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Effectiveness of a Co-Created Multimodal Behavioural Change Model for Improving Infection Prevention and Control Practices Among Healthcare Workers in Conflict-Affected Goma, Democratic Republic of the Congo: A Quasi-Experimental Study


Authors : Akili Fataki Serge; Manaseh Bocha; Faith Chesire

Volume/Issue : Volume 11 - 2026, Issue 9 - September


Google Scholar : https://tinyurl.com/264afpvw

DOI : https://doi.org/10.38124/ijisrt/26sep450

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background: Nosocomial infections constitute a major threat to patients’ safety in low-resource contexts, where healthcare workers’ (HCWs’) limited knowledge of infection prevention and control (IPC) combined with poor working conditions and workload can exacerbate the risk of healthcare-associated infections. Few studies have investigated the effectiveness of co-created, context-specific, multimodal interventions to improve knowledge, attitudes, and practices (KAP) related to IPC in such settings.  Objective: We aimed to assess the effectiveness of a co-created, seven-component multimodal behavioural change model to improve IPC-related KAP among healthcare workers in three hospitals in Goma, Democratic Republic of the Congo.

Keywords : Infection Prevention and Control; Nosocomial Infection; Healthcare Workers; Co-Creation; Multimodal Strategy; Behaviour Change; Difference-in-Differences; Democratic Republic of the Congo.

References :

