Author:
Lee Elizabeth H.,Rashid Ayesha,Lawal Ismail,Adekanye Usman,Adamu Yakubu,Godfrey Catherine,Agaba Patricia A.,Okeji Nathan,Desai Priyanka
Abstract
Abstract
Background
Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities.
Methods
We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: ‘IPC program structure, funding and leadership engagement’; ‘IPC policies, guidelines and standard operating procedures (SOPs)’; ‘infrastructure’; ‘triage and screening’; ‘training, knowledge and practice’; ‘personal protective equipment (PPE) materials, availability and adequacy’; ‘biosafety and waste management’; and ‘monitoring and remediation’ prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation.
Results
IPC readiness remained high at both baseline and follow-up assessments for ‘IPC guidelines, policies, and SOPs’ (96.7%). The components ‘infrastructure’ and ‘monitoring and remediation’, which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in ‘IPC program structure, funding and leadership engagement’, ‘training, knowledge and practice’, and ‘biosafety and waste management’. ‘PPE materials availability and adequacy’ improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for ‘triage and screening’ did not change from baseline to follow-up (73%).
Conclusion
Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
Funder
President’s Emergency Plan for AIDS Relief
Publisher
Springer Science and Business Media LLC
Reference42 articles.
1. Infection prevention and control Geneva, Switzerland: World Health Organization. ; 2023 [Available from: https://www.who.int/health-topics/infection-prevention-and-control#tab=tab_1.
2. Minimum requirements for infection prevention and control programmes. Geneva: Switzerland: World Health Organization; 2019.
3. Weekly Bulletin on Outbreaks and Other Emergencies. Week 25 15–21 June 2020. Geneva, Switzerland: World Health Organization; 2020.
4. Elimian KO, Ochu CL, Ilori E, Oladejo J, Igumbor E, Steinhardt L, et al. Descriptive epidemiology of coronavirus Disease 2019 in Nigeria, 27 February-6 June 2020. Epidemiol Infect. 2020;148:e208.
5. Joy Okwor T, Gatua J, Umeokonkwo CD, Abah S, Ike IF, Ogunniyi A, et al. An assessment of Infection prevention and control preparedness of healthcare facilities in Nigeria in the early phase of the COVID-19 pandemic (February-May 2020). J Infect Prev. 2022;23(3):101–7.