A recent assessment of infection prevention adn control (IPC) practices in Indonesian hospitals reveals significant advancements in safeguarding patient well-being and elevating the standard of care. The evaluation, conducted between November 18 and December 11, 2024, by the Indonesian Ministry of Health (moh) with support from the world Health Association (WHO), indicates that 80% of the hospitals assessed have achieved advanced performance levels across at least five of the eight core IPC components.

Infection Prevention and Control (IPC) is a cornerstone of modern healthcare, employing evidence-based strategies to shield both patients and healthcare workers from preventable infections. Without robust IPC measures, healthcare-associated infections (HAIs) can lead to prolonged hospital stays, long-term disabilities, increased antimicrobial resistance (AMR), greater financial strain on patients and healthcare systems, and, tragically, avoidable deaths. The rise of antibiotic-resistant “superbugs” in American hospitals underscores the critical importance of effective IPC programs. According to the CDC, HAIs result in tens of billions of dollars in added healthcare costs annually in the U.S. alone, highlighting the economic impact of these infections.

Globally, the burden of HAIs is ample.

Out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one health care-associated infection (HAI) during their hospital stay. On average,1 in every 10 affected patients will die from their HAI.

The situation echoes concerns within the U.S. healthcare system, where HAIs remain a persistent challenge despite stringent regulations and guidelines. The CDC estimates that on any given day, about one in 31 hospital patients has at least one healthcare-associated infection.

IndonesiaS Commitment to Patient Safety

In Indonesia, the enhancement of patient safety, including IPC, is a paramount objective. This commitment is reflected in the nation’s Health Transformation Agenda, the Medium-Term National Progress Plan (RPJMN) 2025–2029, and the broader aspiration of achieving universal health coverage (UHC). The implementation of IPC measures is governed by Minister of Health Regulation No. 27 of 2017, which lays out the foundational standards for IPC practices within hospitals and other healthcare settings. Furthermore, IPC is a critical benchmark for hospital accreditation across the country.

Assessment Highlights Progress and Identifies Gaps

The joint MoH and WHO evaluation, utilizing the WHO Infection Prevention and Control Assessment Framework, revealed encouraging outcomes. Eight out of the ten hospitals evaluated were classified as “Advanced,” while the remaining two were designated as “Intermediate” due to specific shortcomings in surveillance, antimicrobial stewardship, and leadership support. Notably, no hospitals were categorized as “Basic” or “Inadequate,” indicating significant overall progress.

However, the assessment also highlighted disparities. Hospitals in urban centers and those under private or military management generally exhibited stronger IPC performance, attributable to more robust funding and greater institutional commitment. Conversely,rural hospitals,especially those in disadvantaged,border,and remote regions,faced considerable challenges stemming from limited resources and a shortage of trained personnel. This mirrors concerns in the U.S.,where rural hospitals often struggle with similar resource constraints,impacting their ability to implement thorough IPC programs.

Indonesia has made great strides in infection prevention, but hospitals need more support, especially public hospitals.

Dr. Irna Lidiawati, MARS, Chairperson of the Healthcare Quality Enhancement Team for Hospitals and Primary Care Units, MoH

Dr. Lidiawati further emphasized the importance of ongoing investment, stating,

Strengthening surveillance and improving access to microbiology services will be key priorities.

Key Recommendations for Improvement

The monitoring and evaluation initiative encompassed self-assessments, site visits, and interviews with hospital leadership and frontline staff.A primary advice is to broaden the scope of HAI surveillance and ensure that all hospitals, particularly public hospitals, have access to microbiology services. This echoes the CDC’s emphasis on robust surveillance systems to track and prevent the spread of infections in U.S. hospitals.

The report also advocates for enhanced IPC training, greater leadership engagement, and stronger integration of IPC compliance into hospital accreditation processes.These measures are expected to improve overall hospital performance and reinforce Indonesia’s contribution to global health security. The Joint Commission, a leading accrediting body in the U.S., also places significant emphasis on IPC standards as part of its accreditation process.

infection prevention and control is essential for resilient health systems, and is at the heart of patient safety.

Prof. Roderick Salenga, WHO Indonesia Team Lead for Health Systems

Prof. Salenga added,

Indonesia’s progress is commendable, but continued efforts are needed so that every hospital, irrespective of location, can implement effective IPC measures, for optimal patient outcomes. WHO remains committed to supporting Indonesia in this endeavour.

Looking Ahead

the assessment represents a significant step forward in strengthening IPC in Indonesia. the next critical phase involves finalizing reports and incorporating the findings into national IPC policies. This will build upon the current momentum,fostering safer healthcare environments for all Indonesians.the U.S. can learn from Indonesia’s commitment to IPC, especially in addressing disparities in resource allocation and ensuring that all hospitals, regardless of location or funding, have the tools and training needed to prevent infections.

Comparative Analysis: IPC in Indonesia and the United States

while Indonesia is making strides in improving IPC, comparing its approach to that of the United States can offer valuable insights. The table below highlights key differences and similarities in their respective IPC strategies: