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Infection prevention and control and related practices in African neonatal units: The Pan-African neonatal care
Irene Frantzis1, Stéphanie Levasseur1, Jack Huebner1
1Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
Insights
Healthcare-associated infections (HAIs) are a major cause of neonatal deaths in LMICs. This study found key areas for improving infection prevention and control (IP&C) in African newborn units, emphasizing low-cost solutions.
Area of Science:
- Neonatal care
- Infection prevention and control
- Global health
Background:
- Neonatal mortality disproportionately affects low- and middle-income countries (LMICs).
- Healthcare-associated infections (HAIs) contribute significantly to neonatal deaths in these regions.
- Limited research exists on infection prevention and control (IP&C) practices in African neonatal units.
Purpose of the Study:
- To assess IP&C and related practices in units caring for small and/or sick newborns in Africa.
- To identify opportunities for reducing HAIs in these vulnerable populations.
Main Methods:
- A mixed-methods approach combining surveys and virtual unit tours was employed.
- Surveys included multiple-choice and open-ended questions delivered via video conferencing.
- Virtual tours allowed for real-time evaluation of specific IP&C practices using a checklist.
Main Results:
- The study included 45 units across 20 African countries.
- Identified areas for improvement include hand hygiene, Water, Sanitation and Hygiene (WASH), Kangaroo Mother Care, and IP&C training.
- Respondents highlighted needs for more space, equipment, supplies, education, staff, and emphasized maternal comfort's role in IP&C.
Conclusions:
- Opportunities exist to enhance IP&C practices through low-cost interventions like education and peer support via learning collaboratives.
- Virtual tours are effective for site-specific assessments and feedback from multidisciplinary experts.
Background:
The burden of neonatal mortality is primarily borne by low- and middle-income countries (LMICs), including deaths due to healthcare-associated infections (HAIs). Few studies have assessed infection prevention and control (IP&C) practices in African units caring for small and/or sick newborns aimed to reduce HAIs.
Methods:
We performed a mixed-methods study composed of a survey and virtual tour to assess IP&C and related practices. We created a survey composed of multiple-choice and open-ended questions delivered to site respondents via Zoom or video equivalent. Respondents provided a virtual tour of their unit via video and the study team used a checklist to evaluate specific practices.
Results:
We recruited 45 units caring for small and sick newborns in 20 African countries. Opportunities to optimize hand hygiene, Water, Sanitation and Hygiene (WASH) practices, Kangaroo Mother Care, and IP&C training were noted. The virtual tour offered further understanding of IP&C challenges unique to individual sites. All respondents expressed the need for additional space, equipment, supplies, education, and IP&C staff and emphasized that attention to maternal comfort was important to IP&C success.
Discussion:
This study identified opportunities to improve IP&C practices using low-cost measures including further education and peer support through learning collaboratives. Virtual tours can be used to provide site-specific assessment and feedback from peers, IP&C specialists and environmental engineering experts.
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