Evaluation of infection prevention and control compliance in Katsina State Hospitals: a multi-center study using WHO IPCAF and hand hygiene frameworks

Abstract

Healthcare-associated infections (HAIs) have remained a major healthcare issue, particularly in developing nations such as Nigeria, contributing significantly to antimicrobial resistance. Effective infection prevention and control (IPC) programs are essential to address this threat. This study assessed IPC implementation and hand hygiene compliance in selected hospitals in Katsina State using the WHO IPCAF and Hand Hygiene tools.The study was a cross-sectional survey that used the WHO IPCAF and Hand Hygiene tools. Hospitals were selected through stratified random sampling which comprise of 11 hospitals including state owned General and Federal hospitals in Katsina State. The IPC implementation was evaluated against the eight main elements of the WHO IPCAF tool, and hand hygiene was measured using the WHO Five Moments approach. The IPCAF scores were categorized as inadequate (0 to 200), basic (201-400), intermediate (401-600), and advanced (601-800).The overall IPC score of all the selected Hospitals is 2417.5 and only the Federal Teaching Hospital Katsina reached an intermediate level of IPC implementation, with a score of 547. While only four of the state owned General hospitals (36.4%) are at the basic IPC implementation level, and six hospitals (54.5%) are in the deficient category. Overall hand hygiene compliance across the hospitals was 43.9%. The differences in staff knowledge, infrastructure availability, and adherence to IPC guidelines were evident from the wide range of scores (107.5 to 547).It was concluded that only 9% of the selected health institutions in Katsina State are at an intermediate level. The study also revealed distinct differences in the practice of IPC across the selected hospitals. Hand hygiene compliance was lower than the WHO-recommended 70%, and the rural hospitals consistently had lower compliance than the urban facilities.