In Ghana, a strong national health insurance scheme is helping people around the country access vital health services. While the insurance scheme has allowed Ghana to make huge strides towards universal health coverage, up until recently infection prevention and control (IPC) and water, sanitation and hygiene (WASH) were still not considered a priority in many health facilities. Policies were outdated, and health workers often did not understand the importance of IPC practices like hand hygiene, appropriate use of personal protective equipment and proper environmental cleaning.
These gaps in WASH and IPC resulted in high rates of hospital-associated infections and longer stays in hospital, loss of productivity, increased health costs, patient and families suffering and even death.
When a devastating Ebola outbreak hit west Africa in 2014-15, Ghana created a new national policy and set up a training programme to build the skills and capacity of more than 34 000 frontline health workers in 170 health facilities.
In 2016, Health Information Officer, Isaac Eyram Tegbey was working at Weija-Gbawe Municipal Hospital in Ghana. As with many health facilities in Ghana at the time, IPC at the hospital was not considered a priority. Health workers had a lack of awareness of the importance of IPC practices, and levels of infections were high. At the time, 19% of babies born at the hospital had sepsis and jaundice.
In his role as health information officer, Isaac had limited knowledge of IPC himself and was never involved in clinical decisions. Then he completed training to become a Regional IPC Champion and facilitator. The training was organized by the Institutional Care Division of Ghana Health Services, supported by USAID Systems for Health.
Isaac’s enthusiasm and interest in IPC contributed to a transformation of IPC practices at his hospital. He helped to completely turn around the quality of IPC in his facility with initiatives like wooden mobile hand washing systems to save money by preventing rust; in-house production of alcohol hand rub; ensuring the supply of wall mountable soap, sanitizer and tissue dispensers; and the introduction of a quality control system that assures the quality of all IPC supplies entering the facility.
“Today I am consulted to make inputs to very critical clinical decisions in my facility,” said Isaac. “IPC is now part of the orientation programme for new staff. Healthy competition has emerged among health care facilities, with results being displayed for all communities to see.”
Isaac is currently the coordinator for IPC for the Greater Accra Region and provides support, mentoring and coaching to facility IPC focal points. His efforts have led to his hospital winning top spot in its regional peer review exercise for three years in a row. But more importantly, it has greatly improved outcomes for patients.
Around the country a greater focus on IPC practices in health facilities has resulted in many improvements in the health of Ghana’s people. While work is still needed, 83% of health care facilities in Ghana have improved sanitation. Newborn sepsis and jaundice has been reduced to zero cases in 2018. There has also been a reduction in neonatal infections in some facilities and improved birth rates . But for these improvements to be sustainable, governments, health actors and IPC and WASH leaders must commit to prioritizing IPC and WASH in health infrastructure and overall quality in service delivery.
WHO and partners are helping drive progress and sustainability through information, standards, policies and implementation strategies. Clean, quality care is a right for all patients and results in the protection and satisfaction of health care workers. With his unwavering enthusiasm and drive for quality, Isaac is an excellent example of a motivated, trained and highly-skilled health workers making a difference in his field. Along with many other health workers, his focus on IPC will continue to save lives.