Infection Prevention and Control in Maternal and Neonatal Care

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An increased number of women are attending health facilities for antenatal care, labour, childbirth and neonatal care. One in ten deaths associated with pregnancy and childbirth is due to sepsis with more than 95% of deaths due to maternal sepsis occurring in low and middle income countries (LMICs). Caesarean section is the single most important risk factor for maternal infection after childbirth. Among hospital-born babies, infections are responsible for 4% to 56% of all causes of death in the neonatal period and three in ten deaths due to neonatal sepsis are attributable to resistant pathogens. Therefore, there is an urgent need for strengthened training strategies, more specifically, on improving successful infection prevention and control (IPC) implementation and country capacity building. Staff working in maternal and neonatal wards – specifically, antenatal care outpatient services, maternal and neonatal inpatient services and neonatal intensive care services.

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Deaths from maternal and neonatal sepsis expose broader health determinants and underlying issues of quality of care including infrastructure constraints, inconsistent use of infection preventive measures, delayed diagnosis, and poor management of infection and its complications. One of the most relevant determinants of this situation is poor knowledge of IPC standards and principles among front line health care workers and the lack of IPC specialists to support training, mentorship and monitoring in LMICs. Therefore, there is an urgent need for strengthened training strategies, including the development of standardized training packages for IPC professionals in low-resource settings to support successful implementation and IPC country capacity building.

The toolkit is divided into 6 sessions. The first session covers the essential knowledge of standard precautions required for good infection prevention and control. The other five sessions develop this knowledge and apply it clinically to common situations in antenatal care, labour, childbirth and neonatal care. Currently the first three sessions are now available.

Course contents

Introduction to infection prevention and control in the context of maternal and neonatal care:
In this module, you will learn about the global burden of health care-associated infections (HAIs), maternal and neonatal infections including sepsis, and how tailored infection prevention and control (IPC) training approaches for health workers providing maternal and neonatal care can help bridge the knowledge gap and reduce HAIs.

Prevention, screening and management of infections during routine care of the pregnant woman in antenatal clinic:
This module refers to prevention, screening and management of maternal infections during pregnancy, and how to IPC standard and additional precautions during provision of routine antenatal care to the pregnant women. Participants should undertake module 1 and associated IPC basic modules, before this module in order to learn about the global burden of HAIs and maternal and neonatal infections, including sepsis, and to be introduced to IPC.

Care of the pregnant woman and baby during uncomplicated labour, childbirth, and the early postnatal period:
This module covers the essential knowledge of infection prevention and control (IPC)precautions during admission of the labouring pregnant women, uncomplicated labour, childbirth and early postnatal period. Participants should undertake module 1 and associated IPC basic modules, before this module in order to learn about the global burden of health care-associated infections (HAIs) and maternal and neonatal infections, including sepsis, and to be introduced to IPC.

Care of the woman during complicated labour and childbirth:
In this module, you will learn about the risks of cross infection and contamination from interventions that may be required in labour, the indications for antibiotic prophylaxis in pregnancy, labour and the postpartum period, related components of antimicrobial stewardship, and how infection prevention in obstetrics; as practices and obstetrical management, can influence the risk for infection or sepsis for the woman, the fetus, and newborn.

Care of the woman undergoing caesarean section:
In this module, you will learn about surgical site infections (SSIs), the burden and risk factors of SSI secondary to caesarean section, how health care-associated infections (HAIs), including SSIs, can be prevented in women undergoing caesarean section, and the skills needed to apply standard infection prevention and control (IPC) precautions during caesarean section

Care of small and sick neonates:
This module provides an overview of the risk factors for infection in small and sick neonates as well as basic infection prevention and control measures that can be put in place to prevent or minimize the risk of infection.

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