Executive Summary:

Hundreds of millions of people are affected annually by infections associated with healthcare, leading to high mortality and illness rates. The risks of healthcare-associated infections (HAIs) are 2-3 times higher in low-income countries and account for 75% of neonatal deaths in sub-Saharan Africa and parts of Asia. HAIs lead to tremendous healthcare costs, and the use of antibiotics contributes to the growing threat of antimicrobial resistance. Preventing HAIs requires minimal budget or changes in healthcare practices. Save the Children, WaterAid, London School of Hygiene and Tropical Medicine, and Kinnos will integrate evidence-based solutions to prevent HAIs. Bold Action to Stop Infections in Clinical Settings (BASICS) will launch in four demonstration countries. In five years, it will prevent 105,000 infections, save $12 million in health costs and avoid 1.4 million patient stay days. BASICS is designed to scale globally to prevent HAIs and save millions of lives.

COVID-19 Response

Though in-person monitoring and data collection activities were initially put on hold due to the pandemic, this is no longer a significant challenge. In most contexts, staff are allowed to resume visits to healthcare facilities while following social distancing and screening precautions. In locations still under travel restrictions, staff have worked with local governments to develop common data reporting and management systems for remote reporting. We then rely on infection prevention coordinators from within healthcare facilities to routinely report on the status of infection prevention indicators and compliance, accompanied by pictures. BASICS' original proposal will remain mostly unchanged, as its work to improve infection prevention in maternal and newborn healthcare settings also inherently supports the fight against COVID-19. However, we have incorporated important COVID-19 preparedness, screening and management measures into our program design to ensure the safety of health facility staff, patients and visitors. Due to the drastic reduction in care seeking for maternal and newborn health services caused by the pandemic, we also plan to incorporate community engagement and risk communication activities to instill confidence in local health systems and increase health facility attendance for critical services (e.g child birth). BASICS recognizes several unknowns for the future of the pandemic (outbreak spots, stress on healthcare systems, reduced care seeking and its effects on health) and is planning as best it can to mitigate these challenges within local contexts. Oddly, the pandemic has also presented an opportunity because there is growing local, national and global support for strengthening comprehensive infection and outbreak prevention efforts.

Racial and Ethnic Injustice Response

COVID-19 has disproportionately impacted low income communities. In particular, seeking maternal and newborn healthcare has dramatically dropped in thise communities due to fear of risk and diversion of resources. It is eroding gains made over several decades in just a few months. This project will target infection prevention through improved hygiene but is also pivoting to include outreach to communities to with information around risk and benefits to help stem this erosion and bring back pregnant women and moms to health care facilities.