INFECTION PREVENTION

Infectious diseases are not new in society but they keep emerging and re-emerging in future. Nigeria is one of the countries that is being burdened by centuries-old diseases such as Malaria, HIV, diarrhoea and the recent COVID pandemic. The main risk factor that contributing to increased infections in Nigeria is poor access to clean water. It is estimated that More than 60 million Nigerians lack a good supply of clean water. Considering that Nigeria has a population of close to 160 million people, lack of clean water poses a major threat. The county is also over burdened by diseases such as HIV and malaria. The study has revealed that implementing hand washing policies would mitigate spread of infectious diseases among children and general public. The study suggests that a country cannot have proper hygiene practices if it cannot supply clean water to its residents. Thus, Nigeria needs to work on policies that would facility supply of clean water to residents to reduce healthcare-related infection among its residents. Nigeria also needs to revise their budgets to improve healthcare and increase infectious diseases surveillance. Lastly, the country ought to increase resources and equipment’s at the hospital to increase surveillance and response to infections. INFECTION PREVENTION 3 Enforcement of Hand Hygiene in Public Places to Prevent Spread of Infections in Nigeria a. Introduction Infectious diseases is a health condition that is highly threatening lives across the world. According to a WHO (2020, p.1) report, Africa is hardly impacted by infectious diseases; approximately 740 million people are at risk of contradicting non-communicable diseases (Gouda et al, 2019, p. 31). Nigeria is a classic example of how African countries are burdened by infectious diseases. The West African country is burdened with diseases such as HIV and AIDs, malaria, river blindness, polio and measles. Malaria is impacting the lives of people in Nigeria and the most affected are people under five years. African countries are also affected by infectious diseases such as typhoid, cholera, influenza, tuberculosis and the new strain of Covid- 19 that causes corona diseases. This study aims to present a policy brief that can be utilized to improve hand hygiene in an effort of preventing infectious diseases in Nigeria. Demographically, Nigeria is the most populous and influential countries in West Africa. Studies have shown that Nigeria accounts for approximately a quarter of the people in the West African region. Most of the Nigerian population lives in the cities as more than 20 of its cities has populations of more than 100,000 each. The Nigerian population is composed of different tribes (see appendix 1), languages and traditions. The main languages spoken in Nigeria include Hausa, Yoruba and Igbo. In 2018, Nigeria was estimated to have a population of approximately 195.9 million people (Gebreyes et al 2017, p. 56). Of the population, children make up approximately 44 per cent, while those in age brackets of 15 – 64 are 53 per cent and elder people of ages above 65 are approximated to e 3 per cent. Life expectancy in Nigeria is estimated to be 51.56 years (Ilesanmi, 2019, p. 4). Nigeria, like other African countries, has its public health facilities burdened by non-communicable diseases. In Nigeria, the main causes of death INFECTION PREVENTION 4 from 1990 to 2016 are diseases such as diarrhoea, malaria, neonatal disorders as well as HIV/AIDS, tuberculosis and other non-communicable diseases (Ilesanmi, 2019, p. 5). In 2014, Nigeria experienced 1.3 million deaths where 70 per cent of them were people aged 70 and older. Infectious diseases are a major cause of death as malaria causes 17 per cent of the death while Diarrhoea, HIV and Aids and lower respiratory infections cause 10, 11 and 8.4 per cent of death respectively (Ilesanmi, 2019, p. 5) (see appendix 2). HIV and AIDs, malaria and cholera create a disease burden in Nigeria. According to Awofala and Ogundele (2018, p. 697) HIV has been a major disease in Nigeria and has been developing for the last 30 years. The diseases has claimed over 25 million people and this makes it one of the most stressful public health issue in the West African country. The diseases has impacted the health, welfare, and other live aspects of the Nigerian populations. Studies indicate that Nigeria is the second in largest in HIV diseases burden in the world; Nigeria has an average of 3.2 million people but the prevalence is reported to be stable at approximately 4 percent (Hadaway, 2020, p.3). Lower respiratory infections have also contributed a lot in the Nigerian disease burden. A report by Feigin and colleague (2014, p. 1) I reports the main causes of premature deaths in Nigeria were associated with malaria, HIV/AIDS as well as lower respiratory and they resulted in a high number of years of life lost in the country. Diarrhea also caused a major burden as it is was linked to disability adjusted life years. The main risk factors that is creating the diseases burden in Nigeria is associated with pollution, and poor sanitation. The Nigerian health system is divided into a three tire system- federal, state and local. The three levels are serve the health care functions through stewardship, financing and service provision. The federal level is deal with policy and technical support for the whole country. The INFECTION PREVENTION 5 state health care system handles the secondary hospitals as regulation of lower level health care facilities. At local government deals with organization of services into wards. Besides public system there are also private institutions that specializing in providing health care to the Nigerian population. The major challenge with the Nigerian system is that it is underfunded as only 5.6 percent goes to health. b. Structure and concept of a policy brief Considering that thousands of people die every day around the from infections they acquire at home or in a hospital setting while they receive care, it is essential to integrate policies that enforce hand hygiene in public places to reduce transmission of diseases. The researcher assumes that hands are the main pathway to the spread of diseases causing germs and thus cleaning them frequently should be a requirement in every pubic place or health care facilities. In this regard, hand hygiene is identified as a key measure to prevent the spread of infectious diseases and preventing healthcare-associated infections c. Importance of hand hygiene policy in Nigeria The issue of people contaminating life-threatening infections in a health care setting is a major problem around the world. According to Tyagi, and cohort (2018, p. 1299) millions of patients are affected by health associated infections across the world. Scholar’s estimate that out of 100 people who seek care in health facilities at least 7 people in developed countries contract a healthcare-related infection. Similarly, the case is slightly high in low and middle-income countries as 10 out of 100 people get such infection (Martins, and Osiyemi, 2017, p. 56). With this figures scholars critique that health care sometimes can expose people to health risks rather than care for the patients. The healthcare linked infections are risky as they cause major mortality INFECTION PREVENTION 6 risks among patients and also implicate hospitals in financial burdens. Considering countries such as Nigeria are low income and their health systems lack equipment and staff these can cause a big burden in providing health care. The healthcare-associated infection would be described as the infections that patients contact in the process of receiving care in hospital or any other health care setting; the infection is incubated at the hospital meaning that it was not present before admission to the facility. The infections are risky in that they might continue to affect the patient even after discharge and they might also occur as occupational infections to the hospital or healthcare facility staff. The world health organization reports that the infections are prevalent as in some countries might be as high as 20 per 100 patients. If the infections hit vulnerable groups of people such as the elderly, those in the intensive care unit or new-borns the implications would amount to millions of dollars in