Hailu Sabagadis, Infection Prevention and Control (IPC) Officer at WHO Ethiopia, and his team in Benishangul Gumuz Region have been regularly providing onsite and remote technical support to multiple healthcare facilities in the region. Hailu assesses and monitors the facilities' IPC capabilities and proper implementation of COVID-19 and other infection prevention activities. After a thorough evaluation and critical assessment, Hailu and his team often provide technical guidance, orientation and corrective actions to the facilities to ensure the health care workers’ adherence to the recommended IPC practices. 
 
According to  WHO Ethiopia COVID-19 Incident Manager, Dr Martins Chibueze Livinus, the assessment serves as a supporting mechanism for global health priorities to achieve universal health coverage and is a tool for ensuring the health and well-being of health workers and the people they serve.

Proper IPC practices are the cornerstone of high-quality health care, are cross-cutting and also an essential component of patient safety. On the other hand, weak IPC programmes and ineffective implementation of the recommended IPC practices contribute to hundreds of millions of healthcare-associated infections (HAIs) among patients and healthcare workers annually, and hence affect all aspects of health system performance. No country and no health care facility, even within the most advanced and sophisticated systems, can claim to be free of the problem of healthcare-associated infections. HAIs can cause serious illness requiring treatment with expensive, broad-spectrum drugs, prolonged stays in health care facilities, long-term disability, and even death, and high additional financial burden on the families and the health system. However, most HAIs can be prevented with readily available, relatively inexpensive IPC strategic interventions such as capacity building through training of health workers on IPC provision of evidence-based guidelines, establishment of management systems, provision of IPC supplies, and supportive supervision and mentorship. 

The overall aim of IPC in health facilities is to make the workplace/health facility “safe”  – safe for the patients/clients, healthcare workers, family/care givers, visitors, students, the environment and the community at large. In an effort to improve monitoring the IPC performances, WHO designed an IPC scorecard as a tool to help healthcare facilities periodically assess their capacity of mitigating the risk of transmission of COVID-19 and other healthcare-associated life-threatening infections.

The scorecard helps to assess availability of supplies and infrastructures to support IPC implementation, identify gaps, provide timely feedback for the IPC focal/staff and ultimately design and implement jointly feasible solutions.   The IPC Scorecard was initially designed to serve COVID-19 treatment, quarantine, and isolation centers. Later, as WHO and countries moved to promoting integrated services, WHO modified the IPC Scorecard and made the scorecard more comprehensive in order to serve healthcare facilities providing integrated and essential healthcare services. 

The tool was introduced in Ethiopia in mid-August 2020. The initial target across the country was to implement the scorecard in 798 healthcare facilities: 375 hospitals and 423 health centers along the transport corridor. Two years after its introduction, by the end of July 2022, 979 healthcare facilities are implementing the scorecard, with a national average score of 76%, which is within the desired margin of 75-100%. 

Through use of the scorecard, Hailu Sebagadis and other WHO IPC experts aim to assess whether facilities have a functional IPC programme complete with an IPC focal point, IPC committee, IPC guidelines and monitoring and evaluation system. They also use the scorecard to check if a facility has a proper triage, isolation/waiting area, functional handwashing facilities and practices, availability of personal protective equipment (PPE), and waste segregation and disposal system, to list a few. The introduction and utilization of the WHO IPC Scorecard significantly improves the performance of healthcare facilities by increasing the national average score and increasing the motivation of health workers and focal persons both in healthcare facilities and higher health system structures. Moreover, the Scorecard played a significant role in identifying the actual performance gaps that helped in designing feasible interventions.

Hailu attests that using WHO IPC Scorecard as an IPC periodic performance monitoring tool, and working closely IPC experts from Benishangul Gumuz Regional Health Bureau and health facility staff, he has been able to identify and address gaps in IPC programmes in the health facilities he helps monitor.

WHO Ethiopia, in collaboration with the Ethiopian Public Health Institute and Regional Health Bureaus, will continue promoting the IPC Scorecard as an effective IPC performance monitoring tool and scaling up its utilization in all healthcare facilities to ensure safety, build confidence of the healthcare workers and consequently improve quality of healthcare and health outcomes by preventing healthcare-associated infections. WHO gratefully acknowledges the financial contribution of the Ministry of Foreign Affairs, Ireland (IrishAid) towards an evidence-based approach to preventing patients and health workers from being harmed by avoidable infection and as a result of antimicrobial resistance.

For technical information, please contact:
Abebe Bedada
IPC Specialist

Email: bedadaa [at] who.int (bedadaa[at]who[dot]int)                                                                                                                                                                                  WHO Ethiopia