National Healthcare-Associated Infections Surveillance & Response Strategic Plan 2025–2030

Objectives

The National Healthcare-Associated Infection Surveillance and Response Strategic Plan 2025–2030 provides Pakistan with a unified framework to establish a sustainable, standardised and integrated surveillance system for healthcare-associated infections. It seeks to reduce preventable infections, associated morbidity and mortality, antimicrobial resistance and wider societal costs, while improving patient safety, quality of care, health-system resilience and national health security.[1][2][3][4]

• Build a resilient health system able to prevent, prepare for, detect and respond promptly to healthcare-associated infections across all levels of care, including during outbreaks and other emergencies.[2][5][6]
• Strengthen national governance, leadership, coordination and regulatory oversight for infection prevention and control and healthcare-associated infection surveillance and response.[7][8]
• Establish national and subnational infection prevention and control units, committees and focal points with clear authority, responsibilities and accountability.[8][9]
• Standardise surveillance methods, case identification, infection definitions, reporting and outbreak investigation to generate reliable and comparable data.[10][11][9]
• Integrate healthcare-associated infection surveillance with antimicrobial resistance monitoring, laboratory networks and Integrated Disease Surveillance and Response.[2][12][13]
• Increase healthcare-facility and laboratory capacity, including microbiological diagnosis, sample transport, quality assurance, water, sanitation and hygiene, isolation and sterilisation services.[7][9][12]
• Develop a sustainable workforce through needs-based, standardised training, certification, mentorship, supervision and professional networks for relevant healthcare cadres.[2][12]
• Use interoperable digital systems, mobile reporting, real-time dashboards, cloud-based platforms and automated or artificial intelligence-supported analytics to improve data flow, early detection, outbreak prediction and decision-making.[6][12][13]
• Promote preventive behaviours and patient-centred infection prevention and control practices that protect patients, healthcare workers, families, visitors and communities.[5][4]
• Advance from minimum World Health Organization infection prevention and control requirements towards full implementation of the World Health Organization core components at national and facility levels, consistent with International Health Regulations (2005) expectations.[11][2]

Implementation

Implementation follows a phased five-year model spanning national, provincial or regional, district and healthcare-facility levels. The Ministry of National Health Services, Regulations and Coordination provides national policy leadership and coordination, while the National Institute of Health, provincial health departments, facilities, laboratories and partners support delivery adapted to local needs within nationally consistent standards.[1][14][5]

• Apply the plan in federal and provincial teaching hospitals, primary and secondary facilities, private facilities and other providers of healthcare or healthcare-related services.[5]
• Support provincial ownership by enabling provinces to design and implement locally appropriate programmes, while retaining federal responsibility for technical assistance, policy development, national coordination and equitable resource allocation.[5]
• Establish or strengthen dedicated infection prevention and control programmes, staffing, budgets, units or cells, focal persons, steering committees and technical working groups at relevant administrative and facility levels.[7][8]
• Develop surveillance and response guidelines, standard operating procedures for investigations, reporting protocols, standardised data-flow mechanisms and digital reporting tools, including designated staff in high-risk clinical areas.[9]
• Conduct routine hospital-based surveillance, periodic point-prevalence surveys, infection-control audits, supportive supervision, data-quality reviews, outbreak investigations and response drills.[13][3]
• Strengthen microbiology laboratories through infrastructure upgrades, diagnostic supplies, sample collection and transport systems, inter-laboratory linkages, and internal and external quality assessment.[9][12]
• Deliver structured workforce development through competency assessments, curricula, master trainers, training rosters, refresher learning, mentorship and supervision.[12]
• Coordinate public and private health facilities, clinical departments, laboratories, public health authorities, professional bodies, communities, patient advocacy groups, veterinary and agricultural sectors, development partners and technical agencies.[7][13]
• Build on existing assets, including national infection prevention and control guidelines, focal points, sentinel sites, a national surveillance dashboard and data centre, District Health Information Software 2, tertiary-hospital microbiology laboratories and international technical support.[6][7][8][13]
• Address fragmented information systems, underreporting, data-quality and privacy concerns, weak enforcement and ownership, infrastructure deficits, shortages of trained personnel and insufficient dedicated resources.[14][6][7][8]
• Monitor implementation through performance indicators, audits, supervision, timely feedback, reporting to facilities and policymakers, and transparent use of findings for corrective action.[6][13][3]
• Mobilise sustainable domestic financing for infection prevention and control continuity, essential commodities, training and capacity-building, supplemented where appropriate by donor and development-partner investment. The plan-development process received Global Fund support through the Common Management Unit for AIDS, Tuberculosis and Malaria under the C19RM project, while the Fleming Fund provided two full-time consultants to the National Institute of Health infection prevention and control team.[6][3][15]

