Post Pandemic Assessment of Infection Prevention and Control Program in Public Sector Hospitals of Islamabad

Abstract

Background: Healthcare-associated infections (HCAIs) remain a major preventable cause of morbidity and mortality, particularly in low- and middle-income countries where infection prevention and control (IPC) systems often lack the structural and operational maturity needed to ensure patient safety. Pakistan’s public hospitals historically demonstrated inadequate IPC capacity, and the impact of COVID-19–related investments on long-term programme strengthening remains unclear. Objective: To assess post-pandemic IPC capacity in four public sector hospitals in Islamabad using the WHO IPC Assessment Framework (IPCAF), compare 2023 findings with 2019 baseline scores, and identify persistent gaps across IPC core components. Methods: A cross-sectional observational study was conducted from February to July 2023 in four tertiary public hospitals previously assessed in 2019. Data were collected using the WHO IPCAF tool through structured interviews, document review, and direct observation. Descriptive statistics were generated, and paired comparisons of overall 2019–2023 scores were performed. Results: All hospitals improved from “Inadequate” (9.7–20.6%) in 2019 to “Basic” IPC capacity (29.2–46.5%) in 2023, with a significant mean increase of 20.5 percentage points (p = 0.018). IPC Guidelines and Built Environment were the strongest components, whereas HAI Surveillance, Multimodal Strategies, and Monitoring/Audit & Feedback remained critically low across hospitals. Conclusion: IPC capacity in Islamabad’s public hospitals improved post-pandemic; however, foundational gaps in surveillance and quality-improvement systems persist. Strengthening these domains is essential for advancing hospitals toward higher IPC maturity and reducing HCAI burden.