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Developing integrated guidelines for healthcare workers in response to the COVID-19 pandemic


Infection prevention and control (IPC) guidelines are critical to ensuring that health workers know how to best protect themselves, their patients and their communities against infectious threats. However, most guidelines are developed in high-income settings and recommend resources and practices that are not suitable to lower resourced settings, such as those found in low-and middle-income countries (LMICs). Work was urgently needed to create COVID-19 IPC guidelines for a range of care settings in LMICs. 

Bringing together Canadian researchers based at the University of Toronto and the University of Waterloo, the research team partnered with local health system actors in the Philippines and Sri Lanka. Formed in early 2020, the team used collaborative methods across research sites to create infection prevention and control guidelines for COVID-19. These guidelines were tailored for use in community health centres, primary care and hospitals in both countries. Throughout 2020 and 2021, health workers in both countries were trained based on the IPC guidelines. In Sri Lanka, the guideline training videos were included in Ministry of Health training for health workers across the country.  

The findings from this research underscored the importance of engaging with the most local levels of health systems to ensure that all staff are trained, protected and well-equipped to safely work during outbreaks. In many LMICs, such as the Philippines, community health workers and NGO workers are an important part of the health workforce. These workers can extend the reach of healthcare and public health into communities. Our research highlighted that these workers welcomed IPC training and reported that it helped them overcome their fears and supported them while working in communities. In Sri Lanka, the work highlighted that IPC training must include all categories of staff in hospitals, including service staff, who may have to take on roles that put them at increased risk of infection during an outbreak.  

Health workers globally are crucial to detecting and responding to emerging health threats in communities. Keeping health workers safe on the job requires IPC guidelines that reflect the reality of an evolving threat and the resources at hand, as well as empowering people to protect themselves and others.