The WHO Core Components of Effective Infection Prevention and Control Program

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Presenter: Malefetsane Tsolo

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Date:24 August 2026

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Objectives

• Strengthen IPC programmes to ensure coordinated implementation across all level of health systems.
• Implement IPC guidelines consistently in every clinical area.
• Provide regular IPC training for all healthcare workers.
• Conduct routine surveillance for HAIs and AMR trends.
• Perform audits with feedback to improve compliance.
• Improve enabling environment through adequate staffing, materials and infrastructure.
• Apply multimodal strategies to strengthen and sustain IPC practices

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Presentation Outline

• Core component 1: Infection prevention and control program.
• Core component 2: National and health facility level infection prevention and control guidelines.
• Core component 3: Infection prevention and control education and training.
• Core component 4: Healthcare-associated infection surveillance.
• Core component 5: Multimodal improvement strategies for implementing infection prevention and control activities.
• Core component 6: Monitoring, evaluation and feedback.
• Core component 7: Workload, staffing and bed occupancy at the health facility.
• Core component 8: Build environment, materials and equipment for infection prevention and control at the health facility.

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1.Infection prevention and control programmes

The first component in the WHO guidelines addresses the establishment of the following:

• A sustainable IPC programme at different levels in a health systems.
• Public and private health sectors.
• Including all types of healthcare service delivery.

Provide guidance to establishing functions of IPC at the following levels:

• National level.
• Provincial level.
• District level.
• Facility level(Hospital and PHC facilities).

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Functions of the National level IPC Programme

• Develop a sustainable and realistic national plan in line with the 2016 WHO guidelines on IPC.
• National plan for preventing or containing HAIs and supporting AMR activities of MAC;
• Develop and strengthen national policies, guidelines and standards of practice regarding IPC activities in health care facilities;
• Set up monitoring of implementation and adherence to the national policies and standards.
• Provide technical input and advice on specification of IPC equipment, materials and the built environment.
• Links with the National Health Laboratory Services and the Surveillance Technical Working Group of the Ministerial Advisory Committee (MAC) AMR towards establishing an active and reliable surveillance of HAIs and AMR.
• Monitor, analyse and provide feedback on HAI data submitted by provinces.
• Provide input into funding needs and budgets for IPC activities.
• Setting achievable goals for HAI and outbreak containment.
• Giving technical support to communicable disease containment. • Advice on the development of a national IPC curriculum.

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Functions of the Provincial level IPC Programme

• Provide strategic direction to districts/health facilities to ensure implementation of the National Strategic Framework.
• Provide technical support and mentorship to the district structures.
• Provide technical input on specification for IPC equipment and materials to districts/health facilities. • Plan and coordinate IPC training for districts/health facilities.
• Develop locally relevant IPC policies/guidelines/standard operating procedures.
• Give guidance to facilities/districts regarding the allocation of funds required to support the implementation of effective IPC activities.
• Review the data on HAIs towards strengthening implementation strategies.
• Submit quarterly HAI surveillance report to the NDoH.
• Provide feedback to the Districts from the National IPC structures.
• Report and share IPC relevant information with the National IPC structures.

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Functions of the Provincial level IPC Programme cont.

• Request technical support from the national technical advisory group on IPC if required.
• Have mechanisms in place to set up alert systems and identify outbreaks in the facility.
• Support provincial CDC units and local government to:
• Develop provincial preparedness plans to respond to facility outbreaks timeously.
• Develop locally relevant guidelines in times of crisis or outbreaks specific to the province;
• Establish and maintain relationships with other departments at the provincial level e.g;
• Engineering,
• Public Works,
• WASH,
• Environmental Health,
• academic institutions and
• EMS.
• Continuously monitor and evaluate IPC programmes.

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Functions of the District level IPC Programme

• Provide technical support and mentorship to health facilities.
• Ensure that budgets are established to support the implementation of IPC activities.
• Monitor that IPC equipment and materials are available at health facilities.
• Plan and coordinate IPC training for staff at health facilities according to the national curriculum.
• Provide guidance with development and review of facility IPC guidelines and policies.
• Provide input within the district on the surveillance, prevention, investigation and control of infectious disease in the community.
• Assist with the containment of community outbreaks to prevent further transmission where possible.
• Review the data on HAIs towards strengthening implementation strategies.
• Submit quarterly HAI surveillance reports to the provincial office.
• Ensure that mechanisms are in place to identify outbreaks and set up alert systems in health facilities.
• Provide input towards the development of district preparedness plans and guidelines to respond to outbreaks timeously.
• Monitor and audit IPC standards and practices in health facilities.

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Functions of the Facility level IPC Programme

• Coordinate and chair the IPC Committee and report on recent IPC events and key performance indicators.
• Liaise with teams in order to prevent, control and reduce HAIs.
• Write IPC standard operating procedures that is evidence based and in line with provincial/district guidelines/policies to prevent transmission of HAIs.
• Provide input into funding needs and budgets for IPC activities.
• Ensure that equipment and materials for IPC are available.
• Train and teach clinical and non-clinical teams in evidence-based IPC practices;
• Attend clinical ward rounds and advise on IPC matters.
• Write reports for relevant stakeholders to inform them of IPC challenges and successes.
• Provide relevant HAI data on pathogens and resistant profiles in antimicrobial stewardship meetings.

