In recent years, there has been increased attention on the importance of healthcare environmental cleaning, including the need to professionalize and support the workforce responsible for performing cleaning, say Patrick, et al. (2024), who add that global agendas and strategies on infection prevention and control (IP&C) and water, sanitation and hygiene highlight the need for improvements to this sector, particularly in resource-limited healthcare facilities in low- and middle-income countries.

Correspondingly, several resources have been developed that aim to (1) improve professional training of cleaners and (2) improve implementation of best practices in resource-limited settings. This commentary seeks to provide insight into the barriers and facilitators to implementing these resources, drawing on the practical experience from two initiatives across four countries from 2018 through 2023. Several common barriers were identified across the diverse settings, including (1) low empowerment and status of the workforce, (2) low pay, inadequate staff time for the high workload needed to achieve best practices and high turnover of staff, and (3) a lack of connection and integration of environmental cleaning with IP&C and patient safety efforts at the participating hospitals.

"Despite barriers, local teams identified effective mitigation measures," the authors write. "While considerable time and effort will be needed to truly overcome these barriers, there are opportunities to build upon attention and momentum on this topic and IP&C initiatives in resource-limited settings in low- and middle-income countries. We propose several broader actions, all of which require local leadership and context-specific approaches."

Reference: Patrick M, et al. Environmental cleaning barriers and mitigation measures identified through two initiatives in four countries, 2018–2023: a commentary. Antimicrobial Resistance & Infection Control. Volume 13, article number 134. (2024)