Identifying indicators and targets for the new World Health Organization global framework on infection and prevention and control : an e-Delphi study

Abstract

Background: The World Health Organization (WHO) recently developed the global action plan (GAP) and monitoring framework (MF) for Infection Prevention and Control (IPC). An e-Delphi survey was conducted as part of a consultative process to achieve consensus on IPC MF indicators and targets. Methods: The study was conducted as an e-Delphi consensus-seeking exercise, with two rounds of sequential surveys. In round 1 participants were asked to assess each indicator and target using a 5- point Likert scale, and in round 2 to re-assess those that did not reach consensus and to rank all indicators and targets in priority order. “Consensus” was defined when >70% of the responses fell within the two positive extreme ranges of the scale and < 5% of the responses fell within the two negative extreme ranges. Findings: 86 country representatives along with experts from 63 countries participated in the initial draft IPC MF development. The e-Delphi study invited 394 participants, with response rates of 36% (142/394) in round 1 and 69% (98/142) in round 2. Of the 134 indicators and 27 targets included in round 1, all but one achieved consensus, and 16 showed >5% level of disagreement. In round 2, three indicators were rejected and participants ranked the top ten global targets and top five national targets. The survey showed strong support for improving IPC surveillance, whilst research ranked lower due to other competing priorities. Conclusion: A high level of agreement on the proposed indicators and targets to be monitored by all countries to track progress in IPC was achieved through a strong consensus building process. The WHO IPC GAP and MF was adopted by all countries during the 77th World Health Assembly in May 2024.