R E S E A R C H N OT E Open Access © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit ​h​t​​​​t​p​:​/​/​c​r​e​​a​​​t​i​ v​e​​c​​o​​m​​m​​o​n​s​.​o​r​g​/​l​i​c​e​n​s​e​s​/​b​y​-​n​c​-​n​d​/​4​.​0​/​​​​​.​​​ Darboe et al. BMC Research Notes (2025) 18:43 https://doi.org/10.1186/s13104-025-07101-w BMC Research Notes *Correspondence: Godsway Edem Kpene kpene96@gmail.com Full list of author information is available at the end of the article Abstract Background  This study evaluated Health Care Workers’ (HCWs) knowledge, attitude, perceived compliance, and potential influencing factors related to Infection Prevention and Control (IPC) standards in the North Bank East region of The Gambia. Method  The study was an analytic cross-sectional study, conducted in 2021 using a multistage sampling technique. Thirteen health facilities were sampled from the North Bank East Region of The Gambia. The sample size was calculated using the Cochrane formula, based on a healthcare worker population of 408, with a 95% confidence interval. Adjustments were made for a 10% non-response rate and a compliance level of 50%. A final sample size of 218 was used for the study. Descriptive statistics, chi-square, and logistic regression were done at a 95% confidence limit and an alpha level of 0.05. A p-value of 0.05 was considered statistically significant. Results  Among the 218 healthcare workers, the majority demonstrated adequate knowledge (86.24%) and a positive attitude (78.4%) toward Infection Prevention and Control (IPC). About half (50.5%) of the HCWs did not comply with IPC standards. Good attitude of HCWs [aOR = 3.13, 95%CI: 1.17–8.41, p-value = 0.023], accessibility of Personal Protective Equipment [aOR = 2.34, 95%CI: 1.01–5.38; p-value = 0.046], and monitoring of IPC practice [aOR = 3.95, 95%CI: 1.84–8.45; p-value = < 0.001] were independently associated with HCWs perceived compliance with IPC standards. Conclusion  Although 188 (86.24%) HCWs displayed adequate knowledge of IPC standards, perceived compliance remains insufficient in Gambian healthcare facilities. To address this, the Ministry of Health should prioritize educational campaigns, and regular training to reinforce HCW knowledge, ensure Personal Protective Equipment (PPE) accessibility, and implement ongoing IPC practice monitoring among healthcare workers. Factors influencing healthcare workers’ perceived compliance with infection prevention and control standards, North Bank East region, The Gambia, a cross-sectional study Sheriffo M.K. Darboe1,2, Sandra A. Darfour-Oduro3, Godsway Edem Kpene4*, Abou Kebbeh1,2, Nuha Fofana1,2, Manjally Ndow5, Kawsu Sanyang1,6, Dwomoh Duah7, Alfred Edwin Yawson8, Ernest Kenu1,4 and Harriet Affran Bonful4 http://creativecommons.org/licenses/by-nc-nd/4.0/ http://creativecommons.org/licenses/by-nc-nd/4.0/ http://crossmark.crossref.org/dialog/?doi=10.1186/s13104-025-07101-w&domain=pdf&date_stamp=2025-1-30 Page 2 of 9Darboe et al. BMC Research Notes (2025) 18:43 Introduction Healthcare-associated infections (HAIs) are a serious global public health issue [1], leading to extended hos- pital stays, disabilities, increased antibiotic resistance, financial burdens, and higher mortality rates [2, 3]. Infec- tion prevention and control (IPC) measures are crucial for reducing HAIs in healthcare settings [4]. However, adherence to these standards is often poor, contributing significantly to HAI occurrences [5–9]. The Gambia integrates IPC across its healthcare sys- tem. The Ministry of Health sets national IPC policies, which are adapted and implemented at regional and facility levels. Health centers and hospitals enforce IPC measures such as hand hygiene, proper use of personal protective equipment, and waste management. Dur- ing the COVID-19 pandemic, a multi-sectoral National Health Emergency Committee was established to coor- dinate the response, supported by the WHO Representa- tive in The Gambia [10, 11]. Two key factors influencing compliance with IPC stan- dards are healthcare workers’ knowledge and attitudes. Knowledge provides the foundation for proper IPC implementation, while attitudes shape compliance behav- iours. Studies across African countries show varying