{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:36:06Z","timestamp":1790282166589,"version":"4.1.0"},"reference-count":32,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/igo\/"}],"funder":[{"name":"The Society of Healthcare Epidemiology of America","award":["In-Kind Support"],"award-info":[{"award-number":["In-Kind Support"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2025,11,12]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>More than 75% of the global population resides in low- and middle-income countries (LMICs), where healthcare-associated infection rates are notably higher than in high-income countries. Little is known about the professional experiences, perceptions and needs of infection prevention and healthcare epidemiology professionals (IPHEP) practising in these countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A voluntary and anonymous online survey of IPHEP in LMICs was conducted via open invitations on social media and email from October 2022 to January 2023. The survey covered five domains: (1) Survey Responders, Practice Setting and Programme Characteristics; (2) Job Responsibilities, Training and Professional Development; (3) Workload and Work Environment; (4) COVID-19 Response; and (5) Priorities and Needs. Descriptive statistics were generated for the total sample and each World Bank region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The number of survey respondents was 148, who represented 28\/138 (20.3%) LMICs. They reported receiving formal training in infection prevention (80\/94, 85.1%), antimicrobial stewardship (44\/94, 46.8%), quality improvement and patient safety tools (55\/94, 58.5%) and leadership (37\/94, 39.4%). Importantly, 48.8% (42\/86) reported job burnout. During the COVID-19 pandemic, 55\/102 (53.9%) respondents reported their programme as effective or extremely effective, and 58\/102 (56.9%) reported moderate or extreme financial hardship for their facility. Hand hygiene, improving antibiotic use and preventing multidrug-resistant organisms were ranked as top three priorities to be addressed, with specific resource needs identified for each programme by 89.0%, 95.0% and 93.8% of the survey respondents, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This survey provides crucial insights into the realities faced by IPHEP in LMICs, emphasising the critical need for developing and strengthening workforce, supporting their organisational environments, allocating resources strategically for infection prevention and control initiatives, as well as improving their connectivity with other IPHEP colleagues across the world to foster greater collaboration and support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjgh-2024-018265","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T11:00:15Z","timestamp":1766142015000},"page":"e018265","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Infection prevention and healthcare epidemiology professionals in low- and middle-income countries: a needs assessment survey and call for action"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1218-8974","authenticated-orcid":false,"given":"Pranavi","family":"Sreeramoju","sequence":"first","affiliation":[{"name":"Internal Medicine\u2014Infectious Diseases, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Song","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cecilia","family":"Bardossy","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Cadena","sequence":"additional","affiliation":[{"name":"Department of Medicine, Infectious Diseases, UT Health San Antonio Long School of Medicine, San Antonio, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey A","family":"Forde","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital, Bridgetown, Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8666-7313","authenticated-orcid":false,"given":"Payal","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Intermountain Health, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Salinas","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Palo Alto, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Tolliver","sequence":"additional","affiliation":[{"name":"The Society for Healthcare Epidemiology of America, Arlington, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassem","family":"Zayed","sequence":"additional","affiliation":[{"name":"WHO, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2111-8131","authenticated-orcid":false,"given":"Sarah L","family":"Krein","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"2025121903200664000_10.12.e018265.1","unstructured":"World Health Organization (WHO) . Global report on infection prevention and control. WHO; 2022. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240051164 [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.2","unstructured":"New world bank country classifications by income level: 2021-2022. July 01, 2021. 2021. Available: https:\/\/blogs.worldbank.org\/en\/opendata\/new-world-bank-country-classificationsincome-level-2021-2022"},{"key":"2025121903200664000_10.12.e018265.3","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1017\/ice.2014.79","article-title":"Guidance for infection prevention and healthcare epidemiology programs: healthcare epidemiologist skills and competencies","volume":"36","author":"Kaye","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2025121903200664000_10.12.e018265.4","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.ajic.2019.04.003","article-title":"Advancing the profession: An updated future-oriented competency model for professional development in infection prevention and control","volume":"47","author":"Billings","year":"2019","journal-title":"Am J Infect Control"},{"key":"2025121903200664000_10.12.e018265.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00809-4"},{"key":"2025121903200664000_10.12.e018265.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2021.04.014"},{"key":"2025121903200664000_10.12.e018265.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.11.025"},{"key":"2025121903200664000_10.12.e018265.8","unstructured":"World Health Organization . Infection prevention and control assessment framework at the facility level. WHO; 2018. Available: https:\/\/www.who.int\/publications\/i\/item\/WHO-HIS-SDS-2018.9 [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix073"},{"key":"2025121903200664000_10.12.e018265.10","doi-asserted-by":"crossref","unstructured":"Song X . Finding gaps: An assessment of infection control needs in China. Int j infect control 2011;7. doi:10.3396\/ijic.V7i4.028.11","DOI":"10.3396\/ijic.V7i4.028.11"},{"key":"2025121903200664000_10.12.e018265.11","unstructured":"World Health Organization . Global infection prevention and control network. WHO; 2025. Available: https:\/\/www.who.int\/groups\/global-infection-prevention-and-control-network\/members [Accessed 10 Jun 2025]."