A renovated handwashing station. Alcohol-based hand rub placed closer to patients. A cleaner operating room. Medical instruments packaged and stored more safely. These changes may seem small, but together they signal something bigger: infection prevention and control (IPC) knowledge moving from the classroom into routine hospital practice.
From December 2025 to May 2026, Cambodia’s Ministry of Health/ Department of Health Services (DHS), PATH, the Vietnam National Infection Prevention and Control Society (VNICS), and the World Bank worked with six provincial referral hospitals to strengthen IPC systems, workforce capacity, and implementation through a blended learning and mentorship model.
From standards to practice
Cambodia has made important progress on IPC. Its 2024 National IPC Guidelines provide a national policy and technical foundation, and the country has incorporated 35 IPC indicators into health care facility accreditation standards.
Yet assessments and hospital observations continued to identify gaps between standards and practice, particularly in hand hygiene, environmental cleaning, instrument reprocessing, IPC monitoring, and health care-associated infection (HAI) surveillance.
PATH and partners during a scoping visit to Cambodia’s Ministry of Health. Photo: PATH.
The project was designed to close this implementation gap, using a progressive, practice-oriented learning model that combined structured training with hospital mentorship and practical coaching. Rather than relying on classroom-based learning alone, the project combined e-learning with three rounds of face-to-face workshops and three rounds of hospital mentorship visits, creating a progressive learning pathway from knowledge to practical application.
IPC experts and hospital teams take part in a hands-on exercise during a practical training session. Photo: PATH.
Practical mentorship became a defining feature of the approach. Mentorship visits followed each face-to-face workshop, allowing IPC experts to work directly with hospital teams through hospital walkthroughs, practical coaching, monitoring practice, HAI surveillance exercises, and action planning. This helped link theory with real hospital practice—an element participants consistently identified as one of the most valuable components of the program.
IPC experts provide on-site mentorship and practical coaching to health workers at a provincial referral hospital. Photo: PATH.
The approach also evolved with participant feedback. Later rounds reduced lecture time and increased demonstrations, case studies, practical exercises, and mentorship-based learning. By Round 2, 89 percent of participants agreed that training had reduced theory and increased practical learning.
To further translate IPC standards into routine practice, PATH and partners developed a standardized IPC package comprising 22 standard operating procedures (SOPs), four monitoring checklists, eight practical posters, three terms of reference for key IPC roles, and a weekly planning tool for IPC focal points.
These resources cover priority areas ranging from hand hygiene and environmental cleaning to medical device reprocessing, isolation procedures, HAI surveillance, and monitoring. Alongside these tools, hospitals strengthened IPC committees and focal point roles, work planning, monitoring and surveillance, and collaboration across clinical departments, laboratories, and hospital leadership, helping embed IPC improvement within hospital systems rather than relying on individual knowledge alone.
The project’s blended learning approach combined structured e-learning, practical workshops, hospital-based mentorship, and tools to support IPC implementation. Photo: PATH.
From learning to measurable impact
The results were substantial. Average basic IPC knowledge scores increased from 74.6 percent to 93.5 percent, while advanced IPC scores more than doubled, from 42.5 percent to 90 percent. All participants improved their advanced IPC scores, including in areas such as HAI surveillance, environmental cleaning, instrument reprocessing, and IPC monitoring.
More importantly, knowledge translated into action. At Kampot Provincial Referral Hospital, teams expanded handwashing facilities and improved instrument packaging and storage. At Pursat Provincial Referral Hospital, teams strengthened environmental cleaning, equipment reprocessing, and operating room organization. At Kampong Chhnang Provincial Referral Hospital, teams introduced hand hygiene audits, placed alcohol-based hand rub at patient bedsides, and strengthened waste management and IPC monitoring. Across participating hospitals, improvements included expanded hand hygiene facilities, stronger environmental cleaning, better waste segregation and storage, improved instrument reprocessing, increased monitoring and supervision, and stronger IPC committees.
By the final evaluation, 62 percent of participants reported already applying IPC learning in their facilities, while 22 percent reported applying it regularly. 92.3 percent reported greater confidence in IPC implementation, and 96.2 percent recommended continuing or scaling up the program.
Evaluation highlights showing improvements in IPC knowledge, application of learning in health facilities, and support for continuation or scale-up of the program. Photo: PATH.
Building systems to sustain impact
Beyond improvements in individual hospitals, the project established a monitoring framework designed to move from accreditation compliance toward continuous improvement, tracking how IPC systems function in practice and linking routine practices with patient safety outcomes. The framework includes monitoring of hand hygiene, environmental cleaning and waste management, medical device reprocessing, and surgical site infection prevention, alongside a pathway toward more active HAI surveillance. It is also designed to progressively transition from project-supported expertise toward national IPC expertise, strengthening local capacity to sustain improvements over time.
The initial six provincial hospitals provide a foundation for this approach, with the framework outlining a pathway toward expansion across Cambodia’s 25 provincial hospitals.
The first phase points to a clear lesson: training builds knowledge, but impact comes when health workers can translate that knowledge into safer practice—and when stronger local systems can sustain those improvements. By combining structured learning with practical mentorship where care happens, Cambodia is building a locally led pathway from IPC standards to safer hospital practice, with a foundation for broader scale.
Watch how Cambodia’s health workers are turning IPC knowledge into safer hospital practice through practical learning and mentorship.