Preventing Infections One Facility at a Time

USAID supports health care workers to provide clean and quality care

Globally, half of health care facilities lack basic hygiene services such as reliable access to safe water and soap, and 688 million people visit health facilities with no basic hygiene services. While progress has been made to scale up infection prevention control and readiness in health care facilities, lack of support for health care workers and cleaning staff to sustain these improvements is putting this progress at risk. 

Many health care facilities also do not have enough masks, gowns, gloves, and other personal protective equipment to protect health workers against the spread of infectious diseases. That’s why USAID supports improved access to personal protective equipment to create a safer environment for health care workers and cleaning staff to do their jobs more effectively and without fear of getting sick themselves. 

Improving hygiene services can significantly improve health outcomes for individuals seeking care. Since the COVID-19 pandemic, infection prevention control has been widely recognized as an effective way to reduce the spread of disease and improving access to hygiene resources has been at the core of USAID’s support to prevent infections in health facilities in partner countries. 

What do health care workers and health care facility cleaners need most? Access to safe and sustainable water, soap for handwashing at key points of care, and adequate personal protective equipment to do their jobs safely and effectively. Providing support and training for health care workers in infection prevention control standards is critical to building a sustainable health system that is prepared for the next pandemic. 

In Uganda, USAID provided training for staff and health workers on cleaning best practices specifically for health care facilities to reduce the risk of hospital based infections.

One cleaner, James Muhindo, said, “The instructors showed us different techniques in cleaning. The work is now easier because they have given me all the personal protective equipment, and now I always see positive results in my cleaning.”

Another cleaner at Rukungiri Health Center in Southwestern Uganda, Ephrance Nsimire, has taken a leadership role to ensure the health center maintains a high standard for having a clean facility. 

“There is a great improvement in general cleanliness across personal, patient, and environmental areas,” she explained. “For instance, hand washing facilities are stationed at every entry point of the health facility and around pit-latrines. Through these mentorships and trainings, I have also started advising and encouraging health workers, patients, and communities to apply infection prevention and control best practices.”

Ritah Niwamanya, a midwife at a community health center in Kanugu, Uganda, said, "After receiving the training, together with my colleagues, we started sensitizing others and patients on the numerous advantages of handwashing. We used communication charts to teach patients how to wash hands and the importance of the practice.” 

Ritah’s health center in Kanugu went from an infection prevention readiness score of 54 to 89 out of 100 and the labor and delivery ward scored a perfect 100 with support received from USAID. 

In India, nurse Shivkala Pandey at the Civil Hospital in Madhya Pradesh took charge of creating innovative ways to ensure infection prevention control standards at her facility at the very beginning of the pandemic in 2020. 

She knew that her facility would need more support to continue these efforts. A USAID supported project contacted Shivkala and her team to provide virtual training and technical assistance for infection prevention control facility readiness through phone calls and occasional visits. 

“These online trainings are very helpful as they clear any confusion we have,” she said. “We knew the basics of the processes, but the trainings helped us translate that knowledge into practice.”

At the height of the COVID-19 pandemic, many Ghanaians would not visit their health centers for fear of contracting the virus. USAID supported teams in Ghana through virtual training to better respond to infection outbreaks and future emergencies with improved infection prevention and control measures. Housekeeping staff were also trained on infection prevention and control measures. 

Health care providers who participated in USAID’s training in Ghana are now quality improvement coaches for other facilities to support more health workers to implement best practices for infection prevention and control. 

The improvements in infection prevention control and readiness has reduced neonatal infections and maternal mortality in health care facilities supported by USAID where these practices have been introduced and sustained. 

USAID’s MOMENTUM Country and Global Leadership COVID-19 program worked in 152 high-risk health care facilities, improving the proportion of health care facilities with access to a basic cleaning service from 49% to 63%; increasing access to basic water service from 75% to 92%; and increasing access to basic sanitation from 24% to 57%.

USAID’s partnership with country governments that support health workers will continue to strengthen health systems to be responsive, robust, and resilient. Clean and hygienic care means quality, safe, and respectful care for all. 

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ABOUT THE AUTHOR: USAID’s Office of Maternal and Child Health and Nutrition works to strengthen WASH and infection prevention control in health facilities globally