Role of governance in infection prevention and control policy and strategy implementation in the public health sector in South Africa

[摘要] Reports have shown that the challenges of policy implementation in South Africa (SA) are themain weakness of the health system. National and provincial guidelines for infection control (IC)have been adapted for the implementation of IC practices in SA. However, research hasrevealed poor infection prevention and control (IPC) in public healthcare in SA.There is no evidence to what extent the IPC guidelines have been implemented and whethergovernance has played a role in the implementation of the National Infection Prevention andControl Policy and Strategy (NIPCPS; 2007). The aim of the study was therefore to explore howgovernance plays a role in the implementation of NIPCPS in SA's public healthcare sector.The study employed a qualitative research approach as the focus was on documenting theshortages of antimicrobial drugs, space and equipment, as well as the maltreatment of patientswith infectious diseases by healthcare workers in SA, and the impact of this on IPC. Data wascollected through the internet and relevant newspaper articles were used for the study. The studyfindings were presented using the thematic approach and inductive and deductive approacheswere integrated to form a coherent narrative. Deductive analysis involved the application of aframework for assessing governance of the health system by Siddiqi et al. (2009).The findings of case study analysis and framework application revealed shortages ofantimicrobial drugs, space and equipment, as well as the maltreatment of patients by HCWs inpublic healthcare in SA several years post the launch of NIPCPS. Shortages of antimicrobialdrugs and the maltreatment of patients by HCWs are due to the lack of accountability by DoH.HCWs in SA still lack training in IPC, they have poor job descriptions, and their participation inpolicymaking and implementation is inadequate. Other healthcare facilities in SA still lackinstitutional IPC guidelines.Shortages of antimicrobial drugs, space and equipment, and the maltreatment of patients byHCWs have a negative impact on IPC. The state of affairs exposes patients to infectiousdiseases, puts them at risk of developing drug resistance and may lead to nosocomial infectionsoutbreaks. It also exposes HCWs to infectious diseases, hampers their jobs by delayingimportant medical procedures and subjects them to medical errors and wrong prescriptions.Further studies are warranted to explore the topic of research.

[发布机构] University of the Free State