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Healthcare-associated infections (HCAIs) are presumed common, underreported, and often severe, with a disproportionate burden among hospitalized neonates and postpartum women, and they pose substantial risks to healthcare workers during outbreaks. Gram-negative pathogens such as\n                    <jats:italic toggle=\"yes\">Klebsiella<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Pseudomonas,<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Acinetobacter<\/jats:italic>\n                    predominate, alongside methicillin-resistant\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    , with widespread resistance to third-generation cephalosporins and other key antibiotics linking HCAIs directly to the region\u2019s antimicrobial resistance crisis. National and regional IPC policy frameworks have expanded, but facility-level implementation lags, reflected in patchy surveillance, weak accountability, and unreliable supplies of alcohol-based hand rub (ABHR), personal protective equipment, environmental cleaning materials, and core WASH and ventilation infrastructure. Evidence from sub-Saharan Africa shows that pragmatic multimodal strategies, locally produced ABHR, infrastructure designed to facilitate hand hygiene, role-specific training for clinical and non-clinical staff, and inclusive approaches involving families can improve practices and outcomes when supplies and supervision are sustained. A whole-system approach is required, prioritizing fit-for-purpose surveillance, stronger WASH and waste management services, development of an IPC workforce, and support for African-led innovation, including local manufacturing and context-specific decision-support tools. Implementing these actions through community engagement, empowered leadership at all levels, and sustainable financing is critical to reducing HCAIs, slowing antimicrobial resistance, and strengthening healthcare quality and resilience in sub-Saharan Africa.\n                  <\/jats:p>","DOI":"10.1128\/cmr.00142-22","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:59:53Z","timestamp":1778763593000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Infection prevention and control in low- and middle-income countries: policy, practice, and implementation challenges in sub-Saharan Africa"],"prefix":"10.1128","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9923-1196","authenticated-orcid":true,"given":"Uduak","family":"Okomo","sequence":"first","affiliation":[{"name":"Vaccines & Immunity Theme, Medical Research Council Unit, The Gambia at London School of Hygiene and Tropical Medicine","place":["Fajara, The Gambia"]},{"name":"Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine","place":["London, United Kingdom"]},{"name":"Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicity","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Faculty of Medicine, Imperial College London","place":["London, United Kingdom"]},{"name":"The Health Research Unit Zimbabwe at the Biomedical Research and Training Institute","place":["Harare, Zimbabwe"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Feasey","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02wn5qz54","id-type":"ROR","asserted-by":"publisher"}],"name":"The School of Medicine, University of St Andrews","place":["St Andrews, United Kingdom"]},{"id":[{"id":"https:\/\/ror.org\/00khnq787","id-type":"ROR","asserted-by":"publisher"}],"name":"Malawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences","place":["Blantyre, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaheen","family":"Mehtar","sequence":"additional","affiliation":[{"name":"Infection Control Africa Network","place":["Cape Town, South Africa"]},{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Faculty of Medicine and Health Sciences, Stellenbosch University","place":["Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Dramowski","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05bk57929","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University","place":["Cape Town, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organisation. 2016. 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