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Infections contracted from healthcase settings (healthcare-acquired infections or HAI) such as sepsis and pneumonia lead to thousands of preventable deaths in sub-Saharan Africa every year, according to a new study.
Treatment of HAIs is costing the region $8.4 billion annually, showed WaterAid, an international non-governmental organization, focused on water, sanitation and hygiene.
Healthcare facilities without adequate water, sanitation and hygiene (WASH) leave patients and staff vulnerable to HAIs, the authors of the report alerted.
The study explores the rates of these infections in Ethiopia, Ghana, Malawi, Mali, Nigeria, Uganda and Zambia.
In 2022, more than 2.6 billion cases of HAIs were reported in the seven sub-Saharan African countries, which led to 277,160 excess deaths.
Nigeria recorded the highest incidence of HAIs in 2022, followed by Ethiopia, Uganda, Ghana, Malawi, Zambia and Mali.
The average number of HAI cases in Nigeria was estimated to be 848,000 in 2022, of which half were predicted to be antimicrobial resistant, the report showed. These HAIs caused 93,600 deaths, the researchers estimated. That year, the total economic costs of HAI in Nigeria was $4.5 billion, they added.
The economic cost of HAIs in the seven countries put together amounted to at least $8.4 billion, costing on average 1.1 per cent of their total gross domestic product and 4.6 per cent of health expenditure, the analysis showed.
Among the seven countries, the proportion of GDP spent on treating HAIs in 2022 was the highest in Malawi (2.9 per cent) followed by Zambia, Ghana, Uganda, Nigeria, Ethiopia and Mali.
Though Nigeria had the highest number of healthcare associated infections, the country spent only 0.9 per cent of its GDP on treatment.
This is equivalent to the total amount needed to provide universal, basic clean water and waste services in healthcare facilities in the 46 least developed countries (LDC), the report underscored.
HAIs are transmitted during treatment and recovery phases in healthcare institutions due unhygienic practices. The most common HAIs are surgical site infections, bloodstream infections and respiratory tract infections, including pneumonia, the authors noted. The highest rates are found in intensive care units and neonatal or pediatric departments, they added.
A growing proportion of these infections are resistant to anti-microbial drugs, which means they are costlier to treat and take longer to recover from, leading to worse health outcomes for patients.
According to WaterAid, at least 50 per cent of these medical costs could be averted by improved handwashing facilities, clean water and decent toilets.
Despite growing recognition of the importance of WASH in healthcare facility, financing from both donors and international financial institutions for WASH in healthcare facility remains inadequate.
New analysis from the seven countries highlighted the urgent need to mobilise additional financing to close the funding gap for WASH in healthcare facilities. These include action by all stakeholders, including donors, private sector and national governments.
WaterAid called upon the country governments, UN member states, international financial institutions and G7 and G20 presidencies to work together to so that WASH services are available in every healthcare facility.
Multilateral development banks and other development finance institutions should recognise the strong return on investment offered by WASH in healthcare facilities, the organisation stressed.
Governments and donors must develop a dedicated budget line for WASH in healthcare facilities, the authors advised.