Strengthening TB infection prevention and control (IPC) in health care facilities in the Western Cape, South Africa

In South Africa, the Department of Health advocates IPC as a pillar for a sound healthcare delivery system. TB-IPC policies are in place although it is difficult to monitor compliance. This project evaluated a training programme for IPC at 8 public healthcare facilities in the WCP. A context specific multi-stage methodology was applied. Following a baseline IPC assessment at 2 hospitals and 6 primary health clinics, a 5-day staff training course was delivered. Impact evaluation of the training was completed 12 months later. There were significant improvements at post-intervention follow-up (n=91) for the following components of IPC: level of knowledge in the use of multi dose vials (p= 0.04) and primed administration sets (p<0.05); health and occupational safety (100% knew their HIV status vs 88% pre-intervention, 31% improvement in handling of sharps and a 16.4% improvement in the use of surgical masks). Monitoring of compliance with IPC policies must be on-going. Cost-effective programmes, including staff training at health facilities as well as regular supervision and evaluation are essential to strengthen IPC and prevent TB transmission.