Gap in knowledge and improvement after an infectious disease training program for Ugandan healthcare workers

Achieving international accreditation standards, including those defined by the Joint Commission International (JCI), requires strong infection prevention and control (IPC) and antimicrobial stewardship (AMS) programs to limit antimicrobial resistance. In Uganda, healthcare workers (HCWs) still face challenges in infectious disease (ID) management due to limited diagnostic resources, standardized protocols, and structured IPC training. This study aimed at assessing possible gaps in knowledge at baseline and short-term improvements after a context-adapted IPC and AMS training program in improving infectious disease management competencies among healthcare workers in Uganda. We conducted a pre–post interventional study between July 21st, 2025, and July 30th, 2025 involving 56 healthcare workers (nurses, midwives, and clinical officers) from rural and peri-urban health facilities in Northern Uganda. The curriculum, which aligns with the World Health Organization, Ugandan Ministry of Health, and JCI standards, covered tuberculosis, HIV, malaria, sepsis, pneumonia, hepatitis, and emerging infections, as well as key IPC and AMS principles. Teaching combined interactive lectures, case-based discussions, and simulation exercises. Knowledge and practice were assessed before and after training using multiple-choice questions (MCQs), clinical case scenarios (CCSs), and Knowledge-Attitude-Practice (KAP) surveys. Paired t tests were used to compare pre- and post-training scores. The 56 participants had a mean age of 34.5 ± 5.2 years and an average of 9.2 ± 4.6 years of professional experience. Post-training performance improved significantly across most thematic domains. The largest increases in the proportion of correct responses were observed in HIV/STI, malaria, viral hepatitis, and bone and joint infections. The mean MCQ score increased from 0.61 ± 0.12 to 0.85 ± 0.08 (p < 0.001), representing a 25% mean gain. CCS scores increased from 0.59 to 0.70 (p < 0.001). KAP-A scores rose from 0.90 to 1.03. Variability in performance decreased post-training, suggesting more uniform understanding. No significant correlation was found between improvement and participants’ age, sex, or education level. Qualitative feedback confirmed greater confidence and adherence to hand hygiene, PPE use, and environmental sanitation practices. The program significantly improved both knowledge and IPC competences across all professional groups. Translating international standards into locally applicable practices strengthened frontline capacity of HCWs’ for infection prevention, clinical safety, and antimicrobial stewardship. Our study was limited to assess improvement at the conclusion of the intervention, therefore refresher sessions, mentorship, and integration with IPC monitoring tools are likely to be useful to sustain this level of knowledge and contribute to foster long-term health system resilience in Uganda.