Department of Statistics, Shahjalal University of Science & Technology, Sylhet, Bangladesh.
Chander Hat Degree College, Nilphamari, Bangladesh.
J Glob Health. 2024 Mar 1;14:04042. doi: 10.7189/jogh.14.04042.
Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items.
In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room).
We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them.
All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.
每年都有数以亿计的人在缺乏感染控制措施和个人防护设备 (PPE) 等基本需求的医疗机构寻求治疗时受到感染。我们旨在评估八个中低收入国家感染控制用品和 PPE 的供应情况，并确定这些用品供应的差异。
在这项研究中，我们结合了 2013 年至 2018 年期间在八个国家进行的公开的具有代表性的国家横断面卫生系统调查（人口与健康调查方案的服务提供评估）：阿富汗、孟加拉国、刚果民主共和国、海地、马拉维、尼泊尔、塞内加尔和坦桑尼亚。使用包含六个项目的清单评估感染控制用品的供应情况（废物容器、锐器容器、消毒剂、一次性使用或自动一次性注射器、肥皂和自来水或酒精基洗手液，以及标准预防指南）。个人防护装备包括四项：手套、医用口罩、手术服和眼部保护。如果在一般门诊区或任何特定服务区域（例如产房）观察到这些物品，则认为该设施具有这些物品。
我们分析了来自 7948 家医疗机构（694 家医院和 7254 家医疗中心/诊所）的数据。总体而言，在感染控制用品和 PPE 中，大多数接受调查的设施均高度供应一次性使用或自动一次性注射器（91.40%）和乳胶手套（92.56%）。在感染控制措施中，感染控制指南在调查中供应最少，在尼泊尔最低（6.15%），在马拉维最高（68.18%）。在 PPE 项目中，在调查期间眼部保护供应最少，在塞内加尔最低（5.4%），在海地最高（28.17%）。只有 1567 家（19.71%）设施看起来拥有所有基本的感染控制材料，1023 家（12.87%）分析设施拥有所有 PPE。在同一国家内，医院和医疗中心/诊所之间的物品供应差异大于两者之间的差异。
我们研究的所有八个国家都缺乏最基本的标准预防用品，以避免感染。这些国家都必须采取措施，减少不足和差距，并提高将卫生系统投入转化为设施提供感染控制标准预防用品的效率-以遏制传染病传播的风险。
