Role of governance in infection prevention and control policy and strategy implementation in the public health sector in South Africa
Binyane, Moleboheng Emily
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Reports have shown that the challenges of policy implementation in South Africa (SA) are the main weakness of the health system. National and provincial guidelines for infection control (IC) have been adapted for the implementation of IC practices in SA. However, research has revealed poor infection prevention and control (IPC) in public healthcare in SA. There is no evidence to what extent the IPC guidelines have been implemented and whether governance has played a role in the implementation of the National Infection Prevention and Control Policy and Strategy (NIPCPS; 2007). The aim of the study was therefore to explore how governance plays a role in the implementation of NIPCPS in SA’s public healthcare sector. The study employed a qualitative research approach as the focus was on documenting the shortages of antimicrobial drugs, space and equipment, as well as the maltreatment of patients with infectious diseases by healthcare workers in SA, and the impact of this on IPC. Data was collected through the internet and relevant newspaper articles were used for the study. The study findings were presented using the thematic approach and inductive and deductive approaches were integrated to form a coherent narrative. Deductive analysis involved the application of a framework for assessing governance of the health system by Siddiqi et al. (2009). The findings of case study analysis and framework application revealed shortages of antimicrobial drugs, space and equipment, as well as the maltreatment of patients by HCWs in public healthcare in SA several years post the launch of NIPCPS. Shortages of antimicrobial drugs and the maltreatment of patients by HCWs are due to the lack of accountability by DoH. HCWs in SA still lack training in IPC, they have poor job descriptions, and their participation in policymaking and implementation is inadequate. Other healthcare facilities in SA still lack institutional IPC guidelines. Shortages of antimicrobial drugs, space and equipment, and the maltreatment of patients by HCWs have a negative impact on IPC. The state of affairs exposes patients to infectious diseases, puts them at risk of developing drug resistance and may lead to nosocomial infections outbreaks. It also exposes HCWs to infectious diseases, hampers their jobs by delaying important medical procedures and subjects them to medical errors and wrong prescriptions. Further studies are warranted to explore the topic of research.