Overview: IPC in OB/GYN Departments in Cameroon
Infection prevention and control (IPC) is a cornerstone of safe obstetric and gynecologic care. In referral hospitals in Cameroon, obstetrics and gynecology (OB/GYN) units manage high-risk deliveries, surgical procedures, and neonatal care. While progress has been made in training and guidelines, gaps persist in knowledge, adherence to protocols, resource availability, and monitoring. This article synthesizes current understanding of IPC knowledge and practices in Cameroon’s OB/GYN departments, highlighting determinants, barriers, and opportunities for improvement.
Key elements of IPC knowledge in OB/GYN
Healthcare workers in OB/GYN settings are expected to be proficient in core IPC concepts. These include hand hygiene, use of personal protective equipment (PPE), sterilization and disinfection of instruments, safe obstetric practices, aseptic technique during cesarean sections and vaginal deliveries, management of urinary and wound care, and the prevention of transmission of bloodborne and environmental pathogens. In many Cameroonian referral hospitals, continuous professional development programs and in-service training emphasize:
- Standard precautions for all patients, including hand hygiene before and after patient contact.
- Aseptic technique in surgical procedures and intrapartum care to prevent surgical site infections and neonatal sepsis.
- Proper use, donning, and doffing of PPE to shield staff and patients during obstetric procedures.
- Instrument sterilization, cleaning, and storage protocols to minimize cross-contamination.
- Waste management, including safe handling of sharps and biohazard disposal.
Knowledge is often shaped by formal policies, guidelines from national health authorities, and international bodies. Yet, knowledge alone does not guarantee optimal practice. The translation of knowledge into routine actions depends on resources, institutional culture, and ongoing supervision.
Actual practices and common gaps
Observational studies and facility assessments in Cameroon reveal variability in IPC practices across OB/GYN units. While many healthcare workers demonstrate good hand hygiene technique, adherence often falls short due to time pressures, high patient loads, and limited access to handwashing stations or alcohol-based hand rubs. Sterilization processes for instruments may be uneven, with discrepancies between theory and practice in sterilization cycle monitoring and documentation. PPE use is generally recognized as essential, but shortages—especially of gloves, gowns, and masks—can hinder consistent use during deliveries and surgical procedures.
Other recurring gaps include:
- Inadequate sterilization of reusable instruments due to insufficient autoclave capacity or maintenance.
- Improper waste segregation and suboptimal sharps disposal practices in crowded labor wards.
- Inconsistent environmental cleaning, including postpartum areas and operating rooms.
- Limited surveillance for healthcare-associated infections (HAIs) and weak feedback loops to clinicians.
These gaps contribute to higher risks of maternal and neonatal infections such as postpartum sepsis, surgical site infections after cesarean sections, and neonatal pneumonia or sepsis in newborns. Addressing them requires a multi-faceted strategy that aligns with local realities and resource constraints.
Determinants influencing IPC performance
Several factors shape how IPC measures are implemented in Cameroon’s OB/GYN units:
- <strongResource availability: Access to clean water, reliable electricity, sterilization equipment, PPE, and cleaning supplies is fundamental. Shortages disrupt routines and erode adherence.
- <strongTraining and supervision: Ongoing education, mentorship, and performance feedback reinforce correct practices and foster accountability.
- <strongWorkload and staffing: High patient-to-staff ratios increase time constraints, reducing opportunities for compliant IPC behaviors.
- <strongPolicies and governance: Clear national and hospital IPC policies, simple checklists, and prompt reporting mechanisms support consistency.
Community and patient engagement—educating mothers about hygiene, wound care, and post-discharge signs—also plays a role in reducing infection risk.
Strategies to improve IPC in OB/GYN departments
To strengthen IPC, hospitals in Cameroon can consider the following, tailored to the OB/GYN setting:
- Strengthen infrastructure: ensure reliable water supply, functional sterilization units, and consistent PPE availability.
- Standardize procedures: implement and monitor checklists for hand hygiene, aseptic technique, instrument sterilization, and waste management.
- Enhance training and mentorship: regular hands-on IPC training, with competency assessments for obstetric procedures.
- Improve surveillance: establish simple, actionable HAIs tracking and feedback to clinicians and managers.
- Promote waste and environmental cleaning rigor: daily cleaning schedules with accountable staff roles in labor wards and operating theatres.
Ultimately, progress depends on sustained investment, leadership commitment, and collaboration among clinicians, infection prevention teams, and hospital administrators. By aligning knowledge with practice, Cameroonian OB/GYN departments can reduce maternal and neonatal infections and improve overall patient outcomes.
