Tuberculosis infection prevention and control in rural Papua New Guinea: an evaluation using the infection prevention and control assessment framework

Tuberculosis infection prevention and control in rural Papua New Guinea: an evaluation using the infection prevention and control assessment framework

Gigil Marme¹, Jerzy Kuzma², Peta-Anne Zimmerman¹, Neil Harris¹, Shannon Rutherford<sup>1

1</sup>1, Gold Coast, QLD, Australia
²2, Madang Province, Papua New Guinea, Papua New Guinea
³1, Gold Coast, QLD, Australia
⁴1, Gold Coast, QLD, Australia
⁵1, Gold Coast, QLD, Australia












Introduction
Tuberculosis (TB) is a major public health problem in Papua New Guinea. This study examines the implementation of the TB infection prevention and control (TB-IPC) policy in rural hospitals in PNG.

Methods
The implementation of the TB-IPC policy was assessed using a survey method based on the World Health Organization (WHO) IPC assessment framework. The study included facility assessment at ten district hospitals and validation observations of TB-IPC practices.

Results
Overall, the implementation of IPC and TB-IPC guidelines was inadequate in participating facilities. Though 80% of facilities had an IPC program, many needed more clearly defined IPC objectives, budget allocation, and yearly work plans. 80% (n-8 of 10) of hospitals had no IPC training and education; 90% had no IPC committee to support the IPC team; 70% had no surveillance protocol to monitor infections, and only 20% used multimodal strategies for IPC activities. Similarly, 70% of facilities had a TB-IPC program without a proper budget and did not include facility managers in the TB-IPC team; 80% indicated that patient flow poses a risk of TB transmission; 70% had poor ventilation systems; 90% had inadequate isolation rooms; and though 80% have personal protective equipment available, frequent shortages were reported.

Conclusion
The WHO-recommended TB-IPC policy is not effectively implemented in most of the participating district hospitals. Improvements in implementing and disseminating TB-IPC guidelines, monitoring TB-IPC practices, and systematic healthcare workers training are essential to improve TB-IPC guidelines operationalisation in health settings to reduce TB prevalence in PNG.

Biography

Gigil Marme is a lecturer in public health at Divine Word University, PNG. He is currently studying for a PhD in Public Health Policy at Griffith University. He has a post graduate certificate in health economics and masters in public health at Griffith University. His research interest is in public health, infection control, health systems research, mixed method, and policy implementation.