Disease outbreak preparedness: a baseline assessment of infection prevention and control practice in healthcare facilities in Lagos, Nigeria

Background: Evidence-based infection prevention and control (IPC) measures in healthcare facilities are critical for preventing and containing outbreaks. However, studies have shown inadequate implementation of IPC practices among healthcare facilities in developing countries. To improve practice among healthcare facilities in Lagos, Nigeria, we conducted a baseline assessment of IPC practices in selected healthcare facilities, aimed at identifying strengths and gaps and giving recommendations to promote standard practices. Methods: We conducted an analytical cross-sectional survey using a multistage random sampling technique to select 415 hospitals/primary healthcare centres, with 214 being private and 201 public, between July and October 2023. A structured questionnaire adapted from the WHO Infection Prevention and Control Assessment Framework (IPCAF) for acute healthcare facilities was used for data collection. Data were analysed using Stata BE 17 statistical software; p≤0.05 at 95% CI was considered statistically significant. Results: The total median IPCAF scores for all the facilities was 207.5 (IQR 132.5-415.0). IPC core components 7 and 8 were observed with the highest median scores of 70.0 (IQR 45.0-95.0) and 67.5 (IQR 47.5-82.5), while core components 1, 4 and 5 scored the least. For the levels of IPC promotion and practice, a total of 48.8% (202) of the surveyed facilities had an inadequate level of IPC practices, 25.5% (106) had a basic level, while the remaining 25.7% (107) had an intermediate level. More of the public 57.7% (116) facilities had an inadequate level of practice compared with 40.2% (86) of private facilities (p value ≤0.05). Conclusion: The study found that IPC practices across surveyed Lagos facilities were inadequate or basic, with none attaining advanced IPCAF standards. Consistent with findings from low-income countries, the results highlight the need for strengthened IPC programmes to improve compliance and sustained quality improvement in Lagos, Nigeria.