Resources to support infection prevention and control in African neonatal units
Keywords:
Infant, Newborn; Infant, Premature; Sepsis / prevention & control; Infection Control / organization & administration; Cross Infection / prevention & control; Infection Control / standards; Health Facility Environment; Africa South of the Sahara; Global HealthAbstract
Background: Sub-Saharan African experiences the highest burden of neonatal sepsis and antimicrobial resistance attributable deaths globally due to inadequate infrastructure, resources, and staffing for infection prevention and control (IPC), suboptimal cleaning, equipment sharing, and re-use of single-use items.
Methods: Fourteen hospitals in the African Neonatal Network responded to an annual facility survey and a health facility survey co-developed by faculty in the African Neonatal Network and Vermont Oxford Network. All analyses use descriptive statistics.
Results: Most hospitals (86%) had guidelines for IPC and policies for environmental cleaning (79%). Running water was routinely available at 9 hospitals (64%). Alcohol hand rub was regularly available at the patient bedside in 8 neonatal units (57%). Almost all neonatal units (93%) re-used single-use consumables and reported using non-standardised decontamination methods such as soaking in sodium hypochlorite. Oral and intravenous antibiotics were shared between neonates at four hospitals (29%), while parenteral fluids were shared at six neonatal units (43%), with several units reporting prolonged use after opening and/or reconstituting medication and fluids.
Conclusion: Although most units had IPC and hospital cleaning guidelines, many lacked adequate infrastructure and consumables to support optimal IPC practices. Clinical care practices such as reprocessing of single-use items and sharing of parenteral fluids and medications, further highlight the major contribution of resource limitations to the burden of healthcare associated infections in African neonatal units.
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