Today, 5 May 2018, we mark the annual global campaign the “SAVE LIVES: Clean Your Hands”. This initiative, led by WHO, is aimed at promoting improvements in hand hygiene practices at the point of care with a view to reducing the burden of healthcare associated infections and spread of antimicrobial resistant agents. In fact, a paradigm shift has occurred in our world that cannot be reversed – multidrug resistant pathogens are here to stay – we need to manage these through infection prevention action. Limited information is available on the endemic burden of these infections in Africa, but a recent review reveals that their prevalence range from 2.5 % to 14.8%, this is twice as high as the average prevalence (7.1%) in Europe. This burden is even more for the neonates as a quarter of the newborn deaths are attributed to sepsis
The theme for this year is “health care-associated sepsis prevention.” Sepsis is estimated to affect more than 30 million patients every year, worldwide. At the Seventieth World Health Assembly in 2017, Members adopted a resolution (WHA70.7) on improving the prevention, diagnosis and clinical management of sepsis. The slogan for this year’s campaign “It’s in your hands – prevent sepsis in health care”. There are five key calls to action, each for a different target group, as follows:
- Infection Prevention and Control (IPC) leads (those dedicated to IPC at the facility level) – “Be a champion in promoting hand hygiene to prevent sepsis in health care”
- Health workers - “Take 5 moments to clean your hands to prevent sepsis in health care”
- Patient advocacy groups – “Ask for 5 Moments of clean hands to prevent sepsis in health care”
- Leaders, “health facility directors” or other health care leaders – “Prevent sepsis in health care, make hand hygiene a quality indicator in your hospital”
- Ministries of health – “Implement the 2017 WHA sepsis resolution (WHA70.7) and make hand hygiene a national marker of health care quality”
Hand hygiene remains at the heart of effective Infection Prevention and Control (IPC) programmes to fight healthcare associated infections, antibiotic resistance, and sepsis. Annual campaigns are important ways of encouraging behavior change towards improving IPC best practices.
In the WHO Guidelines on Core Components of IPC Programmes at the National and Acute Health Care Facility Level, hand hygiene is once again highlighted as the best example of successful implementation of these components with year-round commitment by many dedicated health workers. This is especially important for newborn survival as neonates are susceptible to infection because their host defense mechanisms are not mature. They also occupy an environment in which frequently used antibiotics and invasive interventions often permit the invasion of common nosocomial pathogens, and health-care workers are often the conduit for the spread of such infections to other patients in their care.
Evidence also shows that hand washing by mothers and reduced repeated touching of the newborn baby by other family members especially without proper hand washing, in addition to exclusive breastfeeding, temperature maintenance, can reduce infection-related neonatal deaths by 20-50%.
Health facilities in every country in the African Region must therefore take part in this global annual campaign to continue to promote hand hygiene, fight antibiotic resistance, health care-associated sepsis prevention and commit to progressing towards adherence with all of the core components for IPC programmes. Every year more and more health facilities in the African Region have registered for the Save Lives: Clean Your Hands campaign. This year, we hope to see a big rise in these numbers. I encourage you to join me in promoting the campaign and to engage countries in our region to encourage all health facilities to sign up: www.who.int/gpsc/5may/register/en/index.html.
A number of useful resources are available in the WHO webpage: www.who.int/gpsc/5may/en.
I call upon health leaders, managers, health-care workers, consumer associations and similar bodies in the African region to implement a true quality and safety culture in which both patients, (and their relatives and visitors) and health-care workers work together towards strengthening IPC, and promoting hand hygiene best practices. While the responsibility for hand hygiene in health facilities remains firmly with the health-care workers, patients should support them in improving hand hygiene by practicing and learning more about it.
I call upon Member States to take advantage of this year’s Hand hygiene campaign to awaken to the real threat of healthcare associated infections and sepsis in our region and consolidate our efforts to improve hand hygiene within our health services. No action today means more health care associated infections tomorrow.