},{"key":"2025121903200664000_10.12.e018265.12","unstructured":"World Health Organization . Global action plan and monitoring framework on infection prevention and control (IPC), 2024-2030. WHO; 2023. Available: https:\/\/www.who.int\/teams\/integrated-health-services\/infection-prevention-control\/draft-global-action-plan-and-monitoring-framework-on-ipc [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.13","unstructured":"Centers for Disease Control and Prevention (CDC) . Infection control assessment and response (ICAR) tool for general infection prevention and control (IPC) across settings. CDC; 2024. Available: https:\/\/www.cdc.gov\/healthcare-associated-infections\/php\/toolkit\/icar.html [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.14","unstructured":"Africa Centers for Disease Control and Prevention (Africa CDC) . Policy brief for the legal framework on infection prevention and control. Africa CDC; 2022. Available: https:\/\/africacdc.org\/download\/policy-brief-for-the-legal-framework-on-infection-prevention-and-control\/ [Accessed 2 Jun 2023]."},{"key":"2025121903200664000_10.12.e018265.15","unstructured":"European Centre for Disease Prevention and Control . Training courses on infection prevention and control (IPC). Available: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/directory-guidance-prevention-and-control\/training\/training-courses-infection [Accessed 2 Jun 2023]."},{"key":"2025121903200664000_10.12.e018265.16","unstructured":"World Health Organization . Infection prevention & control. Available: https:\/\/openwho.org\/channels\/ipc [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.17","unstructured":"Centers for Disease Control and Prevention . Infection control: training. Available: https:\/\/www.cdc.gov\/infection-control\/hcp\/training\/index.html [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.18","unstructured":"Infection Control and Hospital Epidemiology (ICHE) . The iche podcast. Available: https:\/\/podcasts.apple.com\/us\/podcast\/the-iche-podcast\/id1459545889 [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.19","unstructured":"The Society for Healthcare Epidemiology of America (SHEA) . SHEA podcasts. Available: https:\/\/podcasts.apple.com\/us\/podcast\/shea-podcasts\/id1192338467 [Accessed 25 Aug 2024]."},{"key":"2025121903200664000_10.12.e018265.20","doi-asserted-by":"crossref","unstructured":"Hofstede G . Dimensionalizing Cultures: The Hofstede Model in Context. Online Readings in Psychology and Culture 2011;2. doi:10.9707\/2307-0919.1014","DOI":"10.9707\/2307-0919.1014"},{"key":"2025121903200664000_10.12.e018265.21","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.ajic.2019.09.027","article-title":"Psychological safety and infection prevention practices: Results from a national survey","volume":"48","author":"Greene","year":"2020","journal-title":"Am J Infect Control"},{"key":"2025121903200664000_10.12.e018265.22","doi-asserted-by":"crossref","DOI":"10.1007\/s11908-020-00741-y","article-title":"Culture of Safety: Impact on Improvement in Infection Prevention Process and Outcomes","volume":"22","author":"Braun","year":"2020","journal-title":"Curr Infect Dis Rep"},{"key":"2025121903200664000_10.12.e018265.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-022-07608-z","article-title":"Burnout and well-being of healthcare workers in the post-pandemic period of COVID-19: a perspective from the job demands-resources model","volume":"22","author":"Zhou","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"2025121903200664000_10.12.e018265.24","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1177\/13591053211012759","article-title":"Factors mediating the psychological well-being of healthcare workers responding to global pandemics: A systematic review","volume":"27","author":"Schneider","year":"2022","journal-title":"J Health Psychol"},{"key":"2025121903200664000_10.12.e018265.25","doi-asserted-by":"crossref","DOI":"10.1007\/s11908-017-0572-y","article-title":"Infection Control in Limited Resources Countries: Challenges and Priorities","volume":"19","author":"Vilar-Compte","year":"2017","journal-title":"Curr Infect Dis Rep"},{"key":"2025121903200664000_10.12.e018265.26","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/17571774211001040","article-title":"Pandemic preparedness and the role of infection prevention and control - how do we learn?","volume":"22","author":"Loveday","year":"2021","journal-title":"J Infect Prev"},{"key":"2025121903200664000_10.12.e018265.27","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1097\/INF.0000000000003321","article-title":"Keeping It Real: Antibiotic Use Problems and Stewardship Solutions in Low- and Middle-income Countries","volume":"41","author":"Basu","year":"2022","journal-title":"Pediatr Infect Dis J"},{"key":"2025121903200664000_10.12.e018265.28","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/NAQ.0000000000000566","article-title":"Reducing Staff Turnover and Clinician Burnout With a Structured Support Group During the COVID-19 Pandemic","volume":"47","author":"Drexler","year":"2023","journal-title":"Nurs Adm Q"},{"key":"2025121903200664000_10.12.e018265.29","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/jocn.16711","article-title":"Nurses\u2019 coping strategies caring for patients during severe viral pandemics: A mixed-methods systematic review","volume":"33","author":"Temeng","year":"2024","journal-title":"J Clin Nurs"},{"key":"2025121903200664000_10.12.e018265.30","doi-asserted-by":"crossref","first-page":"2177242","DOI":"10.1080\/23288604.2023.2177242","article-title":"Potential Strengths and Weaknesses in Hospital Resilience in the Context of the COVID-19 Pandemic in Brazil: A Case Study","volume":"9","author":"de Ara\u00fajo Oliveira","year":"2023","journal-title":"Health Systems & Reform"},{"key":"2025121903200664000_10.12.e018265.31","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.ajic.2020.10.019","article-title":"Unintended consequences of infection prevention and control measures during COVID-19 pandemic","volume":"49","author":"Wee","year":"2021","journal-title":"Am J Infect Control"},{"key":"2025121903200664000_10.12.e018265.32","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab688"}],"container-title":["BMJ Global Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjgh-2024-018265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T11:20:29Z","timestamp":1766143229000},"score":1,"resource":{"primary":{"URL":"https:\/\/gh.bmj.com\/lookup\/doi\/10.1136\/bmjgh-2024-018265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,19]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bmjgh-2024-018265"],"URL":"https:\/\/doi.org\/10.1136\/bmjgh-2024-018265","relation":{},"ISSN":["2059-7908"],"issn-type":[{"value":"2059-7908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}