Jhpiego - What We Do - Infection Prevention and Control

People who provide or receive health care services—whether in a hospital, clinic or any other health care setting—are at risk of acquiring and transmitting potentially life-threatening infections through accidental exposure to blood and body fluids or contaminated objects. Over the past two decades, considerable progress has been made globally in understanding the basic principles of preventing such infections, but they continue to be a significant cause of mortality and morbidity throughout the world.

Occupational exposure to blood and body fluids puts health care providers at risk of infection with blood-borne pathogens, such as hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV. Of the 35 million health workers worldwide, about three million are exposed to such pathogens each year through percutaneous injuries (from syringes and other sharp instruments). These accidents may result in 15,000 HCV, 70,000 HBV and 500 HIV infections. And more than 90% of these infections occur in developing countries, where health workers often lack the knowledge, skills and resources necessary to protect themselves and their clients from becoming infected.

Fortunately, health care-related infections, like other occupational hazards, are largely preventable, as shown by the low rates of such infections in countries that have engaged in serious infection prevention efforts—including training of health workers in infection prevention and control (IPC) practices, HBV immunization, post-exposure prophylaxis (PEP) for HIV, improved waste management and other measures.

Ensuring that health facilities are safe and healthy places, for clients/patients and health workers, is a high priority for the health industry worldwide. It is particularly relevant in countries that face a significant shortage of health care personnel—the human resources for health—who are essential for delivering high-quality health services and achieving the countries’ health goals. These countries cannot afford to continue to lose health workers because of illness, disability or premature death from becoming infected, or from fear of becoming infected.

IPC Expertise—What Jhpiego Can Do

For more than 15 years, Jhpiego has been an international leader in advocating for and implementing evidence-based standards for IPC practices that protect both clients and health workers. Through the appropriate use of simple, cost-effective IPC practices (e.g., hand-washing, wearing gloves, processing reusable instruments), health workers in some of the world's least developed regions can play a critical role in:

Reducing the risk of infection and disease transmission to clients

Protecting themselves and other staff from exposure to life-threatening diseases

Limiting the spread of infection from facilities to communities through effective waste management

Minimizing environmental pollution through appropriate reprocessing of single-use items

By systematically integrating IPC into health care initiatives such as family planning, reproductive health, maternal and newborn health, and HIV/AIDS prevention, Jhpiego has assisted more than 40 countries in reducing the spread of infectious diseases in their health facilities and the communities they serve.

Working with key stakeholders at every level of the health care system—from ministries of health, to facility supervisors, to clinicians and housekeeping personnel—Jhpiego designs a comprehensive IPC approach that fits the country's unique needs and is in accordance with evidence-based best practices and international standards. This approach may include the following activities at site, regional or national levels:

Developing and implementing IPC standards and guidelines for workplace safety

Creating IPC reference and learning materials for use in training health workers

Designing and facilitating IPC training events and systems

Establishing IPC strategies to help governments prepare for, and respond to, an outbreak or epidemic of pandemic (avian) flu

Implementing a Standards-Based Management and Recognition (SBM-R) approach to improve performance and quality of IPC services

Incorporating inexpensive, locally available materials to reduce costs associated with IPC

Removing logistical barriers to improving IPC and other health care services

In addition to preventing and controlling infection, a strong IPC component in health care services can reduce the perceived risk of becoming infected with life-threatening illnesses among health care providers. Changing these perceptions can help reduce health staff attrition and increase the number of people joining the health industry. It can also lead to more compassionate and caring provision of health services by reducing the stigma and discrimination associated with diseases such as HIV/AIDS.

A Global Portfolio—Highlights from Jhpiego's Work in IPC

MOZAMBIQUE: In close collaboration with the Mozambique Ministry of Health (MOH) and other partners, Jhpiego has been working to reduce health worker and client exposures to blood-borne pathogens. Through a hands-on approach based on the standardization of care, this initiative has been successfully implemented in 23 hospitals, and is currently being expanded to the remaining 10 hospitals in the country. As part of this effort, Jhpiego is developing workplace safety and health guidelines, including occupational post-exposure prophylaxis (PEP) for HIV, as well as IPC training materials and job aids for ancillary workers. Jhpiego is also providing technical assistance to improve the sterilization and waste management systems in U.S. Government-supported HIV/AIDS treatment sites throughout the country.

ZAMBIA: Jhpiego and partners are implementing the President’s Emergency Plan for AIDS Relief (PEPFAR) program to prevent medical transmission of HIV in Zambia. As part of this effort, JHPIEGO led the Prevention of Medical Transmission of HIV in Zambia Program, spearheading the assessment and pilot-testing of IPC and injection safety strategies, as well as assisting the Zambian government in the development, production and dissemination of national IPC guidelines and the Zambia National Infection Prevention Implementation Strategy 2005-2007. The program has assisted district- and facility-level managers in the forecasting, procurement and management of essential IPC supplies, resulting in improvements in quality of care at key facilities in Zambia. Jhpiego continues to support the Zambia government in scaling up improved injection safety and IPC programs nationwide in all nine provinces and 72 districts.

MALAWI: In 2001, Jhpiego helped Malawi's MOH and Population and National Quality Assurance Task Force to develop national IPC standards. The standards were implemented at seven pilot hospitals, which resulted in dramatic (more than two-fold) improvements in IPC practices in just over a year. Since then, the program has expanded to 24 health facilities, covering 20 districts across all three regions of Malawi. As part of this initiative, an IPC "logo and recognition" process has been initiated—through JHPIEGO’s SBM-R approach—whereby hospitals are officially recognized for their level of compliance with established, IPC-related performance standards. Impressed with the success of this effort, the MOH now requires all organizations working to strengthen IPC in the country to use the SBM-R approach. In addition, other countries in Africa are planning to adopt the same approach to strengthening the IPC component of their health systems.

INDONESIA: In response to the global threat of an avian flu pandemic, Jhpiego is assisting the Government of Indonesia in developing and disseminating national IPC standards and guidelines specific to avian flu, based on proven best practices, for various cadres of health care workers and support staff. To complement this effort, Jhpiego is also helping to develop, disseminate and implement a national IPC strategy to prepare for, and respond to, an outbreak or epidemic of this disease. The strategy covers acquiring essential IPC equipment and supplies, training health care staff in IPC, and adhering to IPC-specific models of facility management and supervision.

ETHIOPIA: Jhpiego assisted Ethiopia's MOH in developing national IPC guidelines, which have been disseminated to all of the country's health facilities. To date, providers at 89 hospitals have been trained in IPC, most sites now have IPC committees, and trained providers are orienting the other staff at their facilities to various components of IPC. Jhpiego also assisted the MOH in developing performance standards for prevention of mother-to-child transmission of HIV, of which IPC performance standards are a critical component. In addition, Jhpiego is working with the MOH to strengthen national preparedness for a potential outbreak of avian flu. As part of this effort, Jhpiego is supporting the development of a national avian flu training package and training of emergency operating center staff in selected regions.

More Information

For more information on Jhpiego's work in infection prevention and control, browse the feature articles and news releases in the Media Center.