lev- els of understanding and acceptance of IPC practices. For instance, Desta, et al. [12] found that 84.7% of HCWs were knowledgeable while only 57.3% of respondents demonstrated a good practice on IPC practice. A Nige- rian study reported that the median scores for knowl- edge and attitude toward standard precautions were both above 90%, while the median practice score was lower at 50.8% [13]. A Ghanaian study also found that positive attitudes toward IPC increased compliance with hand hygiene protocols [14]. However, in The Gambia, little is known of the attitude, knowledge and practice of IPC standards among HCWs. Hence, this study sought to assess HCWs’ attitude, knowledge and perceived compli- ance with IPC standards as well as potential influencing factors of perceived IPC compliance among HCWs in rural Gambia (North Bank East Region). Understanding these aspects is essential for developing effective behav- ioural change programs to improve IPC compliance and reduce the incidence of HAIs. Methods Study design An analytic cross-sectional study was employed to col- lect data from HCWs such as medical doctors, nurses, public health officers, laboratory personnel and others (orderlies, dental staff, physiotherapists, anaesthetists and laundry workers). Study setting The research was conducted among the HCWs in rural Gambia (North Bank East Region). North Bank East Region is one of the seven health regions in The Gam- bia with Kerewan as its Regional Headquarters. The region stretches from Kerewan to Palodi, covering 75 km. According to the 2013 census, the region had a popula- tion of 221,054 with a population density of 98 inh./km2 [15]. The region has one major health facility, and seven minor health facilities providing both preventive and curative medical services. In addition, there are five com- munity clinics, two service clinics, one NGO and one pri- vate clinic. Farafenni General Hospital, the only tertiary facility, serves as a referral point for all minor health facil- ities within the region. North Bank East region has a staff strength of 408 staff (36, 301, 36 and 35 from Sabach San- jal, Upper Baddibu, Central Baddibu and Lower Baddibu respectively). The staff include medical doctors, nurses (generals and midwives), public health officers, laborato- rians, orderlies, dental staff, physiotherapists, anaesthe- tists and laundry workers (Fig. 1). Sample size determination The assumption of 50% compliance was used to calculate the study’s sample size due to the lack of data regarding IPC standards compliance in The Gambia. Cochrane for- mula [16] was used to calculate the required sample size as follows: n = Z2 (p (1 − p)) e2 Z = 1.96, p = 0.5, e = 0.05. n = 384.16 = 385. The formula was adjusted, taking into account the finite study population of 408 healthcare workers as follows: [17] nf = n / {1+(n-1/N)} where n is Cochran’s sample size recommendation, N is the population size, and nf is the new, adjusted sample size. nf = 385 / {1+(384/408)} =197.8181 = 198. After adding 10% of the estimated sample size to cater for the non-response rate, the final estimated sample is 218. Keywords  Healthcare worker, Knowledge, Compliance, Healthcare-associated infection, Infection prevention and control standards, The Gambia Page 3 of 9Darboe et al. BMC Research Notes (2025) 18:43 Inclusion criteria Clinical staff and non-clinical staff whose jobs exposed them to blood and other bodily fluids during the cause of their work. Exclusion criteria Eligible staff who were on leave and those with work experience of less than 1 year were excluded. Sampling techniques A multistage sampling technique was used to sample at the regional, district and hospital levels. The North Bank East region is subdivided into four districts: Sabach San- jal, Upper Baddibu, Central Baddibu and Lower Baddibu. To minimize bias due to sampling error, HCWs were drawn from each health facility based on the proportion of its size to the target population. As such 19 out of 36, 161 out of 301, 19 out of 36 and 19 out of 35 HCWs were taken from Sabach Sanjal, Upper Baddibu, Central Badd- ibu and Lower Baddibu respectively. At the district level, all the health facilities