Introduction
Healthcare-associated infections (HAIs) pose a significant threat to patients and newborns in Cameroon, particularly within obstetrics and gynecology units. This article examines knowledge gaps, practical IPC measures, and how a referral hospital in Cameroon can strengthen infection prevention and control (IPC) to reduce maternal and neonatal morbidity and mortality. Effective IPC is essential to safeguard vulnerable mothers during labor, delivery, and postpartum care, where at-risk populations are concentrated and resources may be limited.
Current IPC Knowledge and Gaps in Obstetrics and Gynecology
Healthcare workers in obstetrics and gynecology often face challenges such as limited training on IPC, shortages of personal protective equipment (PPE), and gaps in hospital waste management. In many facilities across Cameroon, adherence to hand hygiene, aseptic technique for delivery, instrument sterilization, and environmental cleaning can vary. Understanding local barriers—clinic overcrowding, intermittent water supply, and supply chain constraints—helps tailor practical interventions that are both affordable and sustainable.
Key IPC Practices for Obstetrics and Gynecology
Hand Hygiene and Standard Precautions
Hand hygiene is the cornerstone of infection prevention. Facilities should ensure the availability of alcohol-based hand rub at points of care and train all staff to perform proper handwashing before and after patient contact, after contact with potentially contaminated materials, and after removing gloves. Standard precautions, including use of gloves, masks, gowns when indicated, and safe handling of sharps, reduce exposure to bloodborne pathogens and contaminated secretions during labor and cesarean sections.
Aseptic Technique for Delivery and Procedures
Maintaining asepsis during delivery, cesarean sections, and intrauterine procedures minimizes infection risk for both mother and baby. This includes sterilization of instruments, appropriate use of sterile gloves, drapes, and clean delivery surfaces, as well as proper preparation of the perineal area using antiseptics consistent with local guidelines.
Antimicrobial Stewardship and Surgical Site Infection Prevention
Rational antibiotic use is critical to prevent antimicrobial resistance and reduce surgical site infections (SSIs). Establishing local antibiotic guidelines, timing prophylaxis appropriately (often within 60 minutes before incision), and limiting broad-spectrum use can improve outcomes. Postpartum infections should be monitored, and antibiotic policies should be adapted to local resistance patterns and accessible medications.
Maternal and Neonatal Infection Prevention
Prevention of neonatal infections includes clean resuscitation practices, early breastfeeding initiation, and skin-to-skin contact when safe. For mothers, monitoring for signs of postpartum sepsis, maintaining clean perineal care, and avoiding cross-contamination between patients are essential. Cleaning and disinfection of the environment, including delivery rooms and neonatal incubators, reduce the risk of cross-infection.
Waste Management and Environmental Cleaning
Safe waste handling, segregation of waste at the point of origin, and proper disposal reduce exposure to pathogens. Routine cleaning of surfaces with effective disinfectants, routine maintenance of water and sanitation facilities, and ensuring adequate waste storage capacity are practical steps in resource-limited settings.
Implementation Strategies for Cameroon Hospitals
Successful IPC implementation requires leadership, ongoing training, and simple, visible IPC practices. Strategies include appointing IPC focal persons within obstetrics and gynecology, conducting regular training sessions, audits with feedback, and ensuring a steady supply of PPE, disinfectants, and sterilization consumables. Engaging all levels of staff, from obstetricians to nurses and support workers, reinforces a culture of safety and accountability.
Monitoring and Evaluation
Routine monitoring of hand hygiene compliance, antibiotic use, SSI rates, and postpartum infection rates informs continuous improvement. Data collection should be feasible with existing hospital records, enabling targeted interventions where needed. Regular feedback helps sustain motivation and adherence to IPC protocols.
Conclusion
Infection prevention and control in the obstetrics and gynecology department is a critical component of improving maternal and neonatal outcomes in Cameroon. By addressing knowledge gaps, ensuring essential supplies, and implementing practical IPC measures, referral hospitals can reduce HAIs and move closer to safer, higher-quality care for mothers and babies.
