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Peer-reviewedCC BY-NC-NDInfection prevention in practice

Implementation uptake and healthcare worker adherence following a World Health Organization-aligned multi-modal infection prevention and control intervention in Bangladeshi tertiary hospitals: a multi-centre comparative study.

1 more authors
4 affiliations
  1. 1Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
  2. 2Communicable Diseases Control (CDC), Directorate General of Health Services, Dhaka, Bangladesh.
  3. 3SafetyNet, Dhaka, Bangladesh.
  4. 4University of Dhaka, Dhaka, Bangladesh.

Abstract

Infection prevention and control (IPC) programs remain inconsistently implemented in Bangladeshi hospitals. However, implementation uptake is rarely evaluated alongside observation of healthcare worker (HCW) practices, limiting understanding of how multi-modal IPC interventions translate into routine clinical practice. This study assessed ward-level uptake and HCW adherence following a World Health Organization (WHO)-aligned multi-modal IPC intervention in Bangladesh. A postintervention comparative study was conducted across six tertiary hospitals. Intervention wards received a multi-modal IPC package, whereas non-intervention wards continued routine practices. Implementation uptake was assessed through ward audits, supply checks, and administrative records. HCW adherence (n = 1426) was measured by questionnaire and verified through direct observation of key IPC practices. IPC adherence scores were significantly higher in intervention wards (70.8% vs 59.4%; mean difference = 11.4 percentage points, 95% confidence interval [CI] = 9.3-13.5; P < 0.001). Intervention wards showed markedly greater uptake of alcohol-based hand rub availability (90.9% vs 29.4%), supervision (90.9% vs 64.7%), and administrative engagement (95.5% vs 11.8%). Observed hand hygiene compliance was higher in intervention wards than in non-intervention wards (35.8% vs 16.4%), though substantially lower than self-reported rates in both groups. Working in an intervention ward was independently associated with an 11.85-point increase in IPC adherence (95% CI = 9.71-13.99; P < 0.001). A WHO-aligned multi-modal IPC intervention was associated with higher implementation uptake, HCW adherence, and observed IPC practices. Persistent discrepancies between reported and observed hand hygiene behaviour highlight the need for objective monitoring in IPC evaluation. These findings support bundled IPC implementation as a feasible strategy for resource-constrained healthcare settings.

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BibTeX
@article{sumon2026implementation,
  title = {{Implementation uptake and healthcare worker adherence following a World Health Organization-aligned multi-modal infection prevention and control intervention in Bangladeshi tertiary hospitals: a multi-centre comparative study.}},
  author = {Shariful Amin Sumon and Mollah Niamul Haque and Tanjeemay Tamanna and Antara Swarnali Priyanka and Fairoze Masuda Akther and Tasneem Khan and Somona Afrin and Raisa Sadia and Aninda Rahman and Syed Abul Hasan Md Abdullah and Md Mahabub Ul Anwar and Md Saiful Islam and Md Golam Dostogir Harun},
  journal = {Infection prevention in practice},
  year = {2026},
  month = oct,
  doi = {10.1016/j.infpip.2026.100609},
  url = {https://europepmc.org/article/MED/42999594},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Implementation uptake and healthcare worker adherence following a World Health Organization-aligned multi-modal infection prevention and control intervention in Bangladeshi tertiary hospitals: a multi-centre comparative study.
AU  - Shariful Amin Sumon
AU  - Mollah Niamul Haque
AU  - Tanjeemay Tamanna
AU  - Antara Swarnali Priyanka
AU  - Fairoze Masuda Akther
AU  - Tasneem Khan
AU  - Somona Afrin
AU  - Raisa Sadia
AU  - Aninda Rahman
AU  - Syed Abul Hasan Md Abdullah
AU  - Md Mahabub Ul Anwar
AU  - Md Saiful Islam
AU  - Md Golam Dostogir Harun
PY  - 2026
DA  - 2026/10/08
JO  - Infection prevention in practice
DO  - 10.1016/j.infpip.2026.100609
UR  - https://europepmc.org/article/MED/42999594
AB  - Infection prevention and control (IPC) programs remain inconsistently implemented in Bangladeshi hospitals. However, implementation uptake is rarely evaluated alongside observation of healthcare worker (HCW) practices, limiting understanding of how multi-modal IPC interventions translate into routine clinical practice. This study assessed ward-level uptake and HCW adherence following a World Health Organization (WHO)-aligned multi-modal IPC intervention in Bangladesh. A postintervention comparative study was conducted across six tertiary hospitals. Intervention wards received a multi-modal IPC package, whereas non-intervention wards continued routine practices. Implementation uptake was assessed through ward audits, supply checks, and administrative records. HCW adherence (n = 1426) was measured by questionnaire and verified through direct observation of key IPC practices. IPC adherence scores were significantly higher in intervention wards (70.8% vs 59.4%; mean difference = 11.4 percentage points, 95% confidence interval [CI] = 9.3-13.5; P < 0.001). Intervention wards showed markedly greater uptake of alcohol-based hand rub availability (90.9% vs 29.4%), supervision (90.9% vs 64.7%), and administrative engagement (95.5% vs 11.8%). Observed hand hygiene compliance was higher in intervention wards than in non-intervention wards (35.8% vs 16.4%), though substantially lower than self-reported rates in both groups. Working in an intervention ward was independently associated with an 11.85-point increase in IPC adherence (95% CI = 9.71-13.99; P < 0.001). A WHO-aligned multi-modal IPC intervention was associated with higher implementation uptake, HCW adherence, and observed IPC practices. Persistent discrepancies between reported and observed hand hygiene behaviour highlight the need for objective monitoring in IPC evaluation. These findings support bundled IPC implementation as a feasible strategy for resource-constrained healthcare settings.
SN  - 2590-0889
ER  -