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Functions of the Facility level IPC Programme cont..

• Submit quarterly HAI data to the provincial/district office.
• Ensure that notifiable medical conditions (NMC) are reported timeously.
• Ensure that appropriate measures are in place and adhered to, to prevent the transmission of HAIs .
• Support the monitoring and evaluation of procedures and practices in the health facility:
• Conduct regular IPC audits (e.g. hand hygiene, environmental cleaning, compliance to transmission-based precautions and bundle compliance).
• Identify gaps and develop and implement continuous quality improvement plans.
• Improve self-knowledge and keep abreast of new evidence in IPC.

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2. National and Health facility level infection prevention and control guidelines

The following guidelines should be available/developed as a minimum.

Standard precautions:

• Hand hygiene;
• Appropriate use of personal protective equipment.
• Patient placement.
• Appropriate use of antiseptics, disinfectants and detergents.
• Decontamination of medical devices.
• Safe handling of linen and laundry.
• Health care waste management.
• Respiratory hygiene and cough etiquette.
• Environmental cleaning.
• Principles of asepsis.

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2.National and Health facility level infection prevention and control guidelines cont..

The following guidelines should be available/developed as a minimum.

Standard precautions:

• Injection safety.
• Prevention of injuries from sharp instruments.
• Post-exposure prophylaxis and medical surveillance.
• Transmission-based precautions.
• Built environment and infrastructure for IPC.
• Surveillance of HAIs.
• Antimicrobial stewardship.
• Outbreak response.
• Reporting of notifiable medical conditions.
• Education and training of staff and IPC staff.
• Monitoring and evaluation.

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3.Infection prevention and control education

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4.Healthcare-associated infection surveillance

A good HAI surveillance programme should:

• Have a clear purpose.
• Set out standard definitions, methods data fields, and protocols (including of cohorts or groups to be monitored and periods of data collection).
• Be done under a ‘no blame’ culture with the sole purpose of improving patient outcomes.
• Be carried out by trained personnel who understand data collection:
• Methodology for data collection.
• Understand the information and can interpret the results.
• Provide feedback to relevant stakeholders at both clinical and administrative levels.

Therefore, HAI surveillance is pivotal for IPC programmes to be able to identify:

• Trends in HAI pathogens and their resistance profiles

• Trends in HAIs and patients at risk

• Outbreaks in both healthcare facilities and in the community.

• Effective use of microbiological findings
• Establishment of audit systems
• Areas for improving quality of patient safety and care.

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5.Multimodal improvement strategies for implementation of National IPC Strategic Framework.

1.WHO recommends that the national IPC programme should assess the extent to which standards are being met and activities are being performed according to the programme’s goals and objectives.

2.A MMS consists of several components that are implemented in an integrated way, supported by leadership, increasing accountability via monitoring and feedback, resulting in behavioural change and safe patient care.

The elements of a MMS are:

• System change: availability of the appropriate infrastructure and supplies to enable the implementation of infection prevention recommendations.
• Education and training of health workers and key role-players.
• Monitoring infrastructure, practices, processes, outcomes and providing feedback based on interpretation of data.
• Reminders and communication improvements in the workplace.
• Culture change within the facility or the strengthening of a safety climate.

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6.Monitoring, evaluation and feedback

• WHO recommends regular monitoring and evaluation in a systematic manner and to document the progress and impact of the national IPC programme for defined indicators.
• The Norms and Standards Regulations applicable to different categories of health establishments should be used to monitor progress.
• Hospitals should monitor the compliance rate for implementation of, and adherence to, infection control bundles of care for the prevention and reduction of HAIs.
• Timely feedback should be given on health care practices.
• Staff who need to work together as a team to reduce HAIs and AMR.
• To improve patient safety and clinical outcomes

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7.Workload, staffing and bed occupancy at health facility.

• The bed occupancy should not exceed the standard capacity of the facility.
• Overcrowding leads to extra burden on the infrastructure and patient care facilities.
• Increases the risk of HAIs and the spread of AMR pathogens.
• The longer patients stay in hospital, the more likely they are of acquiring a HAI.

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8.Build environment, materials and equipment for infection prevention and control at health facility

Delivery of quality healthcare should take place in :

• A hygienically clean environment.
• Safe environment with an adequate supply of clean running water.
• Good sanitation for both patients and staff in order to reduce HAIs and transmission of AMR pathogens.
• The infrastructure should be safe and have isolation rooms.
• Medical devices should be available and in working order.
• Decontamination facilities should be available.
• Availability of cleaning materials.
• Availability of PPE.

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Reference

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Department of Health, 2021, Practical Manual for Implementation of National Infection Prevention and Control Strategic Framework, Republic of South Africa.

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Thank you

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