Improvement of infection prevention and control at 37 Tanzanian referral hospitals between 2021 and 2022 through the application of the consolidated framework for implementation research

Inadequate implementation of Infection Prevention and Control (IPC) interventions in healthcare facilities exposes healthcare workers (HCWs) and patients to preventable infections. The COVID-19 pandemic underscored the urgency of strengthening IPC systems globally. Despite this, evidence on IPC improvement in Tanzania remains limited. This study aimed to assess changes in IPC implementation across 37 referral hospitals (RHs) in Tanzania using the Consolidated Framework for Implementation Research (CFIR). A retrospective secondary data study employing both quantitative and qualitative approaches was conducted. Quantitatively, National IPC performance data in 2021 and 2022 were extracted. Descriptive analysis was conducted, and median IPC scores were calculated and compared using the Wilcoxon signed-rank test, with statistical significance set at p < 0.05. Qualitatively, CFIR reports were extracted to explore contextual factors influencing IPC implementation. Thematic analysis was conducted to identify key drivers of change. The study demonstrated a statistically significant improvement in IPC adherence, with median scores increasing from 46% (IQR: 49–55) in 2021 to 64% (IQR: 52–73) in 2022 ( p < 0.001). Mentorship efforts expanded, reaching 1,850 HCWs in 2021 and 1,955 in 2022. Qualitative findings highlighted strong leadership and management support, continuous on-the-job training, inter-facility exchange of best practices, and functional Quality Improvement Teams as key facilitators of IPC improvement. IPC implementation in Tanzanian RHs improved over the study period but remains suboptimal, indicating the need for sustained investment. High-performing facilities were characterized by strong leadership engagement, continuous capacity building, and collaborative learning. Strengthening IPC interventions across all Healthcare facilities is essential for improving healthcare quality and safety.