The role of civil society in strengthening the evidence base and addressing healthcare-associated infections in community settings in Africa
Healthcare-associated infections (HAIs) are too often thought of as a challenge confined to tertiary hospitals — but in African community settings, they manifest in myriad forms: at rural clinics, during home births, through informal caregiving, and via unregulated pharmacies and healthcare settings. These infections amplify health inequities, fuel antimicrobial resistance (AMR), and erode trust in health systems. Civil society has a pivotal and underappreciated role in filling critical gaps: by generating grassroots data, mobilizing action, building capacity, and advocating for systems-level change.
Civil society organizations (CSOs) provide contextualized surveillance. National HAI surveillance systems frequently exclude community-level data, especially in marginalized settings. At Afrihealth Optonet Association, we have witnessed how community-based NGOs, grassroots networks, and faith-based organizations can collect real-time, on-the-ground data on suspected infections, antibiotic usage, and patient outcomes in primary health posts, traditional birth centres, and homes. By collaborating with academic institutions, CSOs can standardize reporting tools and contribute to robust, locally relevant datasets that governments can leverage to design risk-responsive interventions.
Beyond data collection, CSOs play a vital role in behavior change and health education. Evidence is worthless if it remains confined to academic articles. Civil society is uniquely skilled at converting research insights into culturally resonant messages that can be understood by community health workers, traditional healers, caregivers, and patients alike. Through peer education, participatory training, and community dialogues, CSOs can advance practices like appropriate hand hygiene, safe delivery protocols, wound care, and rational use of antibiotics—measures that are foundational to infection prevention and control (IPC).
CSOs accelerate capacity building and innovation. Many community health settings in sub-Saharan Africa lack critical infrastructure such as safe water, sterilization tools, personal protective equipment, and trained personnel. Civil society can fill these gaps by organizing low-cost training programs for health workers, mobilizing resources for essential IPC supplies, and piloting appropriate technologies. For example, deploying solar-powered autoclaves, community-managed hand-washing stations, or low-cost diagnostic tools can be instrumental in reducing infection risks in under-resourced areas.
Civil society also serves as a watchdog and advocate. By leveraging the data they collect and the lessons they learn, CSOs are in a strong position to lobby government bodies, engage regulatory agencies, and elevate IPC and AMR onto national health agendas. Their advocacy can generate vital budget allocations for community-level IPC, push for stronger oversight on antibiotic dispensing, and demand the inclusion of community infection indicators in national health strategies. Moreover, as trusted voices embedded in communities, CSOs can represent marginalized or rural populations in multi-stakeholder forums, ensuring that policy reflects lived realities.
Ultimately, civil society fosters sustainable research partnerships. At Afrihealth Optonet Association (AHOA), we champion collaborative research that centres local priorities, ensures ethical engagement, and reinforces local capacity. By linking community partners with universities, donors, and professional groups, AHOA helps to create lasting infrastructure for research and action. Civil society can also ensure that interventions reach underserved populations like informal settlements, refugee communities, and rural zones, thereby promoting equity in infection prevention.
In conclusion, addressing healthcare-associated infections (HAI) in African community settings demands more than hospital-focused approaches. Civil society organizations bring proximity, legitimacy, adaptability, and advocacy, which are indispensable for generating actionable evidence, driving behavior change, building capacity, and influencing policy. Strengthening and resourcing the role of civil society is not a peripheral concern, but a central commitment to safeguarding public health, preserving antimicrobial effectiveness, and building resilient, equitable health systems mostly across Africa and the developing world.
Dr. Uzodinma Adirieje, FAHOA
Global Health and Dev’t Projects Consultant | Conferences Organizer | Trainer| Facilitator | Researcher | M&E Expert | Civil Society Leader | Policy Advocate
CEO & Perm. Rep., Afrihealth Optonet Association (AHOA) – CSOs global Network & Think-tank
�� �� +2348034725905 / ✉️afrepton@gmail.com / ceo@afrihealthcsos.org /
X: twitter.com/druzoadirieje
�� https://www.afrihealthcsos.org, https://druzodinmadirieje.blogspot.com
LinkedIn: https://ng.linkedin.com/pub/dir/Dr.+Uzodinma/Adirieje
HIFA Profile: Dr. Uzodinma Adirieje is a leading voice in health education, community health, and advocacy, with decades of experience advancing people-centered development across Africa and beyond. His approach to health education emphasizes participatory learning, knowledge transfer, and behavior change communication, ensuring that individuals and communities gain the skills and awareness to make informed decisions about their health. He develops and delivers innovative health promotion strategies tailored to local realities, particularly in resource-limited settings. In community health, Dr. Adirieje has championed integrated primary health care, preventive medicine, and grassroots health initiatives. Through Afrihealth Optonet Association (AHOA), which he leads, he connects civil society, community groups, and health institutions to strengthen healthcare delivery, tackle health inequities, and improve access to essential services for vulnerable populations. His work addresses infectious diseases, maternal and child health, nutrition, climate and health, environmental health, and emerging public health challenges. As a passionate advocate, Dr. Adirieje works with governments, NGOs, and international organizations to influence health policy, mobilize resources, and promote sustainable development goals (SDGs). He amplifies community voices, ensuring that health systems are inclusive, accountable, and responsive. His advocacy extends beyond health to governance, environment, and social justice, positioning him as a multidisciplinary leader shaping healthier and more equitable societies. afrepton AT gmail.com