3069.0: Monday, October 22, 2001 - Board 7

Abstract #21549

Ensuring the safety of customers and providers in rural clinics: lessons learned in infection prevention techniques from Bangladesh

Ferdousi Begum, MBBS, MPH1, Tayla Colton, SM2, and Shabnam Shahnaz, MBBS, MPH2. (1) Pathfinder International-Bangladesh Office, 9 Galen Street, Suite 217, Watertown, MA 02472, (2) Technical Support, Pathfinder International, 9 Galen Street, Suite 217, Watertown, MA 02472

Infection prevention (IP) is an essential element in delivering quality health services, but is often compromised in developing countries, particularly in rural areas, where there may be shortages of clean running water, electricity, disposal and decontamination systems, and trained staff. The Rural Service Delivery Program (RSDP) has devised innovative and affordable methods to ensure IP procedures are at its 175 static clinics and nearly 8,000 monthly satellite clinics in rural Bangladesh. RSDP’s clinics provide an essential health services package, which includes family planning, reproductive health, child health, RTI/STD treatment, and limited curative care.

Recent quality assurance data indicates that almost 90% of RSDP clinics have acceptable compliance with the 4 main IP components: decontamination, cleaning, disinfection, and waste disposal. RSDP created guidelines and trained all of the service providers on IP procedures. In clinics with no running water or electricity, a water retrieval and dispensing system has been successfully implemented to ensure providers’ hands are clean. Special kerosene-run autoclaves for disinfecting IUD insertion instruments and incinerators for waste disposal have been designed and built based on the needs of the clinics. Locally available chlorine bleach is used to decontaminate instruments, and where clinics have dirt floors, temporary plastic sheeting is brought in to prevent dust.

Adherence to IP protocols is possible in rural areas of developing countries where there is little infrastructure. Locally appropriate strategies for infection prevention are inexpensive and easy-to-use. Detailed guidelines, need-based training, and proper supervision are key elements to ensure that IP procedures are being followed.

Learning Objectives: By the end of this session, the participant will be able to: (1) name the 4 components of infection prevention (IP) in clinics; (2) describe techniques used to ensure IP in rural clinic settings in Bangladesh; and (3) apply lessons learned about infection prevention in Bangladesh to other developing country settings.

Keywords: Developing Countries, Rural Health Care Delivery System

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA