Global Scaling of a Surgical Infection Prevention Program to 5 Low-Resource Countries

A new multi-country study has demonstrated the powerful impact of Clean Cut,  a surgical infection prevention program first developed in Ethiopia. Published in JAMA Network Open, the study shows that the program can be successfully scaled across diverse health systems, reducing surgical site infections (SSI) and strengthening adherence to critical safety practices. 

Between 2021 and 2024, the program was implemented in hospitals in Liberia, Madagascar, Rwanda, Malawi, India, and Bolivia. Local teams were trained by clinicians who had previously led the program in Ethiopia, ensuring knowledge transfer and building capacity within each setting. The study followed 1,865 patients from their initial operation through discharge and up to 30 days post-surgery. 

The results were striking. Surgical site infection rates fell from 28.4% at baseline to 12.1% after implementation, cut by more than half. Hospitals also recorded significant improvements in six essential infection prevention standards: 

• Use of the WHO Surgical Safety Checklist 

• Appropriate hand and skin antisepsis 

• Timely antibiotic administration 

• Instrument reprocessing 

• Maintenance of the sterile field 

• Complete gauze counting 

The study confirms not only the effectiveness of the program but also its scalability across low- and middle-income country contexts. By prioritizing hands-on training and peer-to-peer knowledge sharing, the model provides a roadmap for expanding lifesaving surgical safety practices globally. 

Read this publication here: Global Scaling of a Surgical Infection Prevention Program to 5 Low-Resource Countries