in each district were included in the study. At the health facility level, a simple random sample was used to select HCWs. This was achieved by listing the names of eligible staff in each facility on a piece of paper and putting them in a box where the names were randomly picked without replacement. Data collection and tool Data were collected using an interviewer-administered questionnaire. These questionnaires were administered to 218 randomly selected HCWs in all healthcare facili- ties in the North Bank East Region. Before data collec- tion, research assistants were recruited, trained, and a questionnaire was pretested among fifteen (15) HCWs in three (3) health facilities in the North Bank West Region which has similar characteristics to the study site to identify any issues with question clarity, format, or flow before the full-scale study. The questionnaire was devel- oped based on the review of relevant literature [18–20] and was divided into three sections: Section A: captured sociodemographic data such as age, sex, work experience, level of education and staff category. Section B: individual factors affecting compliance with IPC standards, such as knowledge, IPC practice, level of exposure, and use of personal protective equipment (PPE). Section C: organizational factors that affect compliance with IPC standards, such as the availability of IPC guide- lines, accessibility of PPEs, supportive policies, monitor- ing IPC practice and workload. Study variables The dependent variable, perceived compliance with IPC standards, was measured using eight question items. HCWs reported their perceived compliance to spe- cific IPC practices with responses scored as follows: ‘always’ (2 points), ‘sometimes’ (1 point), and ‘never’ (0 points), for a maximum possible score of sixteen. As previously described by Abalkhail, et al. [18], a score of < 50%, 50–79% and ≥ 80% was considered as low, mod- erate and high respectively. For this study, an individual was considered compliant, when the individual scored at least 80% which is a score of 13 or more while a score less than 13 (low and moderate levels) was considered non-compliant. Fig. 1  The map of The Gambia Pointing to the North Bank East Region Page 4 of 9Darboe et al. BMC Research Notes (2025) 18:43 For HCWs’ attitude toward IPC practice, 4-Likert scale questions were used to assess it. Scores ranged from 0 (strongly disagree) to 3 (strongly agree), with a maximum score of 15. For an individual to be considered to have adequate knowledge, the individual must have at least a score of 80%. As such a score of 12 or above indicated a good attitude, while below 12 was considered a poor atti- tude [18]. For knowledge level, seven question items on a 4-Lik- ert scale assessed HCWs using respondents’ agreement or disagreement with IPC standards. Likert scale was used to assess knowledge in this study because it helps quantify subjective assessments of knowledge, making it easier to analyze and compare results across individuals or groups. It is also easy to complete, which can improve response rates and data quality. Scores ranged from 0 (strongly disagree) to 3 (strongly agree), with a maximum score of 21. For an individual to be considered to have adequate knowledge, the individual must have at least a score of 80%. As such a score of 17 or above indicated adequate knowledge, while below 17 was considered inadequate [18]. These were self-reported by the HCWs. The independent variables of the study included sociodemographic characteristics such as age, sex, level of education, and work experience; individual factors, for example, knowledge, and attitude level as well as orga- nizational factors, including availability of protocols, access to materials and equipment, supporting policies, assessment, monitoring and supervision, workload, and workforce. Data management and analysis Data were entered into Microsoft Excel, cleaned, and analyzed in Stata version 16.0. Descriptive and inferential statistics were run. Chi-square tests assessed associations between categorical variables and perceived compliance with IPC standards. Both crude and adjusted logistic regression were used to identify potential