Boosting infection control in health facilities through simulation training in the Solomon Islands

From preventing bloodstream infections to responding to pandemics, infection prevention and control (IPC) has proven critical to keep both patients and health workers safe in health care settings. The importance of IPC has never been more evident, especially in resource-limited settings.

In July 2024, the World Health Organization (WHO) Regional Office for the Western Pacific and the WHO Country Office in the Solomon Islands, in collaboration with international experts and the Ministry of Health and Medical Services (MHMS), introduced a new simulation-based learning and quality improvement module to strengthen IPC practices in health facilities across the Solomon Islands. This initiative was rolled out at the National Referral Hospital (NRH) and in provincial health authorities and hospitals in Makira and Malaita.

The simulation allows stakeholders, such as IPC staff, clinicians, and hospital managers, to evaluate both the structural and procedural factors that affect IPC. It also provides tools to assess the implementation of IPC practices in clinical settings and to create continuous improvement plans tailored to local contexts. This is aiming at strengthening systems resilience against the burden of endemic healthcare-associated infections (HAIs) and antimicrobial resistance (AMR), which affect millions globally, including healthcare workers and patients.

"A key feature of the programme is the ability to upskill healthcare workers, particularly IPC focal points, not only in the delivery of the IPC simulation but also in providing general IPC education and facilitating the programme itself," explained Mr Rolly Viga, National IPC Coordinator at MHMS. "This ensures that the programme can be developed and used nationwide, utilising the expertise of local staff and creating a robust local network of IPC experts," he added.

The module involves using trained IPC healthcare workers acting as simulated patients with infectious diseases, while trained IPC facilitators observe the care provided to them in the health facility. These real-time observations allow for immediate feedback to improve IPC practices.

Following the mission in Makira province, the WHO team met with local officials including the Premier of Makira Uluwa Province, the Honourable Stanley Siapu, Minister of Finance, the Honourable Silas Wagatora, Minister for Health, the Honourable Donald Tahani, and the Director of Provincial Health, Mr John Harara. They expressed Makira province's commitment to protecting health workers and patients.

Empowering the national health workforce

In addition to improving IPC practices, the programme also aims to empower national health workforce.

"WHO is committed to helping the Solomon Islands continually improve the standard of health care delivery nationwide," stated Dr Howard Sobel, WHO Representative in the Solomon Islands. "This IPC programme is one of the three priority programmes in our Country Office, supporting Solomon Islands health facilities to become safer, greener, and climate resilient. IPC is central to improving water, sanitation and hygiene (WASH), environment hygiene, and quality of care. We are committed to supporting MHMS to improve IPC through a strengthened health systems approach."

A collaborative approach

The COVID-19 pandemic underscored the need for stronger IPC measures in health facilities. In response, the module was developed in late 2023 and rolled out across three major hospitals over a three-week period in July 2024, with a focus on scaling it for nationwide implementation.

"Our approach is not just a single intervention, but a multi-stakeholder collaboration built on the commitment of healthcare professionals," said Dr Zhao Li, Technical Officer for Infection Prevention and Control in the WHO Regional Office for the Western Pacific. "We have tailored a simulation exercise that is adaptable to local contexts, aiming to identify tangible and practical improvement actions. It also builds local IPC expertise, empowering teams to conduct routine simulation-based assessments, coaching, and quality improvement initiatives. This makes these practices an integral part of the healthcare systems."

Plans are underway to expand this simulation-based learning approach in more hospitals in the country, as well as in other countries in the Western Pacific Region.

"With more countries set to adopt this approach, we believe they will embrace this systems-based approach to quality and safety improvements, placing IPC principles at the core of clinical services, leading to better health outcomes across the region," said Dr Shogo Kubota, Coordinator, WHO Regional Office for the Western Pacific.

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