Infection prevention for family planning service programs : a problem-solving reference manual

Further, these services are being provided at increasing levels and in more remote and non-traditional settings. This expansion of services is key to keeping pace with the increased demand for services. In the past, the primary focus of infection prevention (IP) in family planning (FP) programs was on preventing serious postoperative infections when providing surgical contraceptive methods. Although serious postoperative infections are still a problem in many countries, the emergence of AIDS, and continuing problems with hepatitis B and the more recently identified hepatitis C and D, has shifted the focus of IP dramatically. Attention must now also be directed towards minimizing the risk of transmitting these diseases not only to clients but also to service providers and staff, including cleaning and housekeeping personnel. Thus, for the l990"s and beyond, the goal of IP for FP service programs must be two-fold: preventing infection, and providing protection to both clients and staff. Major constraints to reductions in infection-related complications and deaths following surgical contraceptives procedures are: (1) a persistent misconception that expensive, high-tech equipment and facilities are required to provide a safe environment for surgery; (2) a erroneous belief that autoclaving instruments and equipment, regardless of whether or not the items have been properly decontaminated and cleaned, will make them safe; (3) a failure to appreciate the importance of simple, inexpensive IP practices such as handwashing and use of protective gloves as a means of reducing the risk of transmitting serious diseases to clients and health care workers; and (4) a failure to disseminate practical, accurate, and consistent information about specific IP procedures which takes into account the resource constraints faced by most programs. This manual addresses these issues. While intended for use in FP service programs in developing countries, the IP practices and data on which these guidelines are based are universally applicable. The primary objective is to help administrators, clinic managers, and health care professionals develop uniform IP guidelines for use in any type or size of FP service program, regardless of location. The information in the manual is presented in a simple, easily understandable, user-friendly format. The manual is divided into three parts. The first part briefly describes the basic principles and practices of modern IP, and documents data supporting their use, relative importance, and applicability in situations where resources and manpower are limited. In the second part, the essential components of preventing infection and disease transmission are outlined for each surgical contraceptive method currently provided worldwide. The emphasis in this section is on IP practices that are practical, easy to apply, and designed to minimize costs and the need for expensive technology and/or fragile equipment, while at the same time assuring a high degree of safety (i.e., they incorporate readily available agents and appropriate technology). The third section is comprised of appendices which provide detailed "how-to" instructions preparing and/or using the recommended procedures as well as information regarding the advantages and disadvantages of each in given circumstances. (Author abstract)