factors influ- encing perceived compliance with IPC standards among HCWs. Results included crude and adjusted odds ratios, p-values, and 95% confidence intervals, with significance set at 0.05. Results Sociodemographic characteristics of healthcare workers in the North Bank East Region (NBER) Of the 218 HCWs, most 90 (41.3%) were nurses, while the least 8 (3.7%) were medical doctors. The median age of respondents was 31.5(13) years with a male prepon- derance of 111 (50.9%). About 50% of the HCWs had worked for more than five (5) years and 58.3% had ter- tiary education. (Table 1). Perceived compliance score Most of the HCWs (73.4%) reported that they always wash their hands with soap under running water. The majority of the HCWs, 74.8%, also alluded that they always wash their hands upon the removal of gloves after contact with patient or body fluids. The study also found that most HCWs, 70.6%, indicated that they always dis- carded all disposable PPEs after use. About 80.7% con- firmed that they always use gloves when handling body fluids. About half (50.9%) of the HCWs sometimes wear goggles and masks when working in clinic and labora- tory environments to reduce the risk of contamination and the transmission of infectious agents. Less than half, 47.3%, sometimes wear an apron while on duty, and a little more than a quarter of the HCWs said they never wear an apron while on duty. About 48.1% of the HCWs reported that they always change gloves before attending to another patient, while 45.9% reported that they some- times change gloves before attending to another patient. The finding of the study also indicated that 50% of the HCWs wash their hands after attending to each patient (Table 2). Perceived compliance with IPC measures among healthcare workers The majority 188 (86.24%) of HCWs had adequate knowl- edge of IPC (Fig.  2A). About three–fourths 171 (78.4%) of the HCWs had good attitudes towards IPC standards Table 1  Sociodemographic characteristics of healthcare workers in NBER, 2021 Respondent Characteristic n(%) Age (years)* 31.5(13) Sex Male 111(50.9) Female 107(49.1) Age category (years) 20–29 84(38.5) 30–39 79(36.2) ≥ 40 55(25.3) Work experience (years) 1–5 108(49.5) > 5 110(50.5) Education level Did not attend school. 45(20.6) Basic 46(21.1) Tertiary 127(58.3) Staff category Medical Doctor 8(3.7) Laboratory Professional 13(6.0) Nurse 90(41.3) Public Health Officer 25(11.5) Others 82(37.5) Data are presented as figures and percentages in parentheses. * is presented as median(IQR). NBER: North Bank East Region Page 5 of 9Darboe et al. BMC Research Notes (2025) 18:43 (Fig. 2B). A little more than half (50.5%) of the HCWs did not comply with IPC standards (Fig. 2C). Bivariate analysis between predictor variables and perceived compliance with IPC standards Among the predictor variables analyzed, only knowl- edge of IPC (p = 0.002), attitude of HCWs (p = < 0.001), availability of IPC guidelines (p = < 0.001), accessibility of PPEs (p = < 0.001) and monitoring of IPC practice by management (p = < 0.001) were found to be significantly associated with perceived IPC compliance. After control- ling for all other variables, attitude of HCWs, accessibil- ity of PPEs, and monitoring of IPC practice were found to be independently associated with perceived compli- ance with IPC standards. HCWs with good attitude had a 3.13-fold increased odds of perceived compliance to IPC standards [aOR = 3.13, 95%CI: 1.17–8.41, p-value = 0.023] compared to those with poor attitude. HCWs who had access to PPEs also had a 2.34-fold increased odds of perceived compliance [aOR = 2.34, 95%CI: 1.01–5.38; p-value = 0.046] compared to those who had no access to PPEs. Finally, HCWs who were monitored in their IPC practice had 3.95 times increased odds of perceived com- pliance [aOR = 3.95, 95%CI: 1.84–8.45; p-value = < 0.001] compared to those who were not monitored (Table 3). Discussion The study looked at the knowledge, attitude and per- ceived compliance of IPC among HCWs in The Gam- bia as well as potential influencing factors to HCWs’ perceived compliance with IPC standards. Surpris- ingly, despite a significant proportion of HCWs having adequate knowledge