Background:
Environmental cleaning is essential to effective IPC, especially in African healthcare settings where healthcare-associated infections (HAIs)—including those from multidrug-resistant organisms (MDROs)—remain prevalent. Strengthening cleaning practices through a multimodal strategy can significantly reduce HAIs and enhance patient safety.

Objective:
To examine the application, challenges, and opportunities of multimodal environmental cleaning strategies in African contexts and their role in advancing sustainable IPC practices.

Methodology:
This presentation synthesizes evidence from peer-reviewed studies, global best practice guidelines, and implementation experiences across LMICs, including pilot programs and case studies.

Key Components of the Multimodal Strategy:

System Change: Addressing infrastructure gaps and ensuring consistent availability of cleaning supplies.

Training and Education: Developing competency-based, context-relevant training for cleaning staff.

Monitoring and Feedback: Utilizing feasible tools like fluorescent markers and checklists to audit and improve cleaning performance.

Reminders and Communication: Reinforcing practices through visual cues and leadership modeling.

Safety Climate and Culture Change: Elevating the role of cleaners, improving occupational safety, and integrating environmental hygiene into IPC frameworks.

Challenges:
Resource constraints, limited training, poor staff recognition, and disconnects between cleaning teams and IPC committees hinder effective implementation.

Innovations:
Integration with WASH programs, context-specific behavior change strategies, leadership engagement and inclusivity, and empowerment of cleaning staff through IPC champions.

Conclusion:
Multimodal environmental cleaning strategies, when adapted to local realities, offer a cost-effective path toward safer healthcare systems in Africa. Prioritizing environmental hygiene is critical to IPC success and AMR containment.