Water Sanitation and Hygiene, and Antibiotics Stewardship in Kenyan Hospitals, 2017-2019

This work was carried in Kenyan public hospital the main aim was to assess hospitals Infection Prevention and Control (IPC) and Antibiotic Stewardship(ABS) capacity as part of tracking and tackling efforts to limit antimicrobial resistance in Kenya. We redesigned an existing WASH facility improvement tool to collect data across 16 county hospitals with a total of 116 wards. There were 65 indicators in 4 domains used for this assessment that is 14 indicators for water, Sanitation 22 indicators, hygiene 18 indicators and 11 for organisational management domain. 32 of these indicators were also assessed at ward level. Addition modifications on the tool allowed us to contrast performance by assessing infrastructural, material and human resources to support WASH services, We the WASH facility tool to to allocate responsibilities at a more health systems level allowing for different levels of hospital leadership to be accountable for the implementation and subsequent improvement of WASH in hospitals. Antibiotic Stewardship - We examined prescription patterns and explored to what extent guidelines are available and how they might influence treatment appropriateness in Kenya. Data on antimicrobial usage were collected from hospitalised patients using a point prevalence survey across 14 Kenyan public hospitals spanning antimicrobials prescribed, laboratory investigations, clinical diagnoses and physical availability of treatment guidelines.