Evaluation of the implementation of infection control policies in health facilities in the Popokabaka health district in the Democratic Republic of Congo.

Background: Healthcare quality in health facilities relies on the implementation of and providers' adherence to an effective infection control program. The aim of this study was to assess the implementation level of infection prevention and control (IPC) guidelines in healthcare facilities in a low-income country. Methods: This was a cross-sectional study conducted in 18 healthcare facilities of the Popokabaka health district in the Democratic Republic of Congo. Data were collected and analyzed following the IPC assessment framework developed by the World Health Organization (WHO). The framework consisted of eight different sections, of which each is scored up to 100. The level of implementation in each facility was assessed based on a scoring system: inadequate (0-200), basic (201-400), intermediate (401-600), and advanced (601-800). Results: The median score of all facilities was 181.3, IQR 145.0-228.1, with a range from inadequate to basic. Ten (55.6%) healthcare facilities had an inadequate IPC implementation level, while eight (44.4%) had a basic level. IPC education and training were the components that were the most poorly implemented in the surveyed facilities. None of these facilities had multimodal strategies to implement IPC interventions. Conclusion: The level of IPC guideline implementation in healthcare facilities of the Popokabaka health district remains basic as a result of low resource investment in the IPC program. It negatively impacts the quality of care and exposes patients and healthcare providers to healthcare-associated infections.