Implementation of infection prevention and control interventions to address healthcare-associated infections in sub-Saharan Africa: a scoping review.

Authors

Nikita Sass, Moshao Makhele, Jennifer A Brown, Niklaus D Labhardt, Lisa Brockhaus

Published in

The Journal of hospital infection. Aug 26, 2026. Epub Aug 26, 2026.

Abstract

Infection prevention and control (IPC) is essential to reduce healthcare-associated infections (HAIs), but implementation remains challenging in resource-limited settings. We aimed to map IPC implementation research targeting HAIs in sub-Saharan Africa and describe effectiveness.
We conducted a systematic scoping review of intervention studies implementing IPC targeting HAIs in sub-Saharan Africa. We searched MEDLINE, EMBASE, CINAHL, the Web of Science Core Collection, African Index Medicus and ProQuest up to February 2025. Studies were mapped by design, setting, HAI type, intervention components, implementation activities according to WHO IPC core components, feasibility, and outcomes. HAI-related effectiveness was summarized descriptively.
We included 35 studies, of which 27 addressed surgical site infections (SSI). Most were conducted in tertiary hospitals (29/35), with limited representation of primary-level and rural hospitals (9/35). Interventions were largely multimodal (28/35), commonly including trainings (33/35), guideline dissemination (31/35), and monitoring or audit activities (19/35). Few addressed routine HAI surveillance (7/35), IPC infrastructure and materials (6/35) or staffing and workload (2/35). Of 21 studies reporting SSI outcomes, 13 found a significant benefit and seven reported non-significant effects in the same direction. Dominant barriers were resource deficiencies, insufficiently addressed organisational factors, and poor sustainability planning. Broad stakeholder engagement and participatory, context-specific, multimodal designs aligned with guidelines were identified as facilitators.
IPC implementation research in sub-Saharan Africa is concentrated in tertiary urban hospitals and largely focused on SSI, with generally beneficial effects across heterogenous interventions. Important gaps remain for other HAIs, rural and primary-level settings, and structural and workforce-related implementation domains.

PMID:
42648542
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

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