Implementation strategies to improve infection prevention and control in healthcare facilities in Sub-Saharan Africa: A scoping review of evidence, practices and gaps

Implementation strategies to improve infection prevention and control in healthcare facilities in Sub-Saharan Africa: A scoping review of evidence, practices and gaps | Research Square Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Implementation strategies to improve infection prevention and control in healthcare facilities in Sub-Saharan Africa: A scoping review of evidence, practices and gaps Dorica Ng’ambi, Rufaro Matorera, Thomasena O’Byrne, Nicholas Feasey, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9114915/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 12 You are reading this latest preprint version Abstract Introduction: Infection prevention and control (IPC) is essential for improving patient safety and reducing healthcare associated infections (HAIs). Many IPC interventions have been implemented across sub-Saharan Africa (sSA), however, implementation strategies used, their processes and reported outcomes have not been synthesised. This scoping review mapped implementation strategies used in health facilities to identify common strategies and approaches, their outcomes and facilitators and barriers to their implementation. Methods : We conducted a scoping review guided by the PRISMA-ScR framework. Peer-reviewed studies conducted in sSA published in English and reporting IPC interventions or implementation strategies across health facilities were included. Data extraction captured study characteristics, IPC practices, implementation strategies and their outcomes and facilitators and barriers of implementation. Descriptive summaries were prepared for each study. Qualitative content analysis was used to synthesise key emergent findings across the studies, ultimately producing a narrative synthesis. Results : Sixty-one studies from 22 countries were included. IPC practices included hand hygiene, environmental cleaning, neonatal IPC bundles and surgical site infection prevention bundles. Five implementation strategies were identified to promote these practices: 1. training and education; 2. monitoring, audit and feedback; 3. quality improvement; 4. improving IPC resources and supplies; and 5. multimodal strategies. Most study interventions used multiple approaches and reported improvements in compliance with IPC practices. Facilitators included leadership support, reliable IPC resources, IPC focal persons and feedback loops. Barriers included staff shortages, high workload, inadequate IPC resources and lack of sustainability if external support to IPC ended. Conclusion : Improvements in IPC practices are feasible when strategies are multifaceted, supported by leadership, IPC resources are provided and continuous monitoring and feedback is established. However, sustainability is still a challenge, as IPC programmes require strong facility-level systems with strong leadership to ensure long-term improvements in IPC practices and reductions in HAIs. Infection prevention and control healthcare associated infections hand hygiene implementation strategies healthcare workers scoping review Sub-Saharan Africa health facilities multimodal improvement strategy Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 09 Aug, 2026 Reviews received at journal 07 Aug, 2026 Reviewers agreed at journal 22 Jul, 2026 Reviewers agreed at journal 21 Jul, 2026 Reviewers agreed at journal 21 Jul, 2026 Reviews received at journal 30 Apr, 2026 Reviewers agreed at journal 23 Apr, 2026 Reviewers agreed at journal 17 Apr, 2026 Reviewers invited by journal 17 Apr, 2026 Editor assigned by journal 16 Mar, 2026 Submission checks completed at journal 16 Mar, 2026 First submitted to journal 13 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information

Related documents

• Innovative Techniques for Infection Control and Surveillance in Hospital Settings and Long-Term Care Facilities: A Scoping Review#202795
• Surgical site infection prevention: a scoping review of strategies, implementation barriers, and emerging approaches.#455413
• The Impact of COVID-19 on Quality of Care In Hospital Settings#314553
• Best practice guidelines for viral hepatitis service delivery in prisons.#345314
• Trial to Reduce Antimicrobial Use In Nursing Home Residents With Alzheimer's Disease and Other Dementias#1008189