of IPC standards 188(86.2%), their perceived compliance was low 108 (49.5%). Even though our finding is comparable to a Northern Ugandan study where HCWs demonstrated a high level of knowledge score of IPC standards of 69%; the rate of compliance with IPC was higher (68%) than what was observed in this study [21]. Also, unlike our finding on knowledge level, a pre-COVID-19 pandemic study conducted by Ghadamgahi, et al. [22] in Nigeria found only 28.75% of HCWs with adequate knowledge of infection con- trol. This disparity in knowledge level observed across these studies could be due to increased IPC training and awareness during the COVID-19 pandemic rela- tive to the pre-COVID-19 pandemic era. Additionally, the high compliance recorded in the Northern Ugan- dan study could be due to the relatively small sample size employed. While this current study recruited 218 HCWs, the Northern Ugandan study used 75 HCWs for their study. It is thus, imperative for pragmatic steps to be established to foster not only the need to improve HCWs’ knowledge of the IPC standards but also the need to comply with them in the current study jurisdiction. To that end, proactive initiatives must be put in place to fos- ter a genuine commitment to adhering to IPC standards. One key strategy involves the establishment of compre- hensive training programs designed to not only impart knowledge but also instill a sense of responsibility and a culture of compliance to IPC standards within the health- care delivery system [23, 24]. These programs should be ongoing and regularly updated to keep HCWs abreast of the latest developments in IPC. The attitude of HCWs remains a key factor in the roll- ing out of institutional policies. Therefore, the signifi- cance of fostering a positive attitude toward infection prevention cannot be overstated in the context of pre- venting HAI. In this study, more than half 171 (78.4%) of the HCWs had a good attitude towards IPC standards. Similarly, studies in Ghana [25] and Northwest Ethiopia [26] also found more than half of the HCWs 55.1% and 57.2% respectively to have good attitude toward IPC. However, this result contrasts the finding by Unakal, et al. [27] in Trinidad and Tobago who found less than half (46.7%) of HCWs to have a positive attitude towards IPC. As a strong determinant of IPC compliance, cultivating a positive attitude among HCWs toward IPC stands as a critical foundation. Consequently, health authorities must implement systematic and effective measures aimed at enhancing the positive attitude of HCWs toward IPC standards. Compliance with IPC standards among HCWs has been demonstrated to yield significant benefits for both HCW and potential clients [8, 28]. This study estab- lished that HCW’s good attitude, accessibility of PPEs, and monitoring of IPC practice were independently Table 2  Perceived compliance with infection prevention and control standards among the healthcare workers in NBER, 2021 Statement Always n(%) Some- times n(%) Never n(%) I wash my hands with soap under running water 160(73.4) 58(26.6) 0(0.0) On removal of gloves, I wash my hands after contact with the patient or body fluids 163(74.8) 53(24.3) 2(0.9) In my unit, all disposable PPEs are discarded after use 154(70.6) 62(28.5) 2(0.9) I use gloves when handling body fluids 176(80.7) 38(17.4) 4(1.9) I wear goggles and a mask to protect myself when in the clinic and labora- tory environments 85(39.0) 111(50.9) 22(10.1) I wear an apron when performing my duties 54(24.7) 103(47.3) 61(28.0) I change gloves before attending to another patient 105(48.1) 100(45.9) 13(6.0) I wash my hands after attending to each patient 109(50.0) 94(43.1) 15(6.9) Page 6 of 9Darboe et al. BMC Research Notes (2025) 18:43 associated with perceived compliance with IPC stan- dards. Regarding HCWs’ attitude, this study found that HCWs with good attitudes were about three times more likely to comply with IPC standards. Consistently, exist- ing evidence points to the fact that compliance with IPC standards is often attributed to good attitudes among HCWs [29–31]. More so, according to Boeker, et al. [32], monitor- ing IPC practice is a way to enhance compliance to IPC standards. This