One of the participants delivering a presentation during the training.
Image: WaterAid / Ulemu Mbengwani

By Ulemu Mbengwani

The Water, Sanitation, and Hygiene (WASH) services in Malawi's Health Care Facilities (HCFs) fall below World Health Organization’s (WHO) standards. The Global progress report on water, sanitation, and hygiene in health care facilities: Fundamentals First (2020) revealed alarming statistics: 24% of public health facilities, including those providing maternal services, lack basic water supply; 23% lack improved and usable sanitation facilities; 32% do not have adequate hand hygiene facilities at points of care, and 58% lack proper waste management facilities.

These deficiencies pose significant challenges to providing quality healthcare, particularly concerning adherence to Infection Prevention and Control (IPC) procedures. The interplay between IPC and WASH becomes pivotal in safeguarding public health on multiple fronts. While IPC focuses on curtailing the spread of infections, WASH addresses clean water availability, proper sanitation, and hygiene practices in various settings. These interconnected pillars collaboratively form a comprehensive approach to disease prevention.

In recognition of this, WaterAid Malawi conducted a three-day pilot training session focused on Infection Prevention and Control (IPC) and Water, Sanitation, and Hygiene (WASH) for Health Care Workers (HCWs) in Ntchisi district. This pilot training utilized innovative IPC and WASH materials recently developed through the Wimbledon Foundation’s strategic project, aiming to gather feedback on the effectiveness of these new materials.

Group discussions during the training.
Image: WaterAid / Ulemu Mbengwani

Lest Longani, a Nursing Officer and Infection Prevention Control Coordinator for Ntchisi district, emphasized the necessity of these new training materials. In the past, IPC and WASH were treated as separate aspects, resulting in various challenges. "Previously, we approached IPC and WASH as distinct programs. However, during our work, it became evident that IPC and WASH are intertwined. Hence, the inception of this new approach," Longani explained.

The goal of this pilot training session is to assess the effectiveness of the new materials and obtain input from Ntchisi's healthcare workers regarding the IPC-WASH training materials. Following this phase, the training materials, along with participant feedback and evaluations, will be submitted to the Quality Directorate in the Ministry of Health for approval.

Longani, also a WASH champion, highlighted the positive impact brought about by the new training materials. Unlike previous methods, the new approach incorporates videos and WhatsApp learning cards, enhancing participants’ understanding of IPC and WASH principles.

We have received encouraging feedback and are confident that these materials will be incorporated into the national guidelines. The subsequent step will involve implementing training using these materials for the entire Malawi Health Care Workforce” added Longani.

The training represents a significant stride in equipping Health Care Workers with IPC knowledge to reduce Hospital Acquired Infections (HAI) and combat Anti-Microbial Resistance (AMR). The comprehensive curriculum covered a range of critical topics, including waste management, hospital cleaning, chlorine handling, equipment decontamination, and hand hygiene.

Group discussions during the training.
Image: WaterAid / Ulemu Mbengwani

Earnest Chipale, employed at Ntchisi district hospital's theatre, noted the distinction of this training from previous ones. This session is notable for its results-oriented approach. As a healthcare worker, the IPC-WASH training holds significant value. It will undoubtedly extend efforts to ensure that HCWs effectively curtail the transmission of infections, both from patients to healthcare workers and vice versa.

Chipale highlighted that they have also gained insight into waste management and segregation, which is crucial in preventing the spread of infections to health care workers, patients, and surrounding communities. He emphasized that all of this will contribute to operating in a clean environment with zero Hospital Acquired Infections (HAI).

WaterAid is providing technical assistance, taking a leading role in material design, and playing a pivotal part in IPC-WASH technical development. WaterAid facilitators consistently offer support throughout the process.

The creation of the new IPC-WASH materials and the forthcoming training sessions mark a significant step in strengthening IPC, WASH, and AMR in the country's healthcare facilities. The favorable response and enthusiastic participation underscore the potential for substantial transformation, highlighting the shared dedication to cultivating a healthier and safer healthcare environment across Malawi's medical centers.