Making Infection Prevention and Control Integral to Quality Health Systems: Insights from the Frontlines of the National Pandemic Response in 13 Countries

July 06, 2022

Making Infection Prevention and Control Integral to Quality Health Systems: Insights from the Frontlines of the National Pandemic Response in 13 Countries

By Fozo Alombah and Andre Zagorski, USAID MTaPS

When the COVID-19 pandemic began in early 2020, infection prevention and control (IPC) became the first line of health system response to contain its transmission. There was an urgency to slow the spread and keep health systems from being overwhelmed with patients. An equally serious concern was avoiding system collapse by protecting the safety of health workers and not stressing the already limited capacity of low- and middle-income countries (LMICs). Simultaneously, personal protective equipment (PPE) and related IPC products disappeared from the markets in most LMICs as the global demand surged. 

The US Agency for International Development (USAID) gave us the complex task of supporting its priority countries with a rapid IPC response. Our quick assessments in the assigned countries indicated they were not adequately prepared, even though countries like Côte d’Ivoire, Mali, and Uganda had dealt with the Ebola crisis and had epidemic response mechanisms in place. While we successfully leveraged our ongoing IPC and pharmaceutical systems strengthening work under the Global Health Security Agenda (GHSA) in supported countries to rapidly bolster their pandemic response (browse COVID-19 response results in 13 countries), the experience left us with some important insights and lessons. 

The USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program—implemented by a consortium led by MSH—has been USAID’s flagship program since 2018 in 13 countries for GHSA, focusing on three technical areas to contain antimicrobial resistance (AMR): strengthening multisectoral coordination, increasing IPC capacity, and fostering antimicrobial stewardship (AMS). Using a health systems strengthening approach, the program employs the World Health Organization’s (WHO) Joint External Evaluation framework and Benchmarks for International Health Regulations Capacities tool to conduct standardized assessments and design interventions to make measurable progress in developing countries’ capacity on IPC and AMS to contain AMR using the One Health multisectoral coordination approach. These IPC and multisectoral coordination interventions became a launch pad for our rapid pandemic response. 

Below, we share some takeaways from our experience over a nine-month period during the pandemic. 

What We Learned from the COVID-19 Response 

Training at health facilities to nationally roll out COVID-19 eLMIS in Bangladesh. Photo credit: MTaPS Bangladesh

What We Set Up Through the Pandemic Response: Sustainable Gains 

Even as we were in pandemic response mode, there were opportunities to implement sustainable approaches that continue to bring benefits and can be expanded on for long-lasting gains in health systems. 

Strong IPC Programs: A Must for Resilient, Quality Health Systems 

IPC is not just about containing the spread of infection during epidemics and pandemics. It’s also about patient safety and the quality of health delivery in normal times. As WHO reports, 10% of patients contract an infection in hospitals. These infections harm treatment outcomes and fuel AMR, which is a growing health crisis. Further, injections come with a significant risk, and with COVID-19 necessitating mass immunization of populations in a short time span, IPC became yet again a major concern—a continued focus of MTaPS’ IPC capacity building in countries. 

Based on our COVID-19 response experience, we call the attention of the health community to the following as we build stronger health systems: