Eliana Sambou, Nurse Midwife and IPC Focal Person at Serrekunda Health Center in The Gambia, explains that there’s a tangible difference for their mothers and babies since Horizons Trust Gambia implemented the Infection, Prevention & Control (IPC) project in the clinic in 2016:
“Before we started this IPC program in the Serrekunda [Health Center] … we have a lot of neonatal infections cases… since the inception of Horizons’ project here, we have a low number of neonatal sepsis now.”
She goes on to explain that while a high percentage of mothers used to come back to the hospital as a result of their newborn contracting an infection, now the number has dropped to as low as 10%. The IPC programme has equipped health workers to educate mothers about the importance of hygiene, so that when they return home after giving birth, they are careful about their baby’s environment. It is often difficult to know whether any infection is contracted in a healthcare setting or at home, so the Infection, Prevention & Control programme targets both. Eliana adds: “They are well-imparted about the information or what they should do when they are home.”
One mother, Inna, who gave birth in an IPC project-supported clinic, says: “Horizons taught us the importance of cleanliness.” Since being piloted at Serrekunda Health Center, the IPC programme has been extended to six health facilities across the country, covering 40% of the population.
In The Gambia, it’s been reported that 11% of maternal deaths are caused by sepsis and other infections, and up to 30% of neonatal deaths. The true figure is thought to be higher.
A high number of maternal and neonatal infections and their consequences can be avoided by implementing appropriate IPC practices.
IPC is a scientific approach that creates a cleaner environment in health settings. By using this method, we have ensured that over 90,000 mothers and babies have benefited from these practices, thus reducing the risk of death, and suffering from infectious diseases.
Across the 6 clinics where the IPC programme was introduced, Horizons Trust Gambia has:
- Trained 515 healthcare staff in IPC - including those who can now train others.
- Improved infrastructure: including installing new washing machines, taps, toilets, showers and providing plumbing maintenance.
- Donated 18,000 pieces of cleaning supplies.
- Installed solar power in Brikama Community Hospital, Serrekunda and Fajikunda Health Centers.
- Raised community awareness of cleanliness during childbirth.
After receiving training on IPC herself, Eliana now trains her colleagues in how to prevent sepsis cases: “Horizons has made me a champion, especially in Serrekunda.” She is the main point of contact for IPC in both Serrekunda Health Center and other clinics where she works part-time. “I would like to thank for Horizons… I'm never left behind. I'm in the forefront.”
As part of the IPC programme, Horizons Trust Gambia also installed solar power at Serrekunda Health Center. In the past, if the mains power is off, which is a common occurrence in The Gambia, and the generator isn’t working, Eliana says “we sometimes lose our babies due to electricity. But since the... the instalment of this solar power, definitely that's the thing of the past now.” Electricity is a vital tool in the fight against neonatal sepsis – and other infections such as hepatitis or HIV – because it’s needed for the sterilisation of materials, keeping medication refrigerated at the right temperature, and helping babies breathe with the help of an oxygen machine.
Eliana adds: “A lot of people…are saying “what happened?” I said Horizons is the backbone of what we are seeing right now.”
In Edward Francis Small Teaching Hospital, a similar IPC training programme was delivered, and Horizons provided doctors, nurses and anyone working inside the maternity theatre with PPE, scrubs and correct shoes.
Ramatoulie Bah, Matron of the Obstetrics and Gynaecology Department at Edward Francis says:
“This has a great impact because…especially our cleaners, they were able to know how to use their PPEs correctly, what they need to do when there's a spillage of blood or fluid…. you could see the cleanliness in the department…in terms of infection prevention and control.”
Overall, knowledge of Infection, Prevention & Control increased by 60% on average at the six recipient clinics. In two of the facilities, neonatal sepsis reduced from 19/1000 births to 10/1000 births after the first year. The Gambia’s Ministry of Health has now included this programme in a project proposal to be rolled out nationwide.