title: Airborne infection control in India: Baseline assessment of health facilities.
abstract: BACKGROUND
  Tuberculosis transmission in health care settings represents a major public health problem. In 2010, national airborne infection control (AIC) guidelines were adopted in India. These guidelines included specific policies for TB prevention and control in health care settings. However, the feasibility and effectiveness of these guidelines have not been assessed in routine practice. This study aimed to conduct baseline assessments of AIC policies and practices within a convenience sample of 35 health care settings across 3 states in India and to assess the level of implementation at each facility after one year.
  
  
  METHODS
  A multi-agency, multidisciplinary panel of experts performed site visits using a standardized risk assessment tool to document current practices and review resource capacity. At the conclusion of each assessment, facility-specific recommendations were provided to improve AIC performance to align with national guidelines.
  
  
  RESULTS
  Upon initial assessment, AIC systems were found to be poorly developed and implemented. Administrative controls were not commonly practiced and many departments needed renovation to achieve minimum environmental standards. One year after the baseline assessments, there were substantial improvements in both policy and practice.
  
  
  CONCLUSIONS
  A package of capacity building and systems development that followed national guidelines substantially improved implementation of AIC policies and practice.
authors.affiliation: National Professional Officer - Drug Resistant TB, World Health Organization - Country Office for India, New Delhi, India. Electronic address: parmarm@who.int.
authors.forename: Malik M
authors.initials: MM
authors.lastname: Parmar
authors.affiliation: Central TB Division, Ministry of Health and Family Welfare, New Delhi, India.
authors.forename: K S
authors.initials: KS
authors.lastname: Sachdeva
authors.affiliation: World Health Organization - Country Office for India, New Delhi, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Rade
authors.affiliation: World Health Organization - Country Office for India, New Delhi, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Ghedia
authors.affiliation: National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India.
authors.forename: Avi
authors.initials: A
authors.lastname: Bansal
authors.affiliation: Department of Community Medicine, ESIC Medical College & PGIMSR, Bangalore, India.
authors.forename: Sharath Burugina
authors.initials: SB
authors.lastname: Nagaraja
authors.affiliation: U.S Centers for Disease Control, Atlanta, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Willis
authors.affiliation: Doctoral Scholar, Tata Institute of Social Sciences, Mumbai, India.
authors.forename: Dyson P
authors.initials: DP
authors.lastname: Misquitta
authors.affiliation: World Health Organization - Country Office for India, New Delhi, India.
authors.forename: Sreenivas A
authors.initials: SA
authors.lastname: Nair
authors.affiliation: U.S Centers for Disease Control, Atlanta, USA.
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Moonan
authors.affiliation: Bill & Milanda Gates Foundation, India Country Office, India.
authors.forename: Puneet K
authors.initials: PK
authors.lastname: Dewan
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D006268:Health Facilities; D006801:Humans; D007194:India; D017053:Infection Control / Q000592:standards*; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission*
keywords: Airborne Infection Control (AIC); Health Care Facilities (HCF); India; Revised National Tuberculosis Control Program (RNTCP); Tuberculosis (TB)