Investigator(s)
| WHO Technical Officer |
Saugat shrestha World Health Organization (WHO) Country Office Nepal Saugat shrestha 
|
| Principal Investigator |
Bala Rai Nursing and social security division, DoHS Bala Rai
|
Title(s) and abstract
| Scientific title | Infection Prevention and Control Performance in 10 federal public hospitals and implementation challenges. A mixed Method Study in Nepal. |
| Public title | IPC Performance in 10 federal public hospitals and implementation challenges in Nepal |
| Background | Infection Prevention and Control (IPC) is essential for protecting patients, families, and health workers from healthcare-associated infections (HAIs). Evidence shows that effective IPC programmes can prevent up to 70% of HAIs, reduce hospital stay, and decrease health system costs. IPC is also a core strategy of the global and Nepal’s national action plans on antimicrobial resistance (AMR). The World Health Organization (WHO) established minimum IPC standards through the Infection Prevention and Control Assessment Framework (IPCAF), which evaluates eight core components and categorizes performance from inadequate to advanced. Nepal began strengthening its national IPC programme in 2020 with the development of guidelines, updated training modules, and establishment of IPC committees at all levels. This study will provide the first national analysis of IPC performance (graded by scores) in federal hospitals of Nepal and an examination of the barriers to implementation. Such evidence is essential to inform improvement strategies, support health system strengthening, and guide effective translation of IPC policy into practice. |
| Objectives | General Objective. To assess IPC programme performance in 10 federal public hospitals in Nepal and explore key implementation challenges. Specific Objectives 1. Quantitative o To determine overall IPC performance scores in 2025 in 10 federal public hospitals. o To examine changes in IPC performance across the eight core components from 2023 to 2025. 2. Qualitative o To explore perceived barriers and potential solutions for optimal IPC implementation from the perspectives of hospital directors, Nursing Chiefs, and IPC focal persons. |
| Study Methods | A mixed-methods explanatory design will be used, beginning with a quantitative cross-sectional analysis followed by a qualitative descriptive study. Hospitals first complete self-assessments followed by joint external assessments using Nepal’s standardized IPC assessment tool (adapted from IPCAF). The tool scores 81 indicators across eight IPC components (IPC programme, guidelines, training, HAI surveillance, multimodal strategies, monitoring and audit, workload/staffing/bed occupancy, and built environment/equipment). Performance is graded on the basis of scores as inadequate, basic, intermediate, or advanced. • Quantitative: Ten purposively selected federal public hospitals with complete IPC assessment data from August 2023, July 2026. • Qualitative: Three hospitals selected for in-depth inquiry. Key informants (hospital directors, nursing chiefs, IPC focal persons) will participate in approximately nine interviews, with final sample size driven by data saturation. Data collection & analysis • Quantitative: Percentage scores in core IPC components will classify performance levels, and changes over time will be described using medians, IQRs, and radar charts. • Qualitative: Interviews (audio-recorded or using field notes) will undergo manual content analysis. Themes on barriers and solutions will be developed through investigator triangulation. Reporting will follow COREQ guidelines. |
| Expected outcomes and use of results | 1. A prioritized set of interventions for the Ministry of Health, hospital administrators, and IPC committees to improve Infection prevention and control program 2. A comprehensive list of systemic, organizational, and behavioural barriers in the implementation of IPC program. |
| Keywords | IPC, HAIs, Assessment, Framework, Nepal, IPC performance, Barrier |
Research Details
| Student research | No |
| Start Date | 24-Feb-2026 |
| End Date | 23-Feb-2028 |
| Key Implementing Institution | Nursing and social security division |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Health Systems Research |
| Research field(s) | |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Primary and secondary data |
| Proposal reviewed by other Committee | Final decision available |