for locally adapted training materials that are tailored to cleaning staff with low literacy was evident, which is a priority recognised more broadly for IPC training in low-resource settings [ 12 ], and something that is being piloted through initiatives such as TEACH CLEAN [ 40 ].…”

“…Challenges posed by staff shortages can be further hampered by a lack of IPC training for personnel and poor compliance with IPC practices, such as hand hygiene [ 9 – 16 ]. Overcrowding [ 9 – 12 , 15 ] and inadequate infection surveillance systems [ 10 , 11 , 13 , 14 , 16 ] have also been documented as key constraints to effective IPC in low resource settings.…”

Increasing Antimicrobial Resistance in Surgical Wards at Mulago National Referral Hospital, Uganda, from 2014 to 2018—Cause for Concern?

“…Healthcare Associated Infections (HAIs) are a global health challenge for patient safety, and are a major driver of antimicrobial resistance (AMR) [1], particularly in lowerand middle-income countries (LMICs) [2]. Studies in Ethiopia and Nigeria have reported HAI cumulative incidences in surgical wards of between 5.7% and 45.8% [3].…”

Antibiotic Discovery and Resistance: The Chase and the Race

“…However, the ability to conduct studies to address the disparities which prevent effective IPC programs, especially in low- and middle-income countries (LMICs), has been affected by a number of factors. These include limited or restricted resources, lack of training in IPC, lack of computer infrastructure to allow for appropriate surveillance, and multiple competing political agendas [ 85 ]. From the perspective of animal health, poor IPC at the level of animal health clinics have also been shown to cause environmental contamination, with resultant colonization transmitting from animals to humans in that environment [ 86 ].…”