Gwaikolo Cozie, Bodo Bongomin, Nabawanuka Doreen, Mukiibi Michael, Seremba Emmanuel, Muyinda Paul, Bakainaga Andrew, Woldemariam Yonas Tegegn, Moore Christopher C, Ssekitoleko Richard
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA.
World Health Organization, Kampala, Uganda.
Infect Prev Pract. 2024 Mar 11;6(2):100355. doi: 10.1016/j.infpip.2024.100355. eCollection 2024 Jun.
In sub-Saharan Africa, the provision of infection prevention and control (IPC) measures are often limited by resource constraints.
To determine the association of supportive supervision activities with the availability of the WHO core components for IPC at health facilities in Southwestern Uganda.
We employed a before and after quality improvement study design. We conducted a baseline assessment of the availability of the WHO IPC core components and provided supportive supervision activities, which was followed by a second IPC assessment. We included health centers II-IV, which have increasing clinical care capacity, and regional hospitals.
Of 244 regional health facilities, baseline assessment occurred at 111 (45%) of which 23 (21%) were reassessed. The number of facilities in the Red (<70%) category for each core component stayed the same or decreased at each facility type, but there was an increase from five to six health center III facilities scoring Red (<70%) for PPE. The number of facilities in the Green (>85%) category for each core component stayed the same or was increased at each facility type, but there was a decrease from four to two health center III facilities scoring Green (>85%) for instrument processing. There was an increase in the median (interquartile range [IQR]) overall score for all facilities (65 [54-72] vs 75 [68-83], =0.0001).
Supportive supervision activities were associated with improved availability of the core components of IPC at health facilities in Southwestern Uganda. PPE should be prioritized in health care facilities in Southwestern Uganda.
在撒哈拉以南非洲地区，感染预防与控制（IPC）措施的提供往往受到资源限制。
确定支持性监督活动与乌干达西南部医疗机构中世卫组织IPC核心要素可用性之间的关联。
我们采用了前后质量改进研究设计。我们对世卫组织IPC核心要素的可用性进行了基线评估，并开展了支持性监督活动，随后进行了第二次IPC评估。我们纳入了临床护理能力不断提升的二级至四级保健中心以及地区医院。
在244个地区卫生设施中，111个（45%）进行了基线评估，其中23个（21%）接受了重新评估。每种核心要素处于红色（<70%）类别的设施数量在每种设施类型中保持不变或有所减少，但个人防护装备（PPE）方面处于红色（<70%）类别的保健中心三级设施数量从5个增加到了6个。每种核心要素处于绿色（>85%）类别的设施数量在每种设施类型中保持不变或有所增加，但器械处理方面处于绿色（>85%）类别的保健中心三级设施数量从4个减少到了2个。所有设施的总体得分中位数（四分位间距[IQR]）有所提高（65[54 - 72]对75[68 - 83]，P<0.0001）。
支持性监督活动与乌干达西南部医疗机构中IPC核心要素可用性的改善相关。乌干达西南部的医疗机构应优先考虑个人防护装备。
