Heroes of Infection Prevention 2019
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Resourcefulness and Commitment Defeat Neonatal Sepsis
Nkwan Jacob Gobte, BSN, MPH
Banso Baptist Hospital, Cameroon Baptist Convention Health Services
Kumbo Bui, Cameroon
Working within the confines of extremely limited resources and technology, Nkwan Jacob Gobte created a program that dramatically reduced neonatal sepsis at his medical facility and now benefits hospitals in multiple, neighboring countries.
Prior to Gobte’s 2002 appointment to the infection preventionist role at Banso Baptist Hospital (BBH) in Cameroon, the hospital experienced multiple, annual outbreaks of neonatal sepsis, an infection closely associated with poor hand hygiene. Gobte had to start from scratch to tackle the problem. “No one knew about infection prevention except me, and there were no data, so I started by conducting an assessment,” he said.
Gobte identified multiple causes for BBH’s neonatal sepsis rates. Handwashing facilities were unavailable or inaccessible for non-physician staff. Infants shared supplies, including Vaseline, soap and bath basins. Staff were using improperly diluted chlorine to disinfect surfaces and tubs. The resulting prevalence of neonatal sepsis at BBH was 86 percent.
Gobte launched a multimodal intervention program that included removing shared bathing items and adding multiple handwashing stations for all staff. When handwashing levels were still insufficient, Gobte found a way to make alcohol-based hand rub available throughout BBH. “Initially we relied on handrub from U.S. doctors,” he said. “Then we figured out how to make it internally. Now we’ve scaled up and centralized handrub manufacturing for multiple centers.”
Finally, Gobte conducted extensive training and education to create consistent behavioral change. By 2006, the neonatal sepsis rate at BBH had declined dramatically.
In 2017, Gobte implemented the Global Handwashing framework, an international strategy to promote handwashing as key to health and development. His handrub program has now been adopted in multiple countries. Despite the scale and impact of his work, Gobte sums up his success very simply: “If you quit, you can’t win,” he said. “If you have to win, you must be consistent and persistent.”