Time for a renewed focus on the role of cleaners in achieving safe health care in low- and middle-income countries

Karen Lee,Claire Kilpatrick,Julie Storr

doi:10.1186/s13756-021-00922-x

Karen Lee, Claire Kilpatrick

Open Access

https://doi.org/10.1186/s13756-021-00922-x

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Abstract

Water, sanitation and hygiene, collectively known as WASH, is an enabler of infection prevention and control (IPC), both of which contribute to safe, quality health care and the prevention of spread of antimicrobial resistance (AMR). This discussion paper considers the importance placed on the role of hygiene, including cleaning and those who clean, in health care facilities, within the context of existing data, guidelines and initiatives. Informed by this, the paper presents five areas for consideration that have the potential to strengthen and further demonstrate the value of this important cadre of staff and their role in clean, safe healthcare, particularly in low- and middle-income countries. The considerations centre around actions to overcome the current data gaps, including the paucity of national data on environmental cleaning and the training of cleaners; strengthening the implementation of norms and standards; combining global and national advocacy efforts; revisiting investment; and addressing research gaps on the issue. The need to act, in line with WHO and UNICEF recommendations to address this overlooked and undercompensated workforce and to elevate their status as important contributors to IPC, WASH and AMR is a pressing one.

Highlights

Water, sanitation and hygiene, collectively known as WASH, is an enabler of infection prevention and control (IPC), both of which contribute to safe, quality health care and the prevention of spread of antimicrobial resistance (AMR) [1]
Data from countries representing nearly 60% of the population of all Low- and middle-income countries (LMIC) found that most healthcare facilities in these settings have inadequate environmental conditions i.e. WASH, and insufficient availability of resources necessary for standard IPC precautions [5] which includes environmental cleaning
In what is considered to be the definitive standard addressing environmental hygiene and health, including cleaning, World Health Organization (WHO) stated that cleaning staff should be made aware of the importance of their role and should be able to apply the basic principles of IPC to their daily work, supported by appropriate training and management [7]

Summary

Introduction

Background and introductionWater, sanitation and hygiene, collectively known as WASH, is an enabler of infection prevention and control (IPC), both of which contribute to safe, quality health care and the prevention of spread of antimicrobial resistance (AMR) [1]. Within the context of IPC, the World Health Organization (WHO) describe cleaning staff as an important part of the workforce and highlight this group as a target for training, given their role in overall health service delivery [3].

Results

Conclusion