An intersectional analysis of infection prevention and control practices in Pakistan: A nationwide survey based on the Infection Prevention and Control Assessment Framework.

Background: Most health care-associated infections are preventable through the effective implementation of infection prevention and control (IPC) program. The study aimed to evaluate the current IPC practices in health care facilities of Pakistan.

Methods: This was a nationwide cross-sectional survey, in which data were obtained from key informants of the IPC team in recruited hospitals using the Infection Prevention and Control Assessment Framework (IPCAF) questionnaire. Based on the IPCAF scoring algorithm, hospitals were categorized as Inadequate, Basic, Intermediate, or Advanced.

Results: The median IPCAF score for all hospitals (N=42) was 387.8/800 (IQR: 219.8-518.8). The median IPCAF score for public and private hospitals was 353 (IQR: 155.3-468.5) and 583 (IQR: 431.3-598.8), respectively. A significant association was found between IPC levels and a hospital's level of care, bed capacity, key informant's qualification, IPC certification, and IPC training.

Discussion: There is a need to strengthen all IPC core components with a special focus on IPC education and training, health care-associated infection surveillance, monitoring/audit of IPC practices and feedback, and workload, staffing, and bed occupancy.

Conclusions: Private sector hospitals demonstrated better commitment to IPC measures by achieving an "Intermediate" level of IPC as compared with public sector hospitals having a "Basic" IPC level.