@article{9c77b86b7ea0455d8ef76ccc008e5430,
title = "Infection prevention and control in healthcare facilities in Albania",
abstract = "Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated. Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women; response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher{\textquoteright}s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants. Results: About 47% of health facilities did not have a designated focal point for IPC issues; the lack of one patient per bed standard was evident in more than one-third of health facilities (37%); and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled. Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care.",
keywords = "Albania, Epidemiology, Healthcare related infections, Infection prevention and control",
author = "Gentiana Qirjako and Alketa Qosja and Xheladin Dra{\c c}ini and Najada {\c C}omo and Jolanda Hyska and Albana Fico and Mariana Bukli and Genc Burazeri",
note = "Funding Information: Acknowledgment: This study was supported by the United Nations Children{\textquoteright}s Fund (UNICEF), Office in Albania. Funding Information: In response to the COVID-19 situation at a global level, the World Health Organization (WHO) developed a self-assessment monitoring tool about “Infection prevention and control health-care facility response for COVID-19” (1). The aim of this instrument is to assess Infection Prevention and Control (IPC) capacities to respond to COVID-19 and other infections in health facilities at all levels of care. This self-assessment tool was developed mainly for acute health-care facilities, but can also be adapted for use in long-term care facilities (1,2). The WHO instrument reflects and considers other useful tools developed by the Centre for Disease Prevention and Control (CDC) in USA (3) and the European Centre for Disease Control and Prevention (ECDC) (4). Regardless of the level of care, the instrument developed by WHO supports health facilities to identify, prioritize and address the gaps in IPC capacities, structures and resources in order to respond adequately to COVID-19 and other infectious diseases (1). Following the WHO guidelines and recent developments, this instrument was recently translated and adapted into the Albanian context. Albania has experienced a considerable demographic change and epidemiologic transition in the past three decades (5,6), following the breakdown of the communist regime in 1990. According to the most recent estimates from the national Institute of Statistics, the proportion of the population aged =65 years was 15% in January 2021 (7), compared with only about 4% in early 1990s. This particularly rapid aging of the population is associated with a significant shift toward non-communicable diseases. According to the most recent estimated provided by the Institute for Health Metrics and Evaluation, the mortality rate from infectious diseases, maternal, neonatal and nutritional diseases in Albania in 2019 was estimated at 27 per 100,000 population comprising only 3% of the overall mortality, whereas in 1990 it accounted for more than 20% of the all-cause mortality (8). However, there is no specific information about the healthcare-related mortality or burden of infectious diseases in Albania. In April 2021, following the translation and adoption into the Albanian context of the WHO self-assessment instrument regarding IPC aspects at health facility level (9), many health professionals (both physicians and nurses) were trained about an array of issues and dimensions pertinent to effective and adequate implementation of safety measures related to IPC. The training was carried out online with technical support from the University of Medicine in Tirana and technical and financial support from UNICEF, Office in Albania. In this framework, the aim of this study was to assess the current status regarding IPC aspects in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic. We hypothesized that many health facilities in Albania would meet the basic IPC standards, based on the grey literature and reports mainly available from the Albanian Ministry of Health and Social Protection website (https://shendetesia.gov.al/). Publisher Copyright: {\textcopyright} 2021, Jacobs Verlag. All rights reserved.",
year = "2021",
month = jan,
day = "1",
doi = "10.11576/seejph-4702",
language = "English",
volume = "17",
journal = "South Eastern European Journal of Public Health",
issn = "2197-5248",
publisher = "Jacobs Verlag",
}