SARS and Kiribati: eyes wide open
A comprehensive infection prevention and control programme (IPCP) is designed to control and prevent thetransmission of infectious diseases within the healthcare environment and the community. Understanding howan IPCP is introduced within a health system can inform actions to encourage their adoption in other locations.This paper explores the adoption stages of an IPCP in a specific case situation of SARS.Data sources and analysis included: 1) Chronological and thematic analysis of IPCP documentation andassessments performed by local staff and external agencies/consultants, and 2) semi-structured interviews withlocal key informants and external agencies (using snow-ball sampling) with thematic analysis. Analysis wasperformed according to Everett Rogers Diffusion of Innovations for Organisations framework.The two key activities of the organisational innovation process were identified. These were: initiation andimplementation. The initiation activity included: 1) agenda-setting: preparations for severe acute respiratorysyndrome (SARS) in 2003 stimulated the identification of organisational IPCP deficits, and 2) matching: deficitswere identified and the decision to adopt an IPCP innovation package was made. Implementation included:a) redefining/restructuring: identification of the components of an IPCP and how they best fit within the localhealth structure, b) clarifying: integration of IPCP into the health services and defining an infection control rolewithin the nursing division and, c) routinising: the IPCP became an ongoing element in health service delivery. The adoption of the IPCP followed the classic Diffusion of Innovations Process for Organisations. The casestudy described serves as an example of IPCP adoption model in other low- and middle-income healthcaresettings and suggests ways to utilise opportunities as they present.