Lack of basic infection control and prevention measures in low-income countries

Bottom Line:

Low-income countries lack basic infection control and prevention measures such as proper hand hygiene, as well as access to and proper use of personal protective equipment.


Roder-DeWan, S. Health system quality in the time of COVID-19. The Lancet Global Health (2020).

Date Published:

6 May 2020


The quality of the existing health systems in low-income Sub-Saharan Africa must be considered in the design and delivery of COVID-19 mitigation measures. Programs that are efficacious in high-income countries may not translate similarly for low-income countries if the quality of healthcare at baseline is poor. Previous studies have shown that providers in low-income Sub-Saharan countries often do not perform many of the basic elements of a high-quality healthcare visit. Additionally, medical equipment and supplies are often scarce, and clinical outcomes directly amenable to high-quality care (e.g. neonatal mortality) are poor. Analysis of observations of infection prevention and control behaviours in 220 Tanzanian facilities in 2018 demonstrated that proper hand hygiene was observed only 6.9% of the time, reusable equipment was disinfected 4.8% of the time, gloves were used in 74.8% of the situations where they were indicated, and waste was disposed of properly in 43.3% of cases. In the context of COVID-19 where supplies are more scarce than before, healthcare providers must rely on basics such as frequent handwashing to prevent the spread of infection. It is imperative to assess systems-level factors that contribute to poor infection prevention and control and implement multifaceted solutions in order to properly address the COVID-19 epidemic in such regions.

Summary by: Spandana Amarthaluru