Building a National Infection Prevention and Control Programme: the 'Turn Nigeria Orange' Programme, 2019-2023

Strong infection prevention and control (IPC) programmes are critical to reducing the burden of healthcare-associated infections and antimicrobial resistance (AMR), yet many low- and middle-income countries (LMICs) lack functional IPC programmes at national and health facility levels. Nigeria prioritised the development of a national programme to provide leadership and coordination for IPC activities throughout the country's healthcare system following a series of outbreaks and gaps identified during the development of the National Action Plan for AMR. We aim to describe the stepwise, evidence-based approach we used to establish and implement Nigeria's National IPC Programme during its first 5 years. This includes the formation and structure of the IPC Programme within the Nigeria Centre for Disease Control and Prevention; assessment of national and tertiary health facility-level IPC programmes to prioritise interventions; development of a structured implementation strategy (the 'Turn Nigeria Orange' programme); publication of national IPC guidelines and revision of the national IPC policy; collaboration with a local university and professional societies to establish a national IPC curriculum and IPC training and mentorship programmes; and establishment of a network of health facilities to strengthen facility-level implementation (the 'Orange Network'). The development of each was guided by the WHO's core components of IPC programmes, evidence-based guidelines which aim to inform the development of effective IPC programmes. The implementation approaches, successes and challenges that we share add to the limited existing literature and can serve as a practical example for other countries, particularly LMICs when establishing and implementing IPC programmes.