ArticleFrontiers in health services2026
Strengthening infection prevention and control during the COVID-19 pandemic: implementation of a decentralised mentorship model across 450 primary health facilities in Sierra Leone, 2021-2022.
Article in Frontiers in health services, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Background: The COVID-19 pandemic exposed significant infection prevention and control (IPC) gaps in Sierra Leone's primary health care system. We evaluated whether a decentralised multicomponent mentorship model could improve IPC performance across 450 government primary health facilities and support sustainable domestic financing for IPC. Methods: We conducted a pre-post quasi-experimental evaluation without a comparison group using facility-level indicators at baseline (April 2021) and endline (January 2022). The intervention package included competency-based IPC training, twice-monthly facility mentorship using structured observation checklists, routine monitoring with feedback using national IPC assessment tools configured in District Health Information Software 2 (DHIS2), targeted support for IPC commodities and water, sanitation and hygiene (WASH)-related infrastructure, community engagement, and budget advocacy through policy briefs and stakeholder meetings. We compared paired facility indicators using McNemar's chi-square test and examined service delivery patterns using month-matched comparisons to pre-pandemic levels (April 2019-January 2020). Primary outcome domains included training coverage, IPC supplies and infrastructure availability, and observed adherence to core IPC practices. Results: Facilities meeting ≥80% staff training coverage increased from 38% to 100% ( Conclusions: A decentralized mentorship model embedded in government structures can rapidly strengthen primary care IPC capacity while catalysing the policy and financing commitments essential for sustainability. The consistency of improvements across indicators supports this approach for similar low-resource settings. Controlled designs are needed to establish attribution and assess long-term impact.
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