Abstract
ABSTRACTTo summarize the historical events and drivers underlying public policy for the prevention and control of healthcare-associated infections in Brazil and in the United Kingdom. In doing so, the article aims to identify lessons and recommendations for future development of public policy. The analysis is based on a historical overview of national healthcare-associated infections programs taken from previously published sources. Findings highlight how the development of healthcare-associated infections prevention and control policies followed similar trajectories in Brazil and the United Kingdom. This can be conceptualized around four sequential phases: Formation, Consolidation, Standardization, and Monitoring and Evaluation. However, while we identified similar phases of development in Brazil and the United Kingdom, it can be seen that the former entered each stage around 20 years after the latter.
Highlights
Healthcare-associated infections (HAI) are a public health concern worldwide
The HAI Programs (HAIP) at local level aim to prevent the occurrence of HAI in patients, healthcare workers, and visitors
The objective of this study was to identify the main drivers and events underlying the development of public policies on HAI prevention and control (P&C) in two countries and draw out policy lessons from historical experience
Summary
Healthcare-associated infections (HAI) are a public health concern worldwide. According to the World Health Organization (WHO), nations should have HAI Programs (HAIP) at national and local (healthcare settings) levels[32]. The objective of this study was to identify the main drivers and events underlying the development of public policies on HAI prevention and control (P&C) in two countries and draw out policy lessons from historical experience. We conducted a historical overview of national HAIP, by an open-ended review of published sources describing key policy developments. From this literature, we identified four sequential phases for the development of HAI P&C policies at national level. Formation (development of infection prevention techniques and practices); Consolidation (acknowledgement of HAI as a public health problem and development of the initial proposals of national HAIP); Standardization (consolidation of HAIP and establishment of nation-wide regulations); Monitoring and Evaluation (full establishment of HAIP at national level including mechanisms for measurement; recognition of HAI as a relevant patient safety issue, focus on continuous quality improvement and cost savings). As presented below (summarized on Figure), elements of each of these four phases were seen in both countries, albeit in different periods
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