observation forms a fine basis for the cur- rent study finding where HCWs who were monitored in their IPC practice were more likely to comply with IPC standards compared to those who were not monitored. Therefore, a continuous and rigorous monitoring sys- tem for IPC practices among HCWs should be in place. It should be conducted regularly and in a non-punitive manner, focusing on identifying areas for improvement and providing feedback to HCWs. This approach will not only help identify compliance gaps but also encourage HCWs to consistently follow IPC standards. Finally, this study like the Ethiopian study [33], observed that HCWs who had access to PPEs were more likely to comply with IPC standards than those who did not have PPEs readily accessible. This observation under- scores the critical role of PPEs in enabling and sustaining IPC compliance. Essentially, IPC protocols often necessi- tate the use of PPEs, and the recurrent unavailability of such essential protective gear could potentially demoral- ize previously compliant staff members, leading to lapses in compliance. Thus, adequate provision and distribution of PPEs should be a priority in healthcare facilities in the study jurisdiction. Conclusion The study found that the level of knowledge about IPC was high, but HCWs’ perceived compliance with IPC was low. Furthermore, individual-level factors associated with Fig. 2  Descriptive statistics on the Knowledge, attitude, and perceived compliance with IPC standards among HCWs in the North Bank East Region (NBER), 2021 Page 7 of 9Darboe et al. BMC Research Notes (2025) 18:43 perceived compliance with IPC include the attitude of HCWs towards IPC practice. Organizational-level factors associated with perceived compliance with IPC standards include accessibility of PPEs and monitoring of IPC prac- tice among staff by management. Limitation In this study, we relied on HCWs’ subjective self-assess- ment. Therefore, the responses might have not accu- rately reflected the true knowledge and compliance with IPC standards. Since this study relied on recall of past behaviours, the information may be prone to recall bias. Furthermore, the information obtained from HCWs was not validated through direct observation. Abbreviations ABHS � Alcohol-Based Hand Sanitizer AIDS � Acquired Immune Deficiency Syndrome CDC � Center for Disease Control and Prevention GBoS � Gambia Bureau of Statistics HAI � Healthcare-Associated Infections HBV � Hepatitis B Virus HCV � Hepatitis C Virus HCW � Healthcare Workers HIV � Human Immunodeficiency Virus ICU � Intensive Care Unit ILO � International Labor Organization IPC � Infection Prevention and Control Table 3  Chi-square test of association of independent variables and perceived compliance with IPC among HCWs in NBER, 2021 Variables Perceived Compliant Non-compliant p-value cOR (95%CI) p-value aOR (95% Cl) P-value Sex 0.280 Male 51 (46.0) 60 (54.0) - - - - Female 57(53.3) 50 (46.7) - - - - Age (years) 0.920 20–29 42 (50.0) 42 (50.0) - - - - 30–39 40 (50,6) 39 (49.4) - - - - ≥ 40 26 (47.3) 29 (52.7) - - - - Work experience (years) 0.890 1–5 54 (50.0) 54 (50.0) - - - - > 5 54 (49.1) 56 (50.9) - - - - Education level 0.451 Did not attend school 23 (51.1) 22 (48.9) - - - - Up to Secondary 19 (41.3) 27 (58.7) - - - - Tertiary education 66 (52.0) 61 (48.0) - - - - Staff category 0.887 Medical Doctor 5(62.5) 3 (37.5) - - - - Laboratory Professional 6(46.2) 7(53.8) - - - - Nurse 43(47.8) 47(52.2) - - - - Public Health Officer 14(56.0) 11(44.0) - - - - Others 42(51.2) 40(48.8) - - - - Knowledge 0.002 Inadequate 7(23.3) 23(76.7) 1 1 Adequate 101(53.7) 87(46.3) 3.81 (1.56–9.32) 0.003 1.38 (0.44–4.31) 0.567 Attitude < 0.001 Poor 9(19.1) 38(80.9) 1 1 Good 99(57.9) 72(42.1) 5.81 (2.64–12.76) < 0.001 3.13 (1.17–8.41) 0.023 Availability of IPC guidelines < 0.001 Not Available 18(29.5) 43(70.5) 1 1 Available 90(57.3) 67(42.7) 3.21 (1.70–6.05) < 0.001 1.87 (0.84–4.14) 0.123 Accessibility of PPEs < 0.001 Not accessible 14 (21.2) 52 (78.8) 1 1 Accessible 94 (61.8) 58 (38.2) 6.02 (3.07–11.82) < 0.001 2.34 (1.01–5.38) 0.046 Monitoring of IPC practice < 0.001 Monitored 95 (62.5) 57 (37.5) 1 1 Not Monitored 13 (19.7) 53 (80.3) 7.86 (3.94–15.67) < 0.001 3.95 (1.84–8.45) < 0.001 Workload 0.890 High 57 (50.0) 57 (50.0) - - - - Not high 51(49.0) 53 (51.0) - - - - aOR: adjusted Odd Ratio, cOR: crude Odd Ratio. P-value is significant at < 0.05. NBEWR: North Bank East Region Page 8 of 9Darboe et al. BMC Research Notes (2025) 18:43 MRC � Medical Research Council NBER � North Bank East Region NGO � Non-Governmental Organization PEP � Post Exposure Prophylaxis PPE � Personal Protective Equipment WHO � World Health Organization Acknowledgements The authors thank the management of Farafenni General Hospital and the Regional Health Directorate North Bank East for their kind cooperation and support during data collection. We are grateful to the healthcare workers for their voluntary participation. Author contributions SMKD conceptualized the study, collected data, analyzed and produced a draft of the manuscript. HAB provided expert guidance from conceptualization to drafting of manuscript, supported by EK. SADO and GEK provided high quality review of the manuscript from the draft of the manuscript to the final review. AK, and NF designed questionnaires and assisted in data collection. MN, KS, DD and AEY assisted in analysis and interpretation of data. All authors read and approved the final manuscript. Funding No funding was received for this study. Data availability The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Declarations Ethics approval and consent to participate Ethical approval (R021039) was obtained from The Gambia Government/MRC Joint Ethics Committee through the Research and Publication Committee of The University of The Gambia (Republic). The Director of Health Services granted permission for data collection. An official latter was sent to the Director of Health Services for his approval, a copy of which was sent to both the region and the hospital. Informed consent was also obtained from participants after explaining the purpose of the study and what was expected of them. Consent for publication Not Applicable. Competing interests The authors declare no competing interests. Author details 1Field Epidemiology and Laboratory Training Program, University of Ghana, Accra, Ghana 2Ministry of Health, The Gambia, Banjul, The Gambia 3Department of Public Health Studies, Elon University, Elon, NC, USA 4Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Accra, Ghana 5Department of Public and Environmental Health, School of Medicine and Allied Health Sciences, University of The Gambia, Brikama, The Gambia 6Department of Livestock Services, Ministry of Agriculture, Abuko, The Gambia 7Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana 8Department of Community Health, University of Ghana Medical School, Accra, Ghana Received: 4 June 2024 / Accepted: 10 January 2025 References 1. Hughes RG, editor. Advances in Patient Safety. Patient safety and quality: an evidence-based handbook for nurses. 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Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. https://doi.org/10.3390/ijerph182211831 https://doi.org/10.3390/ijerph182211831 https://doi.org/10.1155/2021/6619768 https://doi.org/10.1155/2021/6619768 https://doi.org/10.2147/idr.S290992 https://doi.org/10.2147/idr.S290992 https://doi.org/10.11648/j.ajns.20150402.13 https://doi.org/10.11648/j.ajns.20150402.13 https://doi.org/10.3389/frhs.2023.1071517 https://doi.org/10.3390/vaccines10111811 https://doi.org/10.3390/vaccines10111811 https://doi.org/10.1371/journal.pone.0239744 Factors influencing healthcare workers’ perceived compliance with infection prevention and control standards, North Bank East region, The Gambia, a cross-sectional study Abstract Introduction Methods Study design Study setting Sample size determination Inclusion criteria Exclusion criteria Sampling techniques Data collection and tool Study variables Data management and analysis Results Sociodemographic characteristics of healthcare workers in the North Bank East Region (NBER) Perceived compliance score Perceived compliance with IPC measures among healthcare workers Bivariate analysis between predictor variables and perceived compliance with IPC standards Discussion Conclusion Limitation References