• Experts advocate strict adherence to infection control protocols
As Nigeria grapples with high inflation and escalating healthcare costs, the country is estimated to have lost $4.5 billion to Healthcare-Associated Infections (HAIs) due to poor infection prevention and control (IPC) measures in health facilities, leading to extended hospital stays, loss of productivity, and higher medical expenses.
WaterAid estimates that about $4.5 billion was expended in 2023 on HAIs, and warned that healthcare facilities lacking basic water, sanitation, and hygiene (WASH) services leave both patients and staff vulnerable to infections such as sepsis and pneumonia.
It noted that globally, one in five healthcare facilities have no basic water service, while 3.85 billion people receive care in facilities without basic hygiene.
Also, data obtained by The Guardian show that between September 2023 and May 2024, more than 4.5 million Nigerians accessed outpatient services, and 1.6 million inpatient admissions were recorded across 33 federal tertiary hospitals nationwide.
Healthcare-Associated Infections, also known as nosocomial or hospital-acquired infections, occur during the process of care in a hospital or clinic and were not present or incubating at the time of admission. These infections, experts say, prolong hospital stays, increase antimicrobial resistance, heighten mortality risk, and place heavy financial burdens on patients and families.
In Nigeria, about 848,000 HAI cases were recorded in 2022, resulting in 93,600 deaths. The World Health Organisation (WHO) estimates that roughly 15 per cent of hospitalised patients suffer from such infections, including urinary tract, bloodstream, respiratory, gastrointestinal, and surgical site infections.
Experts attributed the high prevalence of HAIs to poor hygiene, weak IPC programmes, overcrowding, and inadequate awareness among health workers and patients. They emphasised that strict adherence to infection control protocols, improved staffing, and effective surveillance systems are essential to reversing the trend.
A virologist and Chair of the West African National Academy of Sciences, Prof. Oyewale Tomori, said patients in West and East African hospitals are at great risk of HAIs due to poor medical practice, understaffing, and inadequate equipment.
“We pay a high price for non-adherence to infection prevention and control practices, particularly the careless use of injections and surgical procedures without proper medical precautions,” he said.
Tomori recalled that some of the most notable hospital-acquired infections in Nigeria were the Lassa fever outbreaks of 1969–1970 in Jos, and a 1995 British Medical Journal report on nosocomial Lassa fever, which described infections among 34 hospital workers and patients. He warned that many similar cases today go unreported.
He urged the government and hospital administrators to prioritise staff training and enforce compliance with IPC guidelines, warning that continued neglect would have “far-reaching, costly, and devastating consequences.”
An infectious disease expert at Adeleke University, Dr Oladipo Kolawole, said infections can be transmitted through contaminated surfaces, equipment, or invasive procedures, while poor hand hygiene and antibiotic misuse worsen the problem.
“To prevent HAIs, health workers must maintain strict hand hygiene, use personal protective equipment (PPE), sterilise instruments, and ensure proper waste disposal,” he advised, adding that regular staff education and antimicrobial stewardship are key to reducing infection risks.
Former President of the Guild of Medical Directors (GMD), Prof. Femi Dokun-Babalola, said hospitals are high-risk environments due to the concentration of sick individuals and invasive procedures that, if poorly managed, can introduce pathogens.
He warned that inadequate hand hygiene, improper sterilisation, and antibiotic overuse have fuelled the rise of antibiotic-resistant bacteria, therebycomplicating treatment and eroding public confidence in hospitals.
“Understaffed wards and inconsistent adherence to WHO guidelines contribute to lapses in infection control,” he said. “A multifaceted approach combining continuous education, improved infrastructure, and enforcement of safety protocols is vital to restore trust in the healthcare system.”
Also speaking, former Director of Public Health at the Federal Ministry of Health, Dr Chukwuma Anyaike, described infection prevention and control as the cornerstone of public health and the bedrock of a resilient health system.
“No patient should become infected while receiving care, and no health worker should contract infection while providing it,” he said. “IPC offers a proven, cost-effective solution to prevent harm, protect lives, and safeguard the integrity of the healthcare system.”