  1. Aghdassi, S. J. S., Schröder, C., Lemke, E., Behnke, M., Fliss, P. M., Gastmeier, P., & Kramer, T. S. (2020). A multimodal intervention to improve hand hygiene compliance in peripheral wards of a tertiary care university centre: A cluster randomised controlled trial. Antimicrobial Resistance & Infection Control, 9, Article 113. https://doi.org/10.1186/s13756-020-00776-9
  2. Alhumaid, S., Al Mutair, A., Al Alawi, Z., Alsultan, A. A., Alshadrawi, A., & Al-Omari, A. (2021). Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: A systematic review. Antimicrobial Resistance & Infection Control, 10, Article 86. https://doi.org/10.1186/s13756-021-00957-0
  3. Allegranzi, B., Tartari, E., Kilpatrick, C., & Pittet, D. (2022). Global infection prevention and control priorities 2021-2030. The Lancet Global Health, 10(7), e1049-e1050. https://doi.org/10.1016/S2214-109X(22)00209-2
  4. Asghar, S., Atif, M., Masood, I., & Khan, M. (2025). A comprehensive review of current status of infection prevention and control programmes in low- and middle-income countries. Infection, Disease & Health, 30(3), 260-283. https://doi.org/10.1016/j.idh.2025.03.005
  5. Bate, P., & Robert, G. (2006). Experience-based design: From redesigning the system around the patient to co-designing services with the patient. Quality and Safety in Health Care, 15(5), 307–310. https://doi.org/10.1136/qshc.2005.016527.
  6. Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). SAGE Publications.
  7. Demoze, L., Tesfaye, A. H., Asnake, A. A., Gebrehana, A. K., Kase, B. F., Asebe, H. A., Tigabie, M., & Yitageasu, G. (2026). Knowledge and practice towards healthcare-associated infection prevention among healthcare workers in East Africa: A systematic review and meta-analysis. Journal of Health, Population and Nutrition, 45, Article 77. https://doi.org/10.1186/s41043-026-01265-2
  8. Donetto, S., Tsianakas, V., & Robert, G. (2014). Using experience-based co-design to improve the quality of healthcare: Mapping where we are now and establishing future directions. King's College London.
  9. Dubiwak, A. D., Tadesse, M., Zewdie, B., Tiruneh, A., Diriba, T. A., Tesfaye, S., Assefa, A., Abebe, G., & Dadi, L. S. (2026). Knowledge, attitudes, and practices regarding infection prevention among healthcare professionals and their predictors at a tertiary hospital in Ethiopia: A cross-sectional study. Health Science Reports, 9(3), e71900. https://doi.org/10.1002/hsr2.71900
  10. Fincham, J. E. (2008). Response rates and responsiveness for surveys, standards, and the Journal. American Journal of Pharmaceutical Education, 72(2), Article 43.
  11. Fleiss, J. L., Levin, B., & Paik, M. C. (2003). Statistical methods for rates and proportions (3rd ed.). John Wiley & Sons.
  12. Gould, D. J., Moralejo, D., Drey, N., Chudleigh, J. H., & Taljaard, M. (2017). Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews, 2017(9), CD005186. https://doi.org/10.1002/14651858.CD005186.pub4
  13. Houghton, C., Meskell, P., Delaney, H., Smalle, M., Glenton, C., Booth, A., & Biesty, L. (2020). Barriers and facilitators to healthcare workers' adherence with infection prevention and control guidelines. Cochrane Database of Systematic Reviews, (1), CD013582. https://doi.org/10.1002/14651858.CD013582
  14. Igwe, U., Okolie, O. J., Ismail, S. U., & Adukwu, E. (2024). Effectiveness of infection prevention and control interventions in health care facilities in Africa: A systematic review. American Journal of Infection Control, 52(10), 1135-1143. https://doi.org/10.1016/j.ajic.2024.06.004
  15. Martín-Madrazo, C., et al. (2012). [Full citation to be confirmed by the author - not present in the source reference list; cited in the thesis discussion regarding a cluster-randomised hand-hygiene intervention in Madrid.]
  16. Nyawere, E., Saito, H., Ajok, R., Aber, B., Owori, F., & Pittet, D. (2026). World Health Organization multimodal improvement strategy for hand hygiene: A stepped-wedge cluster randomized trial. JAMA Network Open, 9(7), e2625250. https://doi.org/10.1001/jamanetworkopen.2026.25250.
  17. Office for the Coordination of Humanitarian Affairs. (2023). Democratic Republic of the Congo: Humanitarian needs and displacement overview, North Kivu. United Nations OCHA.
  18. Price, L., MacDonald, J., Gozdzielewska, L., Howe, T., Flowers, P., Shepherd, L., Watt, Y., & Reilly, J. (2018). Interventions to improve healthcare workers' hand hygiene compliance: A systematic review of systematic reviews. Infection Control & Hospital Epidemiology, 39(12), 1449-1456. https://doi.org/10.1017/ice.2018.262.
  19. Donati, D., Miccoli, G. A., Cianfrocca, C., Di Stasio, E., De Marinis, M. G., & Tartaglini, D. (2020). Effectiveness of implementing link nurses and audits and feedback to improve nurses' compliance with standard precautions: A cluster randomized controlled trial. American Journal of Infection Control, 48(10), 1204–1210. https://doi.org/10.1016/j.ajic.2020.01.017.
  20. Sonpar, A., Hundal, C. O., Totté, J. E. E., Wang, J., Klein, S. D., Twyman, A., Allegranzi, B., & Zingg, W. (2025). Multimodal strategies for the implementation of infection prevention and control interventions update of a systematic review for the WHO guidelines on core components of infection prevention and control programmes at the facility level. Clinical Microbiology and Infection, 31(6), 948-957. https://doi.org/10.1016/j.cmi.2025.01.011.
  21. Wubneh, C. A., Mekonnen, B. D., Alemu, T. G., Techane, M. A., Assimamaw, N. T., Belay, G. M., Tamir, T. T., Muhye, A. B., Kassie, D. G., & Wondim, A. (2024). Knowledge, attitude and practice of healthcare workers on infection prevention and control in Ethiopia: A systematic review and meta-analysis. PLOS ONE, 19(9), e0308348. https://doi.org/10.1371/journal.pone.0308348.
  22. World Bank. (2022). Democratic Republic of Congo: Population health strategy and inequality reduction. World Bank Group.
  23. World Health Organization. (2003). Guidelines on standard operating procedures for microbiology, sampling and health-workforce categorisation in health facility-based studies. WHO.
  24. World Health Organization. (2009). A guide to the implementation of the WHO multimodal hand hygiene improvement strategy. WHO. https://www.who.int/publications/i/item/a-guide-to-the-implementation-of-the-who-multimodal-hand-hygiene-improvement-strategy/.
  25. World Health Organization. (2016). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. WHO. https://www.who.int/publications/i/item/9789241549929.
  26. World Health Organization. (2021). Resource considerations for investing in hand hygiene improvement in health care facilities. WHO. https://www.who.int/publications/i/item/9789240025882.
  27. World Health Organization. (2022). Global report on infection prevention and control. WHO. https://www.who.int/publications/i/item/9789240051164.

Background: Nosocomial infections constitute a major threat to patients’ safety in low-resource contexts, where healthcare workers’ (HCWs’) limited knowledge of infection prevention and control (IPC) combined with poor working conditions and workload can exacerbate the risk of healthcare-associated infections. Few studies have investigated the effectiveness of co-created, context-specific, multimodal interventions to improve knowledge, attitudes, and practices (KAP) related to IPC in such settings.  Objective: We aimed to assess the effectiveness of a co-created, seven-component multimodal behavioural change model to improve IPC-related KAP among healthcare workers in three hospitals in Goma, Democratic Republic of the Congo.

Keywords : Infection Prevention and Control; Nosocomial Infection; Healthcare Workers; Co-Creation; Multimodal Strategy; Behaviour Change; Difference-in-Differences; Democratic Republic of the Congo.

Paper Submission Last Date
30 - September - 2026

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