Table 2 Selected WHO IPC CC training participant responses to knowledge questions in DRC and BF, 2021–2022^§

CC1

There must be at least one trained and dedicated IPC focal person for a minimum of how many beds in the facility?

“at least one professional per 250 beds”

3 (13.6%)*

21 (95.5%)

< 0.001

10/23 (43.5%)*

19 (79.2%)

0.001

CC2

It is essential to monitor the implementation of the IPC guidelines.

“True, regular monitoring of IPC guidelines should be established”

21 (95.5%)

21 (95.5%)

1.000

24 (100%)

24 (100%)

-

CC3

At a minimum, how often should the effectiveness of IPC training be evaluated?

“Establish regular, at least annual, evaluations of the effectiveness of training”

0*

16 (72.8%)

0.001

6 (25.0%)*

13 (54.2%)

0.017

Theoretical training in IPC is more effective than practical training.

“False, use a blended approach to training including…interactive and practical sessions (including simulation and/or bedside training)”

18 (81.8%)*

19 (86.4%)

0.833

23 (95.8%)

22 (91.7%)*

0.564

IPC training should be provided to all front-line clinical staff and environmental/maintenance workers

“True, WHO has identified targets for IPC training: IPC specialists (doctors, nurses), …auxiliary service staff, cleaners, etc”

19 (86.4%)

18 (81.8%)

0.368

22 (91.7%)*

24 (100%)

0.157

IPC training does not have to target senior managers with IPC experience.

“False, WHO has identified targets for IPC training…administrative and managerial staff”

9 (40.9%)

9 (40.9%)

0.607

6/23 (26.1%)

6 (25.5%)

1.000

IPC training and education should be considered for patients and family members

“True, tailored IPC education for patients or family members should be considered to minimize the potential for HAI”

15 (68.2%)

22 (100%)

0.030

22 (91.7%)

22 (91.7%)

1.000

CC4

Hospital administration is not considered a key player that needs feedback on healthcare-associated infection (HAI) surveillance.

“False, surveillance reports should be disseminated …to those at the administration level”

16 (72.7%)*

16 (72.7%)

0.210

23 (95.8%)

23 (95.8%)

0.368

Healthcare-associated infection (HAI) surveillance systems can evaluate the effectiveness of IPC interventions.

“True, surveillance of HAI and antimicrobial resistance (AMR) can…guide IPC strategies and priorities and assess the effectiveness and impact of interventions”

19 (86.7%)*

21 (95.5%)

0.135

23 (95.8%)

24 (100%)

0.317

A system should be in place to assess the quality of surveillance data.

“True, a system for surveillance data quality assessment is of the utmost importance.”

22 (100%)

21 (95.5%)

0.317

23 (95.8%)

24 (100%)

0.317

CC5

Multimodal thinking means that IPC practitioners focus only on single strategies for changing practices.

“False, multimodal thinking means that IPC practitioners do not focus only on single strategies to change practices but rather several integrated elements.”

10 (45.5%)*

15 (68.2%)*

0.160

19 (79.2%)*

20 (83.3%)

0.204

CC6

How often should hand hygiene practices be monitored?

“Regular monitoring should be established”

9 (40.9%)

13 (59.1%)

0.375

8/22 (36.4%)*

6 (25.0%)

0.384

CC7

Staffing should be appropriately distributed according to patient volume.

“True, staffing levels should be adequately assigned according to patient workload.”

17 (77.3%)

18 (81.8%)

0.565

19 (79.2%)*

23 (95.8%)

0.135

Decisions regarding workload, staffing and bed occupancy are the sole responsibility of the IPC Focal Point.

“False, decisions regarding workload, staffing and bed occupancy…also lie with senior managers and directors.”

15 (68.2%)*

17 (77.3%)

0.587

19 (79.2%)*

24 (100%)

0.082

Overcrowding has been recognized as a public health problem that can lead to disease transmission.

“True, overcrowding is also recognized as being a public health issue that can lead to disease transmission.

22 (100%)

22 (100%)

-

20 (83.3%)

22 (91.7%)

0.370

WHO recommends which of the following for bed occupancy standards?

“The importance of not exceeding one patient per bed and ensuring adequate bed locations and space between beds (> 1 m) to reduce the transmission risk and ensure patient safety”

8 (36.4%)

11 (50.0%)

0.314

7/21 (33.3%)*

10/19 (52.6%)

0.174

CC8

Burial in a secure pit is considered an appropriate method of waste disposal in primary and secondary care facilities.

“True, waste should be treated and disposed of safely via autoclaving, incineration, and/or buried in a lined, protected pit”

16 (72.7%)

18 (81.8%)

0.565

10 (41.7%)

15 (62.5%)

0.272

Sufficient and appropriately labelled bins for health care waste segregation should be available within how many meters from the point of generation?

“Sufficient and appropriately labelled bins to allow for health care waste segregation should be available and used (less than 5 m from point of generation)”

2 (9.1%)

18 (81.8%)

0.007

3 (12.5%)*

17/23 (73.9%)

0.008

In a hospital facility, a toilet is needed per how many users?

“A minimum of two functional, improved sanitation facilities that safely contain waste available for outpatient wards should be available and one per 20 beds for inpatient wards”

11 (50.0%)*

21 (95.5%)

0.019

14 (58.3%)*

21 (87.5%)

0.097

General IPC

Standard precautions should only be observed in the event of a COVID-19 or Ebola outbreak.

“False, standard precautions: … must be applied to ALL patients who require health care, by ALL health workers in ALL health settings”

18 (81.8%)

16 (72.7%)

0.368

23 (95.8%)

22 (91.7%)

0.317

Hand hygiene: What are the preferred methods for washing hands if they are visibly soiled?

“Water and soap…ABHR is not a substitute for soap and water for hand hygiene after toileting or when hands are visibly soiled”

17/20 (85.0%)

22 (100%)

0.392

17/18 (94.4%)

19/19 (100%)

0.317