A Tanzanian Doctor’s Insight into the Barriers to Fewer Healthcare-Acquired Infections

This post is part of a series authored by the BASICS (Bold Action to Stop Infections in Clinical Settings) team. BASICS is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%.

 

Written by Dr. Joseph Obure
Maternal and Reproductive Health Advisor, Save the Children

Save the Children President Yanti Soeripto and I had to cover a lot of ground in just 90 seconds in the video that introduces  BASICS (Bold Action to Stop Infections in Clinical Settings) – from why so many millions of mothers and infants acquire debilitating infections in health facilities to how BASICS’ scalable and sustainable solution will prevent many of these infections.

Having been educated in and practiced clinical obstetric and gynecology medicine in Tanzania – one of the four countries where BASICS will be launched with 100&Change funding – I know firsthand of the challenges of preventing infections in places where resources can be precious and where dedicated, overworked staff labor daily to deliver the best care they can.

What does the situation look like in Tanzania when it comes to health care and hygiene? What does a day look like for a doctor in a Tanzanian government hospital?
Like any other developing country, Tanzania faces health systems bottlenecks that affect the provision of quality health care. While there have been significant gains in improving access to services, quality continues to be a problem.

Many health posts, particularly those at the primary care level (health centers and dispensaries) do not have adequate water, sanitation and hygiene (WASH) facilities. These places serve approximately 80% of the people in Tanzania’s rural areas, therefore impacting a huge population.

The lack of reliable clean water is just one problem. Toilets and bathrooms may not be available, and those that are available  can be dirty. Without a place to wash hands and no supplies,  hygiene and infection control practices are poor.

These problems underscore the need to increase investments and support for sustainable solutions like BASICS that improve clinical outcomes, reduce patient and health system costs and lead to a more positive care experiences.

What are the biggest barriers to implementing hygiene protocols?
Funding to support hygiene interventions and health facility infrastructure is limited due to many competing priorities and there’s a focus on coverage of primary care rather than the  quality of care. Health systems have only a limited capacity to operationalize WASH protocols; both health providers and communities have poor behaviors relating to hygiene; and there is little understanding of the cost benefit of improved quality of care on clinical and economic levels.

Lastly, there is a lack of evidence-based policies for hygiene and limited use of simple and feasible solutions based on the context.

Why is BASICS a good solution?
BASICS is unique in that it applies simple, effective and feasible interventions to improve the quality of care, with particular focus on WASH and infection prevention control. It focuses on maternal and newborn delivery points because these environments are quite complicated and overloaded. It’s in these wards that BASICS can achieve a major impact, where we will learn what works best and then scale up the intervention to other service delivery points in health facilities.

 

To learn more about BASICS (Bold Action to Stop Infections in Clinical Settings) is a new initiative that will transform healthcare and reduce healthcare-associated infections (HAIs) by at least 50%, visit savethechildren.org.