Evaluation of Infection Prevention and Control Programs and Development of an Evidence-Based Strategy Using the WHO Multimodal Framework in Public Hospitals, Limpopo Province, South Africa

Infection prevention and control (IPC) is imperative to ensuring patient safety; however, public hospitals in Limpopo Province suffer from poor infrastructure, lack of education, and lack of surveillance. The purpose of this research was to evaluate the performance of IPC programs within Limpopo Province and develop an evidence-based improvement strategy using the WHO Multimodal Framework. A mixed-methods research approach was used over three different phases. In Phase I, retrospective data on IPCAF were collected on all 41 public hospitals. In Phase II, semi-structured interviews were conducted with six IPC nurses. Descriptive statistics (medians and interquartile ranges) were used for quantitative analysis, while qualitative data were analyzed using thematic analysis in ATLAS.ti. An evidence-informed strategy was formulated in Phase III. Overall IPC program performance was moderate (median IPCAF score: 618.0/800), with 58.5% of hospitals having advanced status, 39.0% intermediate status, and 2.4% basic status. The most poorly performing component was workload/staffing (CC7: 60.0). Districts scored between 576.2 (Capricorn) and 636.0 (Mopani). Lack of standardized education, understaffing, and role ambiguity were the main barriers identified. The strategy uses the “Build It, Teach It, Check It, Sell It, Live It” framework.