As global health initiatives move towards the noble goal of universal health coverage (UHC), the importance of laying a strong foundation by emphasizing infection prevention measures becomes increasingly evident. The integration of stringent infection control protocols within the framework of UHC is crucial to ensuring quality healthcare for all. In a recent article published in The Lancet Global Health, titled “Infection prevention: laying an essential foundation for quality universal health coverage,” Allegranzi et al. (2019) highlight the indispensable role of infection prevention in the context of UHC. The research underscores the necessity for solid infection prevention strategies to enhance patient safety and optimize health outcomes as nations strive to provide healthcare access to all citizens.
DOI: 10.1016/S2214-109X(19)30174-3
The article penned by Allegranzi B, Donaldson LJ, Kilpatrick C, Syed S, Twyman A, Kelley E, and Pittet D, hails from authoritative institutions such as the Department of Service Delivery and Safety at the WHO, the London School of Hygiene and Tropical Medicine, and the Infection Control Programme and WHO Collaborating Centre on Patient Safety at the Faculty of Medicine, Geneva University of Geneva Hospitals.
Below are the details of the authors’ affiliations and contributions:
1. Benedetta Allegranzi, the lead author, is affiliated with the Department of Service Delivery and Safety at WHO.
2. Liam J. Donaldson from the Department of Non-communicable Disease Epidemiology at the London School of Hygiene and Tropical Medicine,
3. Claire Kilpatrick, Shams Syed, Anthony Twyman, and Edward Kelley also hail from the Department of Service Delivery and Safety at WHO.
4. Didier Pittet is from the Infection Control Programme and WHO Collaborating Centre on Patient Safety at Geneva University Hospitals.
The premise of the article is that infection prevention and control (IPC) measures are paramount when considering the scale and scope of UHC. The authors argue that without a robust IPC infrastructure in place, UHC runs the risk of falling short in its mission to deliver quality healthcare to populations. The spread of infections within healthcare settings can lead to increased morbidity and mortality, inflated healthcare costs, and a general distrust in healthcare systems – all factors that can impede the successful implementation of UHC.
The authors leverage a significant amount of data to highlight the global burden of healthcare-associated infections (HAIs). These infections disproportionately affect low- and middle-income countries (LMICs), where resources are often limited, and IPC measures may not be effectively implemented or enforced. Despite the clear need for improved IPC protocols in these regions, Allegranzi and colleagues acknowledge the complex interplay of economic, social, and political challenges that influence IPC implementation.
Research shows that effective IPC programs can reduce the incidence of HAIs by more than 30%. Such reductions not only benefit patient safety but also lead to cost savings for healthcare systems. The authors reference the WHO’s core components of an effective IPC program, which suggest that IPC should not be viewed as an isolated activity but rather as an integral part of broader health system strengthening efforts.
The article identifies leadership, evidence-based guidelines, health care worker education, surveillance, multimodal strategies for implementation, monitoring, and continuous feedback as critical elements of successful IPC programs. Enhanced leadership commitment to IPC can galvanize the health workforce, optimize the use of resources, and steer policy in a direction that prioritizes patient safety. Education and training of healthcare workers are also emphasized as pivotal mechanisms for building an IPC culture within healthcare facilities.
Monitoring and surveillance are essential in assessing the effectiveness of IPC interventions, adapting practices to local contexts, and implementing improvements where necessary. The article stresses the value of a multimodal strategy for implementation, which integrates educational tools, process monitoring, feedback, and reminders into routine clinical practice. Such approaches have been demonstrated to improve hand hygiene compliance and have a potential impact on the reduction of HAIs.
In light of the importance of IPC, the authors of the Lancet Global Health article highlight several key recommendations for policy-makers, detailing actions that can reinforce IPC measures within the context of UHC. These include prioritizing IPC programs at the national and facility level, ensuring adequate resources for effective implementation, and incorporating IPC into broader healthcare planning and accountability frameworks.
In conclusion, the article by Allegranzi and colleagues serves as a clarion call for IPC to be recognized as a cornerstone of quality UHC. It makes a compelling case for the integration of robust IPC measures as a means to safeguard patient health, reduce healthcare costs, and augment the trust in medical institutions necessary for the success of UHC initiatives.
References
1. Allegranzi B, et al. (2019). Infection prevention: laying an essential foundation for quality universal health coverage. Lancet Glob Health, 7(6), e698-e700. doi: 10.1016/S2214-109X(19)30174-3.
2. WHO. (2016). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. World Health Organization.
3. Allegranzi B, Pittet D. (2015). Role of hand hygiene in healthcare-associated infection prevention. J Hosp Infect, 86(4), 244-252.
4. Pittet D, et al. (2009). WHO Guidelines on Hand Hygiene in Health Care: a Summary. World Health Organization.
5. Rosenthal VD, et al. (2013). Impact of the International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive care units of 15 developing countries. Infection, 41(6), 1119-1128.
Keywords
1. Infection Prevention
2. Universal Health Coverage
3. Health Policy
4. Infection Control
5. WHO Standards