Related Health Topics: MAQ Bulletin, Issue 1

Guinea, Mali, Niger and Senegal Create Guidelines to Prevent Infection

West Africa infection prevention (IP) conference, the first of its kind in the region, responds to need for IP sensitization

In October 1995, 38 West African decision-makers and key service providers representing Guinea, Mali, Niger and Senegal were sensitized to the importance of IP in RH/FP service delivery. The conference, held in Bamako and organized by JHPIEGO in collaboration with the Malian Division of Family and Community Health and AVSC International, featured both informational sessions and innovative hands-on learning activities. Session topics included HIV/AIDS and Hepatitis in the Health Care Setting, Maternal Morbidity and Mortality Linked to Infection and Postinfection Infertility. Hands-on activities included a handmade poster contest, “IP Bingo” and “IP Golf” games in which participants learned essential IP techniques such as loading IUDs in the sterile package, recapping hypodermic needles, and putting on sterile gloves. The conference made it clear that IP is essential not only to the health of the client, but also to the health of all levels of clinic personnel including service providers, maintenance staff and laundry staff.

Delegates returned to their home countries with a draft IP policy document which they will incorporate into their Reproductive Health Service Delivery Guidelines. The cross-institutional partnership that was formed among delegates, who represented West African medical and nursing schools, Ministries of Health, and RH/FP programs, was considered crucial to the initial success of the conference and its potential for impact within the region.

IP Conference Delegates Learn Appropriate Technique for Putting on Sterile Gloves: (Left to right) Col. Lamine Cissé Sarr from Senegal, Dr. Emmanuel Malano from Guinea, and Dr. Henriette Carvalho Kouyate from Senegal play a game of “IP Golf.”

Potentially harmful practices found in West African service delivery sites

Blood on equipment and clinic walls

Instruments and other soiled objects not correctly decontaminated

High-level disinfection not correctly performed

Service providers and maintenance staff not washing hands correctly and not wearing gloves correctly

Service providers not wearing protective barriers and exposed to infections such as HIV or hepatitis B

Improper handling of needles and sharps which could lead to infectious needle-stick injuries

Skin not correctly prepped prior to surgery

Flaming of material and instruments for disinfection instead of using correct boiling techniques

Underutilization of steam autoclaves

Poor usage of antiseptics and antibiotics

Improper disposal of waste materials

Service providers performing female circumcision—or not sensitizing the population about the harmful effects of this practice

National IP guidelines will be implemented

All health personnel will be targeted for IP sensitization, including:

RH administrators

Service providers

Clients

Maintenance and laundry staff

Community-based distribution workers

In addition:

IP will be integrated into both preservice and inservice training curricula.

The importance of handwashing and the use of protective barriers will be emphasized.

Policy documents for the four countries recommend inclusion of postabortion care in RH/MCH programs.

Harmful and unnecessary practices will be discontinued

Delegates agreed to put an end to the following practices that are either harmful or not cost-effective, such as:

Shaving before surgery

Flaming of instruments for procedures (boiling, to replace flaming, was recommended for high-level disinfection)

Use of antibiotics for several days after surgery

Female genital mutilation

Infection prevention committees will be established All four countries will establish infection prevention committees.

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