Development of a Guideline for Infection Prevention and Control in Childcare Centers in Nigeria using the ADAPTE Process

Background Infectious diseases remain a leading cause of morbidity and mortality among children under five, especially in low- and middle-income countries like Nigeria. Childcare centers present high-risk environments for the transmission of infections due to poor hygiene practices, overcrowding, and lack of standardized infection prevention and control (IPC) guidelines. This study aimed to develop a contextually relevant IPC guideline for Nigerian childcare centers using the ADAPTE framework. Methods A methodological approach was adopted, employing the ADAPTE process, which consists of three phases: set-up, adaptation, and finalization. The PIPOH framework guided the formulation of health questions relevant to infection control in childcare settings. Eight international IPC guidelines were identified through systematic searches of academic and grey literature, out of which five were selected based on quality and applicability. The AGREE II instrument was used to appraise these guidelines. Stakeholders including public health professionals, paediatricians, education officers, and caregivers contributed to the external review of the adapted guideline. Results The adapted guideline addresses ten core IPC domains including hand hygiene, nasal hygiene, environmental cleaning, personal protective equipment use, food handling, waste management, immunization, and care of sick children. The final guideline was organized into four chapters and validated using the AGREE II tool. High domain scores (above 85%) were achieved in scope and purpose, stakeholder involvement, clarity, and applicability. The external reviewers confirmed the guideline's relevance and recommended it for implementation with minor modifications. Conclusion This study successfully adapted a practical, evidence-based IPC guideline suited to the Nigerian childcare context. The guideline has the potential to improve infection prevention practices, reduce childhood morbidity, and enhance caregiver competency. Future research should focus on implementation, training, and outcome evaluation across diverse Nigerian regions to ensure scalability and sustainability.