The supplied text identifies global monitoring ambitions for countries with national surveillance systems for healthcare-associated infections and related antimicrobial resistance of 30% by 2026, 50% by 2028 and more than 80% by 2030. It does not provide a quantified national budget, detailed financing schedule, indicator definitions, reporting frequencies or a complete accountability matrix.[11][13][3]

Monitoring & Evaluation

The plan envisages a standardised, integrated national healthcare-associated infection (HAI) surveillance and response system for 2025–2030, designed to improve detection, recording, reporting, analysis, prevention and outbreak response across all levels of care.[1][2]It links HAI surveillance to infection prevention and control (IPC), antimicrobial resistance (AMR) monitoring, laboratory networks and Integrated Disease Surveillance and Response.[2][13]

• Establish standardised surveillance procedures, including uniform case identification, case definitions and reporting protocols. HAI identification is intended to use clinical, microbiological and radiological evidence and a defined timeframe, generally 48 hours after admission.[14][11]
• Deploy interoperable electronic reporting systems, including District Health Information Software 2, mobile data collection, real-time dashboards and automated analytics to improve data timeliness, accuracy, predictive analysis and outbreak response.[12][13]
• Strengthen laboratory confirmation through upgraded microbiology infrastructure, sample collection and transport systems, diagnostic supplies, laboratory networks, and internal and external quality assessment.[9][12]
• Conduct routine hospital-based surveillance, periodic point-prevalence surveys, infection-control audits, outbreak investigations and response protocols to measure burden, identify high-risk populations and procedures, and assess IPC interventions.[10][3]
• Monitor IPC implementation, including hand hygiene, water, sanitation and hygiene compliance, isolation and sterilisation standards, injection and infusion safety, and reporting by healthcare facilities.[7]

Monitoring and evaluation are to be embedded in governance and operational delivery. The framework calls for supervision at national, provincial, district and facility levels; routine supportive supervision; data-quality audits; regular analysis; prompt feedback to facilities and decision-makers; and performance reviews that support corrective action.[9][13][3]Training performance is to be assessed through competency assessments and performance indicators.[12]

• Define responsibilities and mandates for national and subnational IPC units, committees, technical working groups and focal persons, supported by regulatory enforcement and compliance monitoring.[7][8]
• Use performance indicators, regular audits and transparent data collection and reporting to strengthen compliance, trust and continuous improvement.[6]
• Maintain surveillance during emergencies through flexible protocols, system redundancies and preparedness arrangements for outbreaks and natural disasters.[5][6]
• Disseminate surveillance findings to healthcare workers and decision-makers to inform public health measures and IPC action.[15][9]

The plan references a global IPC monitoring framework target for countries with national HAI and related AMR surveillance systems: 30% by 2026, 50% by 2028 and more than 80% by 2030.[11]It also aims for a fully functional, standardised and sustainable national HAI surveillance system by 2030.[14]The supplied text does not provide a complete indicator dictionary, numeric national targets beyond these milestones, reporting frequencies, evaluation timetable or detailed accountability matrix.[1][13]

Implementation must address major information and assurance risks, including underreporting, poor data quality, lack of standardised methods, differing provincial health information systems, data-privacy concerns, limited monitoring capacity and resistance to HAI reporting.[10][7][8]Existing national dashboard and data-centre capacity, piloted surveillance in some hospitals, and digital-platform expansion provide assets for scale-up.[7][8]

Costing & Financing

Costing detail is limited. The plan identifies sustained financing, dedicated staff and recurrent investment as necessary to establish and maintain HAI surveillance, IPC programmes, laboratory capacity, digital systems, essential commodities and workforce development, but it provides no quantified total budget, activity-level costings, financing schedule or monetary funding-gap estimate.[6][9][12]

• Secure sustainable domestic financing to maintain IPC activities during emergencies and ensure continuity of surveillance and response.[6]
• Provide dedicated funding for essential commodities, staff, training and capacity-building at national, provincial and health-facility levels.[6][7]
• Invest in laboratory infrastructure, diagnostic supplies, information technology, electronic data systems and surveillance workforce capacity.[9][12]
• Mobilise donor and development-partner investment for IPC capacity-building, surveillance infrastructure and workforce development, aligned with national priorities.[3][4]

Financial support for development of the strategic plan was provided by the Global Fund through Pakistan’s Common Management Unit for AIDS, Tuberculosis and Malaria under the C19RM project.[15]The Fleming Fund also provided two full-time consultants to the National Institute of Health IPC team and supported drafting and final review.[15]

The financing context includes insufficient IPC resources, dedicated staff and budgets, alongside wider constraints in human resources, laboratory capacity, technical expertise and infrastructure.[10][6][7]International funding support is identified as a possible enabling factor, while economic challenges, political instability, weak infrastructure and facility resistance may threaten implementation.[8]No economic assumptions, unit costs, cost-effectiveness analysis, funding allocations or quantified domestic and external financing commitments are specified in the supplied text.[7][8]