Assessment for IPC compliance among health facilities in Uganda: Analysis of data from the 2023 IPC survey

Title : Assessment for IPC compliance among health facilities in Uganda: Analysis of data from the 2023 IPC survey

Abstract:

Background: Infection Prevention and Control (IPC) is vital for safe, high-quality care and the protection of patients and health workers. Uganda’s IPC capacity was rated Level 2 (limited) in the 2023 Joint External Evaluation, indicating partial implementation with major gaps. In response, the Ministry of Health conducted a nationwide survey to assess IPC implementation and compliance across all facility levels, to inform policy and strategy development.

Methods: During April 2023, we conducted a stratified survey across 261 facilities, including 4 National and 17 Regional Referral Hospitals. We systematically sampled 21 General Hospitals, 36 Health Centre IVs, 166 Health Centre IIIs, and 17 specialized clinics across 15 sub-regions. Facilities were proportionally chosen by region and ownership. IPC focal persons and facility in-charges were interviewed using a structured electronic questionnaire based on the WHO Infection Prevention and Control Assessment Framework (IPCAF), assessing 8 IPC core components and grading performance into four levels: inadequate (0–200), basic (201–400), intermediate (401–600), and advanced (601–800).

Results: The national median IPCAF score was 426/800 (53.3%; range 10–702.5), reflecting an intermediate level of IPC compliance. Of 261 facilities, 133 (51.0%) were intermediate, 72 (27.6%) basic, 23 (8.8%) advanced, and 33 (12.6%) inadequate. IPC guidelines and SOPs had the highest median score (70%), while HAI surveillance (47.5%) and workload, staffing, and bed occupancy (35%) scored lowest. North Central region recorded the highest median score at 570/800 (71.3%), while Kigezi had the lowest at 234/800 (29.3%). Government facilities (54%) majorly scored at the intermediate level, whereas most (38%) general hospitals were classified as inadequate.

Conclusion: IPC capacity in Uganda is at an intermediate level, with variation across facility levels, ownership, and regions. Gaps are prominent in HAI surveillance, workload, staffing, and bed occupancy. We recommend prioritizing support to underperforming regions and general hospitals. MoH should develop HAI surveillance framework and improve staffing for IPC.

Keywords: Infection Prevention and Control, IPCAF, Assessment, IPC Survey, Uganda.

Biography:

Dr. Michael Mutegeki is a Medical Doctor and Infection Prevention and Control (IPC) Officer at the Ministry of Health, Uganda, where he coordinates IPC activities across all levels of the health system. He holds a Master of Public Health from Uganda Martyrs University and a Certificate in IPC with the Infection Control Africa Network (ICAN). He is currently a Field Epidemiology Fellow with the Uganda Public Health Fellowship Program.

With over eight years of experience in clinical practice and health systems strengthening, He has served at both facility and national levels. He has been actively involved in Uganda’s Ebola and COVID-19 responses, contributing both as a frontline clinician and as a national coordinator under the Case Management Pillar. His professional interests lie in infection prevention, health leadership, and strengthening emergency preparedness and response capacities across the health sector.