Infection prevention and control (IPC) and water, sanitation and hygiene (WASH) status of healthcare facilities in the Greater Kampala Metropolitan region during the COVID-19 pandemic in Uganda

Abstract Background Infection Prevention and Control (IPC) and Water Sanitation and Hygiene (WASH) are critical in preventing the spread of healthcare associated infections (HCAIs), including COVID-19. However, there is limited evidence on the status of IPC and WASH in healthcare facilities (HCFs) in Uganda amidst the COVID-19 pandemic. This study assessed IPC and WASH status for HCFs in the Greater Kampala Metropolitan Area (GKMA), Uganda, during the COVID-19 pandemic, so as to inform programming and policy. Methods A cross-sectional study that utilized both quantitative and qualitative data collection methods was conducted between October and November 2020 after the first wave of COVID-19 in Uganda. The Mwater survey tool was used in 75 HCFs in the GKMA, to collect quantitative data on IPC and WASH, while a key informants’ guide was used to collect qualitative data. Quantitative data were imported into STATA version 16 and analyzed. Data were then summarized using descriptive statistics and presented in tables and graphs. A content approach, aided by Nvivo 12 was used to analyze qualitative data. Results Overall, 86.7% (65/75) of the HCFs had an IPC committee and 72.3% (47/65) of these were functional. The majority, 90.7% (68/75) of the HCFs had an IPC focal person, and 49.3% (37/75) had an IPC programme with a clear annual activity plan. Only, 32.3% (21/65) of the HCFs had their IPC activities supported by budget lines. In terms of WASH, almost all HCFs, 96.0% (72/75) had a basic water service, 10.7% (8/75) had basic sanitation service, 60.0% (45/75) had a basic hand hygiene service, 82.7% (62/75) had a basic waste management service, and 22.7% (17/75) had a basic environmental cleanliness service. Conclusion Our study indicates a need for improvements across all the WASH domains i.e., water, sanitation, hand hygiene, environmental hygiene and waste management. We therefore recommend an earmarked budget line for IPC and WASH activities with deliberate investments in WASH infrastructure and supplies. HCFs need clear plans for the operation and maintenance of WASH infrastructure so as to ensure sustainability. Further, it is necessary to set terms of reference for IPC committees to support their functionality.