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Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

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Leena N Patel, Samantha Kozikott, Rodrigue Ilboudo, Moreen Kamateeka, Mohammed Lamorde, Marion Subah, Fatima Tsiouris, Anna Vorndran, Christopher T Lee, On behalf of the African Primary Health Care IPC Strengthening Community of Practice

Summary box

  • Infection prevention and control (IPC) measures are essential to protect healthcare workers (HCWs), patients and communities from SARS-CoV-2 and other outbreaks.

  • Despite this critical need, IPC measures are suboptimal around the world, especially in resource-limited settings with austere health systems, where barriers to effective IPC include limited workforce of trained IPC professionals, paucity of availability of personal protective equipment (PPE), and limited clinical infrastructure at the primary health facility level for required environmental controls and water and sanitation for safe health service delivery.

  • In response to COVID-19, we designed an emergency intervention to address these constraints in 22 African countries by supporting rapid in-service training, systematic data collection and stopgap provision of PPE and other supplies. These interventions may have contributed to improved IPC capacity at primary healthcare facilities.

  • Despite this short-term success, emergency response efforts are not an optimal way to strengthen IPC systems. Urgent attention is needed to ensure the development of national IPC policies, guidelines, training curricula, supportive supervision, and monitoring and evaluation systems. Domestic and global investments are needed to enhance health facility infrastructure and to ensure availability of adequate PPE and supplies to protect HCWs and the communities they serve.