Abstract

Healthcare-associated infections (HAIs) remain a significant cause of morbidity, mortality, and healthcare costs in tertiary hospitals, particularly in low- and middle-income settings where infection prevention and control (IPC) practices are inconsistently applied. Despite the availability of international and national IPC guidelines, compliance among healthcare workers is often suboptimal due to structural, behavioral, and organizational challenges. This proposes a multidimensional framework designed to strengthen IPC compliance in tertiary hospitals by addressing governance, workforce behavior, infrastructure, monitoring systems, and community engagement in an integrated manner. The framework emphasizes a systems-level approach, highlighting the interactions among hospital leadership, clinical staff, patients, and ancillary services. Policy and governance components provide legal mandates, protocols, and oversight mechanisms to ensure adherence, while workforce development focuses on continuous training, competency assessment, and behavioral interventions to promote a culture of safety. Infrastructure and resource management ensure the availability of personal protective equipment, hand hygiene facilities, sterilization equipment, and isolation rooms necessary for effective IPC. Monitoring and evaluation are facilitated through digital and paper-based systems, enabling real-time compliance tracking, feedback loops, and data-driven decision-making. Patient and community engagement further reinforce IPC practices by raising awareness, reducing infection-related stigma, and encouraging active participation in preventive measures. Implementation strategies include pilot testing, capacity building, strategic partnerships, phased scaling, and continuous evaluation, ensuring that the framework is both contextually appropriate and sustainable. By integrating these components, the framework provides a structured and actionable roadmap for tertiary hospitals seeking to enhance IPC compliance and reduce the incidence of HAIs. This multidimensional approach offers a practical pathway to improve healthcare quality, patient safety, and operational efficiency, addressing both systemic and human factors that influence IPC adherence.