While in India I am interested in exploring how hospitals and intensive care clinics handle infection and disease control in women. There are many infections that have become “common” in India, such as Malaria, Cholera, Tuberculous, Typhoid, Hepatitis, Jaundice, Leptospirosis, Diarrhoeal Diseases, Amoebiasis, Brucellosis, Hookworm Infection, Influenza, Filariasis, and many more. These infections in this country are under-recognized and I would like to expand my knowledge on their methods of prevention, treatment for women displaying symptoms, fatality rates, as well as the emotional/behavioral effects infections have on mothers and children.

 

The National Centre for Disease Control (NCDC) assists Indian states with infectious disease control through assistance with multidisciplinary outbreak investigations, communicable disease surveillance, networking of public health labs, and capacity building. There is a significant gap in surveillance of healthcare associated with infections in India and the CDC is very aware of it. The NCDC even clearly states on their website that their goal is to expand to their use of national surveillance. As a means of aid, the United States has offered technical support from their CDC to help India’s existing Antimicrobial Resistance (AMR) networks begin programmes for the systematic assessment and improvement of infection prevention and control practices and the implementation of standardised surveillance of healthcare associated infection. The aim is to develop models that can serve as the basis for a sustainable Indian national network for standardized implementation, strengthening, and reporting of healthcare-associated infections and infection prevention and control practices for the purposes of public health action. (Swaminathan)

 

A qualitative study to assess the facilitators and barriers to infection control practices at a 1250 bed tertiary care hospital in Haryana, northern India by Anna Barker showed that person, task, and organizational level factors were the primary barriers and facilitators to infection control at this hospital. Major barriers included a high rate of nursing staff turnover, time spent training new staff, limitations in language competency, and heavy clinical workloads. A well-developed infection control team and an institutional climate that prioritizes infection control were major facilitators. This study concluded that institutional support is critical to the effective implementation of infection control practices. Prioritizing resources to recruit and retain trained, experienced nursing staff is also essential. (Barker) Another study by Rajesh Mehta concluded that current infection control procedures and practices during labour and delivery in health facilities in Gujarat revealed a need for improved information systems, protocols and procedures, and for training and research. Simply incentivizing the behavior of women to use health facilities for childbirth via government schemes may not guarantee safe delivery. (Mehta)

 

Understanding there's an issue with infections is clear. At this point, I would like to see what there can be done to help control infection. I plan to tour hospitals/clinics and speak with medical professionals (doctors, nurses, midwives, etc) about their practices, protocols, guidelines, resources, limitations, vaccinations, and personal opinions of how it affects families and the community.

 

This topic sticks out to my personal interests and in my graduate studies, I would like to explore the medical fields of epidemiology, neonatology, and surgery. With such high rates of disease and infection in India, I thought this would be the perfect time to get my feet wet and start my research. My immediate goal after my visit to India would be to help spread awareness of their health conditions among the US. Seeing as the United States CDC has already gotten involved, our citizens and medical professionals should offer their help as well. We shouldn't wait for a deadly outbreak before taking action.

 

References:

Barker, Anna K., et al. "Barriers and Facilitators to Infection Control at a Hospital in Northern India: A Qualitative Study." Antimicrobial Resistance & Infection Control, vol. 6, 08 Apr. 2017, pp. 1-7. EBSCOhost, doi:10.1186/s13756-017-0189-9.

 

“Healthcare Infection Control Practices Advisory Committee (HICPAC).” Centers for Disease Control and Prevention, U.S. Department of Health & Human Services , 9 Mar. 2018, www.cdc.gov/hicpac/index.html.

 

“India National Centre for Disease Control” India | IANPHI, www.ianphi.org/membercountries/memberinformation/india.html.

 

Mehta, Rajesh, et al. "Infection Control in Delivery Care Units, Gujarat State, India: A Needs Assessment." BMC Pregnancy & Childbirth, vol. 11, no. 1, Jan. 2011, pp. 37-44. EBSCOhost, doi:10.1186/1471-2393-11-37.

 

Swaminathan, Soumya, et al. “Strengthening Infection Prevention and Control and Systematic Surveillance of Healthcare Associated Infections in India.” The BMJ, British Medical Journal Publishing Group, 5 Sept. 2017, www.bmj.com/content/358/